Is the artificial pancreas safe and effective in young type 1 diabetics living at home?

This trial aimed to determine the safety and effectiveness of an artificial pancreas in young type 1 diabetics living at home.

An insulin pump allows patients with type 1 diabetes (T1D) to enter in the carbohydrate content of a meal and the pump releases insulin based on this. A continuous glucose monitor (CGM) is a device which allows patients to view their blood glucose (sugar) levels every few minutes. This device receives information about the blood glucose levels though a sensor placed underneath the skin and the device then displays the blood glucose levels on the screen.  

The combination of both the insulin pump and CGM is called the sensor-augmented insulin pump (SAP). This system can offer better control of blood glucose levels. An alarm sounds when blood glucose levels go too low. 

A closed loop delivery system (artificial pancreas) differs from SAP in that the CGM measures blood glucose levels and sends information to the insulin pump wirelessly. This allows the insulin pump to release insulin in a glucose-dependent manner. The artificial pancreas is currently being investigated in clinical trials.

This trial aimed to compare the safety and effectiveness of the artificial pancreas to SAP. This trial involved 16 teenagers with T1D on insulin pump therapy. Participants used SAP for 3 weeks and then used the closed loop artificial pancreas system for another 3 weeks.

Blood glucose levels were in the target range of 70–144 mg/dL more often using closed loop insulin delivery. Blood glucose levels at night were reduced by 14 mg/dL using closed loop delivery. Time spent in hypoglycemia (blood glucose levels below 70 mg/dL) was low in both groups. The number of nights when blood glucose levels were below 63 mg/dL for more than 20 minutes was lower with closed loop delivery (10% of nights) in comparison to SAP (17% of nights).

This trial concluded that closed-loop insulin delivery at home is feasible and safe in teenagers with T1D. Glucose control is also improved and low blood glucose levels at night occurs less often.

The sample size of 16 patients was quite small. In addition, the 3 week study period should be extended to determine the long-term safety and effectiveness of the artificial pancreas. 

Consult with your physician regarding the availability of insulin pumps and continuous glucose monitors to improve blood glucose levels.