By Denise 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 this technology could help millions of people living with type 1 diabetes live 2 diabetes.
Type 2 is the more common form of diabetes and is closely linked to obesity.
The pancreas produces insulin, the hormone that helps blood sugar (or glucose) enter cells to be used for energy.People with type 1 diabetes produce little to no insulin. When insulin is scarce, glucose builds up, leading to extreme fatigue, blurred vision, weight loss, and confusion. Some people with type 2 diabetes also need daily insulin injections to keep their blood sugar levels under control.
Enter the artificial pancreas, an automated insulin delivery system that mimics the function of the pancreas.
“Approximately 20% to 30% of people with type 2 diabetes use insulin therapy to control their diabetes, and we have shown that this type of closed-loop insulin delivery is much more effective than their current insulin injections to manage glucose to achieve goals,” said study author Dr. Charlotte Boughton, Clinical Lecturer at the University of Cambridge in England.
In closed systems for type 1 diabetes, the user enters information about the timing and size of their food intake several times a day, but insulin delivery between meals and overnight is automated. In contrast, the new system for people with type 2 diabetes is a completely closed loop. This means that users do not have to enter any information.
It was developed using over-the-counter devices including an off-the-shelf glucose meter and insulin pump with an app called CamAPS HX. This software predicts how much insulin is needed to keep blood glucose levels in target range. People wear the blood glucose sensor and insulin pump and carry a smartphone with them to make the system work, Boughton said.
“This fully automated, closed-loop system is a safer and much more effective way for people with type 2 diabetes to control their glucose levels than the current standard of care insulin,” she said.
How effective was it? When people with type 2 diabetes used the new system, they spent twice as much time with glucose levels in the target range as when they tested blood sugar and gave themselves insulin shots, the researchers found.
Boughton said this equates to an extra eight hours a day and was achieved without increasing the risk of dangerously low glucose levels.
“We hypothesize that the improvements in glucose control that we have seen may reduce the risk of diabetes complications such as eye disease, kidney disease and amputation, but a much larger study with longer follow-up is needed to investigate this,” added she added.
The new study included 26 people with type 2 diabetes. One group used the artificial pancreas for eight weeks and then switched to multiple daily insulin injections. The others were treated in reverse order.
On average, people using the artificial pancreas were within their blood sugar target range two-thirds of the time. According to the report, this is double what has been seen with standard insulin syringes.
In addition, people who gave insulin via syringes spent two-thirds of their time with high glucose levels, compared with 33% when using the artificial pancreas, the researchers found.
The system also helped 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 occur when the device fails to keep blood sugar levels within target ranges.
And then there’s the improvement in quality of life that comes from not having to constantly check blood sugar levels, inject insulin, or take medication. Nine out of ten participants said they spend less time treating their diabetes when using the artificial pancreas.
This technology could be game-changing for millions.
“The number of people being diagnosed with type 2 diabetes is increasing worldwide, and people are being diagnosed at a younger age, so they are living longer with type 2 diabetes,” Boughton said. “Anyone with type 2 diabetes who is struggling to keep glucose levels where they should be with insulin injections could benefit from this system.”
The devices cost more than traditional insulin injections and glucose testing kits.
“If the closed-loop system can reduce the risk of very costly diabetes complications — like dialysis, visual impairment and amputations — over the long term, then they can be cost-effective.” However, a much larger study with longer follow-up is needed to investigate this,” stressed Boughton.
The researchers have previously shown that an artificial pancreas powered by a similar algorithm is effective in people with type 1 diabetes, and they’ve also tested this system in people with type 2 diabetes who need kidney dialysis .
These systems can be pretty easy to use: you wear the devices, load them with insulin, and go about your daily routine, explained Dr. John Buse, chief of endocrinology and director of the Diabetes Center at the University of North Carolina at Chapel Hill.
“No such device is available in the US or anywhere in the world to my knowledge,” said Buse, who reviewed the new study.
Similar testing technologies cost about $10,000 a year for the vendor’s equipment, supplies, insulin and support, he said. “[They cost] more in the first year of upfront costs and less over time,” he explained.
More research is needed before this device is ready for prime time, but the promise is real, Buse added.
“Keeping glucose within a relatively narrow range promises to reduce long-term complications of diabetes — blindness, kidney failure, amputations, heart attacks, strokes, as well as minimizing the risk of urgent hospitalization related to high or low glucose levels as a potentially reduced risk of infection, more cognitively.” Decay and other important issues that are common in diabetes,” he said.
The results were published online on January 11th naturopathy.
Learn more about the artificial pancreas at the US National Institute of Diabetes and Digestive and Kidney Diseases.
SOURCES: Charlotte Boughton, PhD, Clinical Lecturer, University of Cambridge, UK; John Buse, MD, PhD, Professor, Medicine, Director, Diabetes Center and NC Translational and Clinical Sciences Institute, University of North Carolina, Chapel Hill; natural medicine, January 11, 2023 online