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Posted by on Aug 8, 2017 in Diabetes mellitus | 0 comments

In a nutshell

This study investigated if a bionic pancreas, that releases insulin and glucagon (bihormonal), could improve glycemic (blood sugar) control in patients with type 1 diabetes.

They found that the bionic pancreas was more effective than a conventional insulin pump in monitoring and managing glycemia in these patients.

Some background

Glycemic control (blood sugar) is crucial in the treatment of type 1 diabetes. There are many strategies to monitor glycemic control. The most common strategies are self-measurement and administration of insulin or sensor-mediated insulin pump therapy.

A new emerging possibility involves the use of a bionic pancreas. This bionic pancreas performs continuous glucose monitoring (CGM) similar to an insulin pump. When the sensor detects low or high blood sugar it releases hormones, either insulin or glucagon, similar to a real pancreas. The effectiveness of a bionic pancreas in a ‘regular’ home-based setting has not been studied thus far.

Methods & findings

39 participants were included in the study. The study lasted 11 days. During the study patients were assigned either the bionic pancreas or conventional insulin pump therapy. During the study average CGM glucose concentrations were recorded and evaluated. After the first 11 days, patients switched to the other type of therapy.

The bionic pancreas led to reduced average blood glucose levels (7.8 mmol/L) compared to the insulin pump (9.0 mmol/L). The bionic pancreas was also associated with reduced occurrence of hypoglycemia (dangerously low blood glucose, 0.6%) compared to the insulin pump (1.9%).  There was also a reduction in carbohydrates needed to treat hypoglycemia in patients with a bionic pancreas. Some patients experienced nausea during the bionic pancreas phase.

The bottom line

 This study found that the bionic pancreas improved glycemic control in patients with type 1 diabetes.

The fine print

This study used a small number of participants and was short in duration. The long-term effects of using a bionic pancreas were not investigated. More patients experienced nausea in bionic pancreas group which may limit long-term usage. The participants had baseline Hba1c that is lower than most type 1 diabetes patients. The bionic pancreas may not be efficient in patients with uncontrolled blood sugar levels. 

What’s next?

If you are interested in obtaining more information on glycemic control strategies, you should discuss them with your doctor. 

Published By :

Lancet (London, England)

Date :

Dec 19, 2016

Original Title :

Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial.

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