Is an artificial pancreas effective for type 1 diabetes patients living at home?

This study aimed to determine the effectiveness of a closed-loop delivery system in type 1 diabetes patients living at home.

An insulin pump allows the patient to enter the carbohydrate content of a meal,  releasing an appropriate amount of insulin based on this estimation. A continuous glucose monitor is a device which allows patients to view their blood glucose levels in real-time. The combination of both the insulin pump and continuous glucose monitor is called the sensor-augmented insulin pump (SAP). A closed-loop delivery system (artificial pancreas) is an alternative to SAP as the continuous glucose monitor measures the blood glucose levels and sends the information to the insulin pump wirelessly. This allows the insulin pump to release insulin in a glucose-dependent manner.

This study involved 17 adults with type 1 diabetes on insulin pump therapy, with an average age of 34 years. Participants were randomly assigned a sensor-augmented insulin pump or a closed-loop insulin delivery. Participants remained at the clinical research facility for 1 day, spent 7 days at home and then repeated this process once more. The average glucose levels were measured while participants were at home and the percentage of time when the glucose levels remained in the target range of 3.9-10 mmol/L was noted. The percentage of time when hypoglycemia (blood glucose levels lower than 3.9 mmol/L) and hyperglycemia (glucose levels greater than 10 mmol/L) occurred was also recorded.

The average glucose levels were lower during closed-loop delivery (8.1%) in comparison to the sensor-augmented insulin pump (8.8%). Glucose levels remained in the target range more often during closed-loop delivery (75% of time) than in the sensor-augemented insulin pump (62% of time). There was no difference in the frequency of low blood pressure between both groups.

This study concluded that one week of closed-loop insulin delivery at home can improve glucose levels and does not increase the risk of hypoglycemia.

The sample size of 17 patients was quite small and the study was carried out for a small length of time (1 week).

Consult your physician regarding the new technology available to improve blood glucose levels.