In a nutshell
This study compared the use of the artificial pancreas (APs) with sensor-augmented pumps (SAPs) in children with type 1 diabetes (T1D). It found that these devices decreased the amount of time spent in hypoglycemia (dangerously low blood glucose) but increased average glucose levels.
Some background
A traditional insulin pump is a small device that continuously delivers insulin, without the need for multiple daily injections. An additional bolus injection can be given manually before meals. SAPs are traditional insulin pumps that also have a continuous glucose monitoring (CGM) system. CGMs measure glucose levels throughout the day by placing a sensor in the fat just under the skin. This gives the patient up-to-date information on their glucose levels.
APs use information from a CGM system to automatically control the release of insulin from a pump. This is similar to how the pancreas changes the amount of insulin it releases when blood glucose levels change.
Previous studies have found that APs improve glucose regulation in adults with T1D. Good regulation of glucose levels is important to reduce the risk of complications of T1D. However, there is very little evidence on the use of APs in children.
Methods & findings
This study recruited 30 children, aged 5-9, with T1D. The patients used an SAP for 3 days and an AP for another 3 days, with a 1 day break between treatments. The patients attended a summer camp for the duration of the study, where meal content and physical activity were regulated.
The overall time spent in hypoglycemia decreased from 6.7% with the SAP to 2.0% with the AP. However, the time spent at target glucose levels decreased 10% with the AP, compared to the SAP. Furthermore, with the AP there was a 15% increase in average glucose compared with SAP. Average glucose was still within the target range in both cases.
The bottom line
The study concluded that APs are safe, and reduce the time spent in hypoglycemia compared to SAPs. However, this comes at the expense of decreased time at target glucose levels, and an increase in average glucose levels.
The fine print
This study was carried out on a small number of patients over a short time period. Furthermore, several of the authors of this study had financial and professional connections to companies that manufacture APs.
What’s next?
Discuss the safety and effectiveness of APs with your physician.
Published By :
Diabetes Care
Date :
May 10, 2016
