The artificial pancreas shown to improve the treatment of type 1 diabetes

November 26, 2014, University of Montreal
The world's first clinical trial comparing three alternative treatments for type 1 diabetes was conducted in Montreal by researchers at the IRCM and the University of Montreal, led by endocrinologist Dr. Remi Rabasa-Lhoret. The study confirms that the external artificial pancreas improves glucose control and reduces the risk of hypoglycemia compared to conventional diabetes treatment. The results, published today in the scientific journal The Lancet Diabetes & Endocrinology, could have a significant impact on the treatment of type 1 diabetes, a chronic disease that can cause vision loss and cardiovascular diseases. Credit: IRCM

The world's first clinical trial comparing three alternative treatments for type 1 diabetes was conducted in Montréal by researchers at the IRCM and the University of Montreal, led by endocrinologist Dr. Rémi Rabasa-Lhoret. The study confirms that the external artificial pancreas improves glucose control and reduces the risk of hypoglycemia compared to conventional diabetes treatment. The results, published today in the scientific journal The Lancet Diabetes & Endocrinology, could have a significant impact on the treatment of type 1 diabetes, a chronic disease that can cause vision loss and cardiovascular diseases.

An emerging technology to treat type 1 diabetes, the external artificial pancreas is an automated system that simulates the normal pancreas by continuously adapting insulin delivery based on changes in glucose levels. Two configurations exist: the single-hormone artificial pancreas that delivers insulin alone and the dual-hormone artificial pancreas that delivers both insulin and glucagon. While insulin lowers blood glucose levels, glucagon has the opposite effect and raises glucose levels.

"Our clinical trial was the first to compare these two configurations of the artificial pancreas with the conventional diabetes treatment using an insulin pump," says Dr. Rabasa-Lhoret, Director of the Obesity, Metabolism and Diabetes research clinic at the IRCM and professor at the University of Montreal's Department of Nutrition. "We wanted to determine the usefulness of glucagon in the artificial pancreas, especially to prevent , which remains the major barrier to reaching glycemic targets."

People living with type 1 diabetes must carefully manage their blood glucose levels to ensure they remain within a target range in order to prevent serious long-term complications related to high glucose levels (such as blindness or kidney failure) and reduce the risk of hypoglycemia (dangerously low blood glucose that can lead to confusion, disorientation and, if severe, loss of consciousness, coma and seizure).

"Our study confirms that both artificial pancreas systems improve and reduce the risk of hypoglycemia compared to conventional pump therapy," explains engineer Ahmad Haidar, first author of the study and postdoctoral fellow in Dr. Rabasa-Lhoret's research unit at the IRCM. "In addition, we found that the dual-hormone artificial pancreas provides additional reduction in hypoglycemia compared to the single-hormone system."

"Given that low blood glucose remains very frequent during the night, the fear of severe nocturnal hypoglycemia is a major source or stress and anxiety, especially for parents with young diabetic children," adds Dr. Laurent Legault, paediatric at the Montreal Children's Hospital, and co-author of the study. "The artificial pancreas has the potential to substantially improve the management of diabetes and the quality of life for patients and their families."

IRCM researchers are pursuing clinical on the artificial pancreas to test the system for longer periods and with larger patient cohorts. The technology should be available commercially within the next five to seven years, with early generations focusing on overnight glucose control.

According to the Canadian Diabetes Association, an estimated 285 million people worldwide are affected by diabetes, approximately 10 per cent of which have type 1 diabetes. With a further 7 million people developing diabetes each year, this number is expected to hit 438 million by 2030, making it a global epidemic. Today, more than nine million Canadians - or one if four - are living with or prediabetes.

The randomized controlled trial compared the dual-hormone artificial pancreas, the single-hormone and the conventional insulin pump therapy in 30 adult and adolescent patients with , who had been using an insulin pump for at least three months. Patients were admitted to the IRCM's clinical research facility three times. Each visit included three meals, chosen social activities, an evening exercise, a bedtime snack and an overnight stay, throughout which blood glucose levels were monitored.

Explore further: Dual-hormone artificial pancreas is a step closer for patients with Type 1 diabetes

Related Stories

Dual-hormone artificial pancreas is a step closer for patients with Type 1 diabetes

January 28, 2013
For patients with type 1 diabetes, a dual-hormone artificial pancreas system (also known as a closed-loop delivery system) improved the control of glucose levels and reduced the risk of hypoglycemia compared with conventional ...

Do closed-loop insulin delivery systems improve blood glucose control in type 1 diabetes?

August 25, 2014
In a closed-loop control approach to managing type 1 diabetes, glucose sensors placed under the skin continuously monitor blood sugar levels, triggering the release of insulin from an implantable insulin pump as needed. The ...

Bionic pancreas outperforms insulin pump in adults, youth

June 16, 2014
People with type 1 diabetes who used a bionic pancreas instead of manually monitoring glucose using fingerstick tests and delivering insulin using a pump were more likely to have blood glucose levels consistently within the ...

Modified iPhone shows promise against type 1 diabetes

June 16, 2014
A device that uses a modified iPhone to help regulate the blood sugar of people with type 1 diabetes appears to work better than an insulin pump, researchers say.

Overnight home use of artificial pancreas 'feasible and beneficial'

April 23, 2014
(Medical Xpress)—Children with type 1 diabetes have been able to use pioneering artificial pancreas technology, developed at the University of Cambridge, for the first time overnight at home without the supervision of researchers.

Hypoglycemia link to HbA1c has declined in type 1 diabetes

October 7, 2014
The link between low average glucose blood levels and greater risk for severe hypoglycemia and hypoglycemic coma substantially declined between 1995 and 2012 in young Germans and Austrians with type 1 diabetes, according ...

Recommended for you

Gut protein mutations shield against spikes in glucose

November 20, 2018
Why is it that, despite consuming the same number of calories, sodium and sugar, some people face little risk of diabetes or obesity while others are at higher risk? A new study by investigators at Brigham and Women's Hospital ...

Can't exercise? A hot bath may help improve inflammation, metabolism, study suggests

November 14, 2018
Hot water treatment may help improve inflammation and blood sugar (glucose) levels in people who are unable to exercise, according to a new study. The findings are published ahead of print in the Journal of Applied Physiology.

Diabetic foot ulcers heal quickly with nitric oxide technology

November 12, 2018
Diabetic foot ulcers can take up to 150 days to heal. A biomedical engineering team wants to reduce it to 21 days.

Diabetes drug might also ease heart failure risks

November 12, 2018
(HealthDay)—The diabetes drug Farxiga might do double-duty for patients, helping to ward off another killer, heart failure, new research shows.

Marijuana use tied to serious diabetes complication

November 8, 2018
(HealthDay)—People with type 1 diabetes who use marijuana may double their risk of developing a life-threatening complication, a new study suggests.

Researchers report connection between intestinal bacteria and development of diabetes

November 7, 2018
Researchers at Örebro University have, together with a well-known research team in Denmark, developed a method for studying how metabolism in gut bacteria influences health. Their method will now be published in its entirety ...

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.