Artificial Pancreas Beats Insulin Pump

Fully automated artificial-pancreas systems currently in development combine an insulin pump with a glucose sensor via a computerized control algorithm, which directs insulin delivery in response to sensor data.

The current study compares the MD-Logic artificial pancreas — a closed-loop system with real-time alarms — with a sensor-augmented pump system in 56 children with type 1 diabetes. The MD-Logic artificial-pancreas system was developed at Schneider Children’s and tested in the multinational study, called Diabetes Wireless Artificial Pancreas Consortium (DREAM), at 3 camps, 1 each in Israel, Slovenia, and Germany.

The 56 children were aged 10 to 18 years, with type 1 diabetes of at least 1-year duration and insulin-pump treatment for at least 3 months. Each child was randomized to either the artificial pancreas or a sensor-augmented insulin pump on the first night and then switched to the other treatment the next night.

Results showed that there was significantly less hypoglycemia shown in the artificial pancreas group. Seven children in the artificial pancreas group compared to 22 in the insulin pump group experienced hypoglycemia. However, overnight glucose levels were almost identical in both groups. Of 39 hypoglycemia alarms in the artificial-pancreas group, 13 were false, compared with 27 false alarms out of 41 with the sensor-augmented pump. There were a total of 26 carbohydrate interventions overall during the artificial-pancreas nights and 25 during the control nights.

"In our study, the significant improvement in patients’ overnight glucose control and the reduction in the number of events and duration of hypoglycemia appeared to be related to the combined effect of better control of the amount of insulin provided and better control of the timing of insulin delivery, together with the presence of an alarm module, in the artificial pancreas," they observe.

Pediatr Diabetes. 2013 Feb 28. doi: 10.1111/pedi.12025.