Successful trial of artificial pancreas for use with type 2 diabetes

Cambridge scientists have successfully tested an artificial pancreas for use by people with type 2 diabetes. Powered by an algorithm developed at the University of Cambridge, the device doubles the time a patient is within his blood sugar target range and halves the time he experiences hyperglycemia compared to standard care. shortened.

Approximately 415 million people worldwide are estimated to be living with type 2 Diabetesannual global healthcare costs are about $760 billion. According to Diabetes UKIn the UK alone, more than 4.9 million people have diabetes, 90% of whom have type 2 diabetes, which is estimated to cost the NHS £10 billion a year.

Type 2 diabetes causes glucose levels to—blood sugar— getting too high. Normal, Blood glucose level It is controlled by insulin release, but insulin production is disrupted in type 2 diabetes. Over time, this can lead to serious problems such as eye, kidney and nerve damage. Heart disease.

The disease is usually managed with a combination of lifestyle changes (such as eating better and exercising more) and medication to keep blood sugar levels low.

Researchers at Cambridge University’s Wellcome-MRC Institute for Metabolic Sciences pancreas Helps maintain healthy glucose levels. The device combines an off-the-shelf glucose monitor and insulin pump with an app developed by the team known as CamAPS HX. The app is powered by an algorithm that predicts how much insulin you need to keep your blood sugar within your target range.

Researchers have previously shown that an artificial pancreas that runs on a similar algorithm is effective in adult-to-adult patients with type 1 diabetes. very young childrenThey also succeeded tried the device For type 2 diabetics requiring kidney dialysis.

today, natural medicine, the team reports the first trial of the device in a wider population living with type 2 diabetes (which does not require kidney dialysis).Unlike the artificial pancreas used for type 1 diabetes, this new version It’s a completely closed loop system. Patients with type 1 diabetes, on the other hand, need to tell their artificial pancreas to eat in order to be able to regulate their insulin. A version that allows you to leave your device to function fully automatically.

Researchers recruited 26 patients from the Wolfson Diabetes and Endocrine Clinic at Addenbrook Hospital, part of the Cambridge University Hospitals NHS Foundation Trust, and a local GP surgery group. Patients were randomly assigned to one of two groups. In the first group, he tried an artificial pancreas for eight weeks before switching to standard treatment with multiple daily insulin injections. A second group will receive this control therapy first and switch to an artificial pancreas after 8 weeks.

The team used several methods to assess how effectively the artificial pancreas works. The first was the percentage of time the patient spent with blood glucose levels within her target range of 3.9–10.0 mmol/L. On average, the patient using the artificial pancreas spent 2 (66%) of his 3 minutes within the target range. Twice as many in the control group (32%).

The second measure was the percentage of time spent with glucose levels above 10.0 mmol/L.Over time, high glucose levels increase the risk of potentially serious complications. high blood sugar—This was halved to 33% with an artificial pancreas.

Mean blood glucose levels decreased from 12.6mmol/L when receiving control therapy to 9.2mmol/L when using the artificial pancreas.

The app also lowered levels of a molecule known as glycated hemoglobin (HbA1c). Glycated hemoglobin occurs when hemoglobin, a protein in the body, is produced. red blood cell It carries oxygen throughout the body and binds with glucose in the blood for “saccharification”. Measuring HbA1c gives clinicians a complete picture of a person’s average blood sugar levels over weeks or months. For diabetics, the higher the HbA1c, the higher the risk of developing diabetes-related complications. Mean HbA1c levels after control treatment were 8.7%, but 7.3% after using the artificial pancreas.

No patient experienced dangerously low blood sugar levels (hypoglycemia) during the study. One patient was hospitalized for an abscess at the site of the pump cannula while using an artificial pancreas.

Dr Charlotte Bourton of the Wellcome-MRC Institute for Metabolic Sciences, University of Cambridge, who co-led the study, said: insulin injection. artificial pancreas We can provide a safe and effective approach to help them, and the technique is easy to use and can be safely performed at home. “

Dr. Aideen Daly of the Wellcome-MRC Institute of Metabolic Science said: None of the patients in our study experienced these, and very few patients spent their blood glucose levels below target.”

Feedback from participants indicated that they were satisfied with having their blood sugar levels automatically controlled by the system, with 9 in 10 (89%) reporting that they spent less time managing their diabetes overall doing. Users highlighted the elimination of the need for injections and finger testing, as well as increased confidence in blood sugar control, as key benefits. Downsides included increased anxiety about the risk of hypoglycemia. glucose leveland the practical annoyance of wearing the device.

The team now plans to conduct a larger, multi-center study based on their findings, with the aim of making the device commercially available to outpatients with type 2 diabetes, for regulatory approval. submitted.