Artificial pancreas may improve overnight control of diabetes in adults

April 15, 2011, British Medical Journal

Two small randomised trials published in the British Medical Journal today suggest that closed loop insulin delivery (also known as an artificial pancreas) may improve overnight blood glucose control and reduce the risk of nocturnal hypoglycaemia (a sudden drop in blood glucose levels during the night) in adults with type 1 diabetes.

The number of people with type 1 diabetes is increasing at a rate of 3% per year, particularly in white northern European populations. Lifelong insulin therapy is needed to control blood glucose levels, but the risk of hypoglycaemia remains a major challenge, especially during the night.

Recent advances have led to the development of a closed loop insulin delivery system that automatically computes insulin dose according to glucose levels detected by a sensor. Previous studies have shown that this system is effective in children and adolescents, but its effectiveness in adults is unknown.

So a team of researchers, led by Roman Hovorka from the University of Cambridge, carried out two studies to compare the safety and efficacy of overnight closed loop insulin delivery with conventional insulin pump therapy in adults with type 1 diabetes.

The group consisted of 24 adults (10 men and 14 women) aged 18-65, who had used insulin pump therapy for at least three months.

In the first study, 12 participants were twice monitored overnight after consuming a medium sized meal (60 g carbohydrate) at 7pm: they were randomly assigned to use either closed loop delivery of insulin or conventional insulin pump therapy and then, on a night one to three weeks later, they used the other delivery method. In the second study, the other 12 participants were twice monitored overnight (using one or other of the two insulin delivery methods) after consuming a larger meal (100 g ) at 8.30pm, accompanied by alcohol.

The time spent with in the target range increased by up to 28% during overnight closed loop insulin delivery. Closed loop delivery also lowered glucose variability overnight and significantly reduced the time spent hyperglycaemic.

These findings provide further evidence that overnight closed loop delivery can operate safely, effectively, and consistently across different age groups, insulin sensitivities, and lifestyle conditions, conclude the authors.

They add that the closed loop system "may in future allow more flexible lifestyles in conjunction with improved glycaemic control for people with type 1 diabetes."

In an accompanying editorial, Professor Boris Kovatchev from the University of Virginia says that, while closed loop control shows promise in a research setting, further development and system miniaturisation is needed in practice to greatly improve the health and lives of people with .

Related Stories

Recommended for you

Neuroimaging reveals lasting brain deficits in iron-deficient piglets

February 21, 2018
Iron deficiency in the first four weeks of a piglet's life - equivalent to roughly four months in a human infant - impairs the development of key brain structures, scientists report. The abnormalities remain even after weeks ...

Iron triggers dangerous infection in lung transplant patients, study finds

February 21, 2018
Researchers at the Stanford University School of Medicine have identified elevated tissue iron as a risk factor for life-threatening fungal infections in lung transplant recipients.

Products derived from plants offer potential as dual-targeting agents for experimental cerebral malaria

February 21, 2018
Malaria, a life-threatening disease usually caused when parasites from the Plasmodium family enter the bloodstream of a person bitten by a parasite-carrying mosquito, is a severe health threat globally, with 200 to 300 million ...

Scientists in Germany improve malaria drug production

February 21, 2018
Scientists in Germany who developed a new way to make a key malaria drug several years ago said Wednesday they have come up with a technique to make the process even more efficient, which should increase global access and ...

Early results from clinical trials not all they're cracked up to be, shows new research

February 21, 2018
When people are suffering from a chronic medical condition, they may place their hope on treatments in clinical trials that show early positive results. However, these results may be grossly exaggerated in more than 1 in ...

Clues to obesity's roots found in brain's quality control process

February 20, 2018
Deep in the middle of our heads lies a tiny nub of nerve cells that play a key role in how hungry we feel, how much we eat, and how much weight we gain.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.