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Use of artificial pancreas technology in a group of patients with type 2 diabetes leads to better disease control, say UK researchers.
A trial of a fully-closed loop system in 26 patients with type 2 diabetes found the device doubled the amount of time spent in the target range for glucose compared to standard treatment and halved the time spent with high glucose levels.
It is the first study to look at use of the technology in a wider population of individuals with diabetes rather than a specific group such as inpatients or those waiting for kidney dialysis.
The team at Cambridge University used an off-the-shelf glucose monitor and insulin pump with an app they had developed – CamAPS HX – to calculate how much insulin is needed to maintain glucose levels in the target range.
Unlike for type 1 diabetes the system used in the study is fully automatic so patients do not have to input information about what they eat.
Reporting in Nature Medicine, the researchers said patients, recruited from a diabetes clinic and GP practices, were randomly allocated to either trialling the artificial pancreas for eight weeks before switching to standard therapy of multiple daily insulin injections or vice versa.
On average, patients using the artificial pancreas spent 66% of their time within the target range of between 3.9 and 10.0mmol/L compared to 32% with standard care.
In addition, while on control therapy patients spent 67% of their time with high glucose levels compared to 33% when using the technology.
Overall, average glucose levels fell – from 12.6mmol/L when taking the control therapy to 9.2mmol/L while using the device.
After the control therapy, average HbA1c levels were 8.7%, compared with 7.3% after using the closed loop technology.
No patients experienced hypoglycaemia but one patient was admitted to hospital due to an abscess at the site of the pump cannula.
Those taking part were happy using the technology and nine out of ten reported spending less time managing their diabetes overall, the team said.
They are now planning a larger multi-centre study to test the use of the technology in this group of patients further.
Study co-lead Dr Charlotte Boughton from the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge: 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.’
Co-author Dr Aideen Daly, 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.’
Meanwhile, people who are struggling to manage their type 1 diabetes could be offered the latest artificial pancreas technology under draft guidance from NICE – but only if a lower price can be agreed.
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