If your wellness is affected by type 1 diabetes, a dual-hormone artificial pancreas system (also known as a closed-loop delivery system) may improve your glucose level control and reduce your risk of hypoglycaemia, This is according to a trial published in CMAJ (Canadian Medical Association Journal), which compared the closed-loop delivery system with conventional pump treatment.
Controlling your glucose levels is a challenge when you have type 1 diabetes, because having too low a level of glucose puts your wellbeing at risk of hypoglycaemia. Even with insulin pump treatment, which provides a continuous predetermined subcutaneous supply of insulin, hypoglycaemia still occurs. According to Ahmad Haidar, Institut de Recherches Cliniques de Montréal and McGill University, and his co-authors, ‘Hypoglycaemia is feared by most patients and remains the most common adverse effect of insulin therapy.’
For the study, the researchers recruited 15 adult patients who had been using an insulin pump for at least three months. During two 15-hour experiments, the patients’ glucose levels were controlled using the artificial pancreas system, and, in the other visit, using conventional pump treatment. The results of the study revealed that participants’ glucose levels were in the target zone 71% of the time when using the artificial pancreas system, and just 57% with the conventional pump treatment.
The authors wrote, ‘[The dual-hormone artificial pancreas] improved glucose control and reduced the risk of hypoglycaemia in our 15 participants, as compared with continuous subcutaneous insulin infusion. Rates of hypoglycaemia were reduced, with no increased risk of hyperglycaemia.’ They concluded, ‘Closed-loop delivery systems have the potential to substantially improve the management of diabetes and the safety of patients. These systems will probably be introduced gradually to clinical practice, with early generations focusing on overnight glucose control and using insulin alone.’
Drs. David Nathan and Steven Russell, Massachusetts General Hospital, Harvard Medical School, commented, ‘Although [this] study is neither the first nor the longest investigation using a dual-hormone artificial pancreas, it is the first to compare such an apparatus to conventional intensive therapy in a randomized design. Treatment with the artificial pancreas increased the amount of time patients spent in the target range of blood glucose levels and decreased hypoglycemia. Thus, Haidar and colleagues show that low doses of glucagon administered under the control of a computer algorithm can act as a counter-regulatory hormone, preventing glucose levels from falling too low.’
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