'Artificial pancreas' could remove multiple daily finger prick tests for children with type 1 diabetes
An artificial pancreas system being developed by scientists at Cambridge in the UK could help safely manage type 1 diabetes in children. The new system combines a commercially available continuous glucose monitor and an insulin pump, and uses a sophisticated algorithm which calculates the correct amount of insulin to deliver based on real-time glucose readings.
The research team found that using an artificial pancreas system overnight can significantly reduce the risk of hypoglycemia, or "hypos", when blood glucose levels drop dangerously low, while sleeping. "Hypos" are a major concern for children and adults with type 1 diabetes.
The Cambridge University team studied 17 children and teenagers with type 1 diabetes, measuring how well the artificial pancreas system controlled glucose levels compared with the children's regular continuous subcutaneous insulin infusion (CSII) pump, which delivers insulin at preselected rates.
The study included nights when the children went to bed after eating a large evening meal or having done early evening exercise. Both are challenging to manage - a large evening meal because it can lead to so-called "insulin stacking" and, as a result, a potentially dangerous drop in blood glucose levels later in the night, and late afternoon or early evening exercise because it increases the body's need for glucose in the early morning and can therefore increase the risk of night time hypoglycemia.
The results showed the artificial pancreas kept blood glucose levels in the normal range for 60% of the time, compared with 40% for the CSII. It also halved the time that blood glucose levels fell below 3.9mmol/l - the level considered as mild hypoglycemia - and prevented blood glucose falling below 3.0mmol/l, which is defined as significant hypoglycemia.
Dr Roman Hovorka of the Institute of Metabolic Science at the University of Cambridge said: "Our results show that commercially-available devices, when coupled with the algorithm we developed, can improve glucose control in children and significantly reduce the risk of hypos overnight."
"This is the first randomized study showing the potential benefit of the artificial pancreas system overnight using commercially-available sensors and pumps. Our study provides a stepping stone for testing the system at home."
Type 1 diabetes, a chronic, life threatening condition is on the increase. Children and adults require multiple daily insulin injections or pump infusions and many finger prick blood tests each day. However, treatment with insulin increases the risk of hypoglycemia.
The artificial pancreas could remove the need for multiple daily finger prick tests and insulin injections, as well as offer better control of blood glucose levels overnight.
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Better to have a glucose-sensitive insulin as it reduces the lag time and requires less calculation, and may only need a basic 'dumb pump'.
That, and C-peptide co-administration, amylin/symlin, etc.