Our scientists show that an artificial pancreas could transform care for people with Type 2 diabetes during hospital stays.
Our scientists at the University of Cambridge have shown that an ‘artificial pancreas’ could transform the care some people with Type 2 diabetes receive during hospital stays, by improving blood glucose control without increasing the risk of hypos.
The artificial pancreas, or closed-loop insulin delivery system, continuously monitors blood glucose levels, calculates the amount of insulin required (through a device such as a tablet or mobile phone), and automatically delivers insulin through a pump.
Most research to date has focused on the development of the artificial pancreas for people with Type 1 diabetes. In Type 1 diabetes, the immune system attacks insulin-producing cells in the pancreas, so people need to take insulin therapy to control the levels of glucose in their blood. However, many people with Type 2 diabetes also need to take insulin to manage their condition.
People using the artificial pancreas spent an average of 24.2 per cent more time with blood glucose levels in the target range (5.6 to 10.0mmol/l), compared to those receiving insulin injections. They also had lower average blood glucose levels (8.5 vs 10.5mmol/l). This was achieved without increasing their daily insulin dose and without an increased risk of hypoglycaemia (dangerously low blood glucose levels), also known as hypos.
The trial took place at two hospitals in the UK and Switzerland, and involved 136 people with Type 2 diabetes who needed insulin to manage their condition. They were randomly assigned to receive their insulin therapy via the artificial pancreas or via standard insulin injections for up to 15 days (or until they were discharged from hospital). The two groups were matched for age, blood glucose control and BMI (Body Mass Index).
The research comes as recent figures from the National Diabetes Inpatient Audit 2017 show that hospital care for people with diabetes in England and Wales is falling short of expectations. Latest figures show that a third of inpatients with diabetes (31 per cent) experienced a medication error, and around one in five (18 per cent) had a hypo during a hospital stay. This can prolong hospital stays and increase the risk of associated health problems, such as infections.
Lead researcher, Dr Roman Hovorka from the University of Cambridge, said: “The results surpassed our expectations. We did not realise the difference the artificial pancreas can make for people on insulin staying in hospital. Further research is needed to understand the wider benefits of improved glucose control during hospital stay.”
Dr Elizabeth Robertson, our Director of Research, said: “We know that people living with Type 2 diabetes experience poorer outcomes and longer stays in hospital compared to people who do not have Type 2 diabetes. Type 2 diabetes is a serious condition that needs to be carefully managed, so it is vital that people with the condition receive first-class care in hospital.
“This important study shows that the artificial pancreas system could can help people with Type 2 diabetes to manage their condition while they’re in hospital, building the evidence needed to offer this type of support to people in hospitals in the future.”
Before technology like this can be made available to people with Type 2 diabetes, larger studies are needed to assess the practicality of this approach and assess the costs involved.
We’ve supported research to develop the artificial pancreas for decades and are committed to making sure this technology can benefit as many people with diabetes as possible in the future. Read more in our research impact report.