Improving glucose control in non-critically ill inpatients with Type 2 diabetes
Dr Roman Hovorka will build on his successful research into an artificial pancreas for people with Type 1 diabetes to study its safety and effectiveness for the treatment of hospital inpatients with Type 2 diabetes. His work could lead to shorter hospital stays and fewer associated health problems for people with Type 2.
Background to research
In addition, the National Diabetes Inpatient Audit has highlighted the shortcomings of diabetes care among hospital inpatients, with many not achieving blood glucose targets. Problems with diabetes management can prolong hospital stays unnecessarily and lead to hypos in people treated with insulin if the incorrect dose is prescribed or if meals are missed. A range of different issues need to be addressed in order to resolve this problem, but one useful approach might be to give people with insulin-treated Type 2 diabetes access to an artificial pancreas that could manage their blood glucose automatically during hospital stays. Trials supported by Diabetes UK in 2011 revealed that a prototype artificial pancreas could be used safely and effectively to improve the management of Type 1 diabetes in a hospital setting.
Dr Roman Hovorka and his team will build on their successful studies of a prototype artificial pancreas for people with Type 1 diabetes to investigate its use for the management of Type 2 diabetes in hospital inpatients. The researchers will study the safety and effectiveness of the system in 20 inpatients with insulin-treated Type 2 diabetes over a 72-hour period. They will compare the results obtained to those achieved by 20 inpatients using conventional insulin injection therapy.As in previous trials, the artificial pancreas system will involve using a portable computer to link a continuous glucose sensor with an insulin pump – enabling them to talk intelligently to each other. The system will continuously measure glucose levels in the body and rapidly adjust the insulin dose provided to maintain these levels within a target range.
Potential benefit to people with diabetes
Research published in 2014 has shown that the majority of people using insulin in the UK have Type 2 diabetes. Dr Hovorka hopes to see the artificial pancreas being used in clinical practice in around 10 years and expects it to be safer and more effective than conventional insulin therapy. Results from this study could improve care for Type 2 diabetes inpatients by helping to eliminate medication errors, reduce hypos and improve overall glucose control. Ultimately, this could lead to shorter stays in hospital and fewer associated health problems (such as infections and kidney failure) for people with Type 2 diabetes.