An “artificial pancreas” has been trialled successfully in patients with type 2 diabetes, it is announced today.
Scientists at the University of Cambridge have for the first time successfully trialled a device that doubles the amount of time patients are in the target range for glucose compared to standard treatment.
It also halves the time spent experiencing high glucose levels, according to their study, which is published in the latest edition of *Nature Medicine*.
The findings are announced just days after NICE recommended a hybrid closed loop system for managing blood glucose levels in type 1 diabetes.
The team, from the university’s Wellcome-MRC Institute of Metabolic Science, say unlike the artificial pancreas used for type 1 diabetes, this new version is a fully closed loop system.
Whereas patients with type 1 diabetes need to tell their artificial pancreas they are about to eat to allow adjustment of insulin, this version enables them to leave the device to function entirely automatically.
The researchers recruited 26 patients from the Wolfson Diabetes and Endocrine Clinic at Addenbrooke’s Hospital and a local group of GP surgeries.
Participants were randomly allocated to one of two groups, one trialling the artificial pancreas, which device combines an off-the-shelf glucose monitor and insulin pump with the newly developed CamAPS HX app, for eight weeks before switching to the standard therapy of multiple daily insulin injections. The second group took the control therapy first before switching to the artificial pancreas after eight weeks.
The team measured the proportion of time that patients spent with their glucose levels within a target range of between 3.9 and 10.0mmol/L, finding that patients using the artificial pancreas spent, on average, 66% of their time within the target range. This was double that while on the control (32%).
A second measure was the proportion of time spent with glucose levels above 10.0mmol/L. Patients taking the control therapy spent 67% of their time with high glucose levels and this was halved when using the artificial pancreas.
Average glucose levels fell from 12.6mmol/L when taking the control therapy to 9.2mmol/L while using the artificial pancreas and the app also reduced levels of glycated haemoglobin (HbA1c). After the control therapy, average HbA1c levels were 8.7% compared to 7.3% after using the artificial pancreas.
Dr Charlotte Boughton, from the Wellcome-MRC Institute of Metabolic Science who co-led the study, said: “Many people with type 2 diabetes struggle to manage their blood sugar levels using the currently available treatments, such as insulin injections. The artificial pancreas can provide a safe and effective approach to help them, and the technology is simple to use and can be implemented safely at home.”
Dr Aideen Daly, also from the Wellcome-MRC Institute of Metabolic Science, added: “One of the barriers to widespread use of insulin therapy has been concern over the risk of severe ‘hypos’ – dangerously low blood sugar levels. But we found that no patients on our trial experienced these and patients spent very little time with blood sugar levels lower than the target levels.”
The team is to carry out a larger multicentre study to build on their findings and have submitted the device for regulatory approval.
Daly AB, Boughton CK, et al. Fully automated closed-loop insulin delivery in adults with type 2 diabetes: an open-label, single-centre randomised crossover trial. *Nature Medicine* 11 January 2022; doi: 10.1038/s41591-022-02144-z
Leave a Reply