by Dennis Mann
Health Day Reporter
FRIDAY, Jan. 13, 2023 (HealthDay News) — An artificial pancreas has long been considered the holy grail for people with type 1 diabetes, and new research suggests a more convenient version of the technology could help millions of people with type 1 diabetes. Diabetics 2 diabetes.
Type 2 is the more common form of diabetes and is strongly associated with obesity.
The pancreas produces insulin, a hormone that helps blood sugar (or glucose) get into cells to be used as energy.People with type 1 diabetes produce very little insulin. When insulin is in short supply, glucose builds up, leading to extreme fatigue, blurred vision, weight loss and confusion. Some people with type 2 diabetes also need daily insulin to control blood sugar.
Enter the Artificial Pancreas, an automated insulin delivery system that mimics the function of the pancreas.
“Approximately 20 to 30 percent of people with type 2 diabetes use insulin therapy to manage their diabetes, and we have shown that this delivery of insulin through a closed-loop system is more effective at reaching blood sugar level goals than their current insulin injections,” the study said. Author Dr Charlotte Bowden, a clinical lecturer at the University of Cambridge, UK, said.
With a closed-loop system for type 1 diabetes, users enter information about the timing and size of food intake multiple times a day, but insulin delivery between meals and at night is automated. In contrast, the new system for people with type 2 diabetes is a complete closed loop. This means that the user does not have to enter any information.
It was developed using over-the-counter devices, including off-the-shelf glucose monitors and insulin pumps with an app called CamAPS HX. The software predicts how much insulin is needed to keep blood sugar levels within the target range. People wear blood glucose sensors and insulin pumps and carry their smartphones with them for the system to work, Boughton said.
“This fully automated closed-loop system is a safer and more effective approach for people with type 2 diabetes than the current standard treatment with insulin,” she said.
How effective is it? The researchers found that when people with type 2 diabetes used the new system, they kept their blood sugar levels within target range twice as long as when they tested their blood sugar and gave themselves insulin injections.
That equates to an extra eight hours a day without increasing the risk of dangerously low blood sugar levels, Boughton said.
She added: “We anticipate that the improvements in blood sugar control we’re seeing may reduce the risk of diabetes complications such as eye disease, kidney disease and amputations, but larger studies with longer follow-up are needed to investigate this .”
The new study included 26 patients with type 2 diabetes. One group used the artificial pancreas for eight weeks and then switched to multiple daily insulin injections. Others are processed in reverse order.
On average, people using the artificial pancreas were in the target blood sugar range two-thirds of the time. This is reportedly double what is seen with standard insulin injections.
What’s more, the researchers found that people who injected insulin by injection were hyperglycemic two-thirds of the time, compared with 33 percent when using the artificial pancreas.
The system also helps lower levels of glycated hemoglobin, or HbA1c, which provides a snapshot of blood sugar levels over time.
No one in the study experienced dangerously low blood sugar, or hypoglycemia, which can happen if the device fails to keep blood sugar levels within the target range.
Then there’s the improved quality of life, not having to constantly check blood sugar levels, inject insulin or take medication. Nine out of 10 participants said they spent less time managing their diabetes when they had an artificial pancreas.
This technology could be a game-changer for millions.
“The number of people diagnosed with type 2 diabetes is increasing globally, and people are being diagnosed at a younger age, so they are living with type 2 diabetes for longer,” Boughton said. “Anyone with type 2 diabetes who has difficulty keeping blood sugar levels where they should with insulin injections could benefit from this system.”
The devices do cost more than standard insulin injections and glucose testing kits.
“Closed-loop systems may be cost-effective if they can reduce the risk of very expensive complications of diabetes in the long-term — such as the need for dialysis, vision impairment, and amputations — but larger studies with longer follow-up are needed to assess the investigation,” Boughton stressed.
The researchers have previously shown that an artificial pancreas run by a similar algorithm works in people with type 1 diabetes, and also tested the system in people with type 2 diabetes who require kidney dialysis.
These systems are fairly simple to use: You put the devices on, load them with insulin, and go about your daily life, explained Dr. John Booth, director of the UNC-Chapel Hill Diabetes Center and chief of endocrinology.
“There is no such device in the United States, and as far as I know, nowhere in the world,” said Buse, who reviewed the new study.
A similar research technique costs about $10,000 a year for equipment, supplies, insulin and vendor support, he said. “[They cost] Acquisition costs increase in the first year and decrease over time,” he explained.
Buse added that more research is needed before the device is ready for prime time, but the promise is real.
“Keeping blood sugar in a relatively narrow range is expected to reduce the long-term complications of diabetes — blindness, kidney failure, amputation, heart attack, stroke, as well as minimize the risk of emergency hospitalizations associated with high or low blood sugar, And because it may reduce the risk of infections, cognitive decline and other important problems common to diabetes,” he said.
The findings were published online Jan. 11 in natural medicine.
More information
Learn more about artificial pancreas at the National Institute of Diabetes and Digestive and Kidney Diseases.
SOURCE: Charlotte Boughton, MD, Clinical Lecturer, University of Cambridge, UK; John Buse, MD, PhD, Professor of Medicine, Director, UNC Chapel Hill Diabetes Center and NC Translational and Clinical Science Institute; natural medicine, January 11, 2023, online
