Management of type 1 diabetes is a difficult balancing act that involves finger-prick sampling and insulin injections to keep blood glucose levels in check, but the notion of an "artificial pancreas" promises to lighten the load. Scientists at the University of Cambridge have been pushing the boundaries of this technology for more than a decade and have now reported promising findings from trials in very young children, where their solution produced "life-changing" results.
Back in 2020, University of Cambridge scientists launched what was billed as the world's first licensed, downloadable artificial pancreas smartphone app for type 1 diabetes. Like other artificial pancreas technologies under development, the idea is to fulfill the role of the pancreas in diabetes sufferers, where it is no longer able to produce the insulin needed to absorb glucose from the blood.
The team's CamAPS FX smartphone app works with a glucose monitor and pump, using a complex algorithm to determine when the user is in need of insulin and delivering it as needed. The newly published study was designed to investigate how the technology can benefit young children, in which type 1 diabetes management is particularly problematic due to irregular eating and activity, along with high variability in the amount of insulin they require.
The study involved 74 children with type 1 diabetes, aged one to seven, with all subjects using the CamAPS FX artificial pancreas system for 16 weeks. They then used current technology called sensor-augmented pump therapy, in which parents monitor their child's glucose levels and manually adjust insulin delivery via a pump, also for 16 weeks. This allowed the scientists to compare the performance of the two.
"CamAPS FX makes predictions about what it thinks is likely to happen next based on past experience," explains study author Professor Roman Hovorka. "It learns how much insulin the child needs per day and how this changes at different times of the day. It then uses this to adjust insulin levels to help achieve ideal blood sugar levels. Other than at mealtimes, it is fully automated, so parents do not need to continually monitor their child's blood sugar levels."
When using the CamAPS FX app, the children spent 71.6 percent of their day in the target range for glucose levels, around nine percentage points, or 125 additional minutes, higher than the control. They also spent 22.9 percent of the time with raised blood sugar levels, nine percentage points lower than the control, and also exhibited lower average blood sugar levels, reducing their risk of diabetes-related complications.
"Very young children are extremely vulnerable to changes in their blood sugar levels," said Dr. Julia Ware, the study's first author. "High levels in particular can have potentially lasting consequences to their brain development. On top of that, diabetes is very challenging to manage in this age group, creating a huge burden for families. CamAPS FX led to improvements in several measures, including hyperglycemia and average blood sugar levels, without increasing the risk of hypos. This is likely to have important benefits for those children who use it."
This study marks the first time the CamAPS FX system has been proven effective in very young children over a period of several months, with parents describing it as "life-changing." As it stands, the technology is available through certain hospital trusts in the UK, but the scientists hope as it continues to prove itself through these types of trials, it can change the lives of more and more sufferers of the condition.
"From the first clinical trials of our algorithms to today's findings has taken well over a decade, but the dedication of my team and the support of all the children and families who have taken part in our studies, has paid off," Hovorka said. "We believe our artificial pancreas will transform the lives of families with very young children affected by type 1 diabetes."
The research was published in the New England Journal of Medicine.
Source: University of Cambridge via Phys.org