Scientists in Cambridge have shown that an 'artificial pancreas' can be used to regulate blood glucose in children with Type 1 diabetes. A trial found that combining a real-time sensor measuring glucose levels with a pump that delivers insulin can boost overnight blood glucose control.
The Lancet study showed the device significantly cuts the risk of blood glucose levels dropping dangerously low. In total, 17 children and teenagers with Type 1 diabetes took part in the study over 54 nights in hospital.
Insulin dose based on real-time readings
System lets blood glucose monitor 'speak' to insulin pump
Individually, the glucose monitoring system and the insulin pump used in the study are both already widely used and commercially available. But in order to turn them into a 'closed loop' system, which monitors the patient's condition and delivers treatment accordingly, the researchers developed a sophisticated algorithm to calculate the appropriate amount of insulin to deliver based on the real-time glucose readings.
Artifical pancreas compared with continuous insulin pump
They then measured how well the artificial pancreas system controlled glucose levels compared with the children's regular continuous pump, which delivers insulin at pre-selected rates.
Testing was done in different circumstances and, overall, the results showed the artificial pancreas kept blood glucose levels in the normal range for 60 per cent of the time, compared with 40 per cent for the continuous pump.
Effect on hypoglycaemia
And the artificial pancreas halved the time that blood glucose levels fell below 3.9mmol/l - the level considered as mild hypoglycaemia. It also prevented blood glucose falling below 3.0mmol/l, which is defined as significant hypoglycaemia, compared with nine hypoglycaemia events in the control groups.
An important step forward
“This research demonstrates that closed-loop insulin delivery can achieve safe and tighter overnight glucose control in children and adolescents," said Dr Victoria King, Research Manager at Diabetes UK.
"This is an important step forward in managing overnight blood glucose levels as well as in the eventual development of a full 'artificial pancreas' which could vastly improve the quality of life for people with Type 1 diabetes and reduce the risk of the associated complications.
“Research is already underway to tackle the challenges of using this type of system at meal-times and during exercise, as well as further research funded by Diabetes UK to extend the use of this technology in adults and pregnant women.”
The study was funded by Juvenile Diabetes Research Foundation (JDRF).