Integrating your smartphone with your artificial pancreas may reduce episodes of low blood sugar

This study examined the use of smartphone technology to automate the glucose monitoring and insulin delivery systems of an artificial pancreas.

The artificial pancreas, which delivers insulin through an insulin pump implanted in the abdomen based on continuous monitoring of blood glucose (sugar) levels, is an important treatment advance in type 1 diabetes. These systems, also called closed-loop systems, can increase the time a patient spends within their target blood glucose range, decrease episodes of hypoglycemia (dangerously low blood glucose levels), and can offer better overnight blood glucose control.

These systems, however, have needed much control and input from the user, as glucose level readings would need to be entered into the insulin pump, as would many insulin pump commands. To be useful for all patients, these processes must be automated (able to be undertaken by a computerized device), such as the automated transfer of glucose readings to the pump, and automated control of insulin release based on those readings.

The current study examined the use of a closed-loop insulin pump system that made use of smartphone technology to automate the glucose reading and insulin delivery systems. The system was tested on 18 patients with type 1 diabetes. Each patient participated in two 40-hour experimental sessions. In one session, patients used the non-automated system, while in the other session the patients used the closed-loop system automated by the smartphone. All patients completed both session types, but the order of the sessions was randomized. Blood glucose measures by finger stick were also completed at mealtimes, 2-hours post-mealtimes, and at bedtime, to ensure readings by the closed-loop system were accurate.

Patients using the smartphone-automated system were at least 46% less likely to experience hypoglycemia than were patients using the non-automated systems. Patients using the automated system decreased the frequency of hypoglycemic episodes that required treatment by half. Automated treatment resulted in a slight increase in average blood glucose levels (8.9 mmol/L compared to 8.4 mmol/L in the non-automated system).

This study concluded that a closed-loop system integrated with smartphone technology reduced hypoglycemia and the need for hyperglycemic treatment compared to a non-automated closed-loop system.

This was tested on a relatively small  number of patients. Larger, more long-term trials need to be completed.