Artificial Pancreas Beats Insulin Pump in Test
An artificial pancreas also needs a place to house its computer program or algorithm. Right now, that's generally housed in a laptop that sits on the bedside overnight, as it was in the current study. The hope is that the algorithm could exist within one of the other devices, or maybe even as an application on a cell phone.
In the new study, 56 children from three different diabetes camps in Israel, Slovenia and Germany were randomly assigned to an overnight session on the artificial pancreas, or with standard treatment using an insulin pump and continuous glucose monitor. The following night, they switched.
All of the children had type 1 diabetes, and were between the ages of 10 and 18.
Diabetes camps offer a great place to test the artificial pancreas, because the children are often far more active than usual. All that extra activity leaves them prone to low blood sugar levels throughout the night. Also, staff members are already assigned to check blood sugar levels at certain times in the night.
The artificial pancreas system tested in this study shuts off insulin delivery when it senses that blood sugar levels are going too low. It can also deliver additional insulin when blood sugar levels are rising.
A low blood sugar level is below 70 milligrams per deciliter (mg/dL). On nights that children were on standard treatment, 36 episodes of low blood sugar occurred. On nights that youngsters were on the artificial pancreas, only 12 low blood sugar episodes occurred. Phillip said adjustments could be made to the artificial pancreas to reduce the number of episodes on the artificial pancreas even further.
One diabetes expert talked about the device.
"Overnight control is the most difficult and worrisome part of diabetes management," explained Aaron Kowalski, vice president for treatment therapies at JDRF (formerly the Juvenile Diabetes Research Foundation), based in New York City.
"It's amazing how effective the artificial pancreas is at reducing low blood sugar levels without having to wake up a child and make them eat something, which disturbs their sleep, adds calories to their day and leaves sugar on their teeth overnight," Kowalski said.
The artificial pancreas also maintained blood sugar levels at an average of about 126 mg/dL compared to 140 mg/dL for the standard treatment. The goal of insulin treatment is to maintain blood sugar levels as low as possible without dropping below 70 mg/dL, so the artificial pancreas offered more effective treatment.
Phillip said his group is now testing the artificial pancreas in people's homes.
JDRF's Kowalski said outpatient trials of different artificial pancreas systems are going on in the United States as well.
For more about the artificial pancreas system, visit the U.S. Food and Drug Administration.