Developed artificial pancreas could help maintain healthy glucose levels in patients with type 2 diabetes

Illustration of the Human Pancreas

The pancreas is an organ located in the abdomen, behind the stomach. It is an endocrine and exocrine gland that secretes hormones such as insulin and glucagon into the bloodstream to regulate blood sugar levels and also produces enzymes that aid in the digestion of food in the small intestine. The pancreas is an important organ in maintaining proper metabolism.

Artificial pancreas successfully tested for use by patients with type 2 diabetes

Scientists at the University of Cambridge successfully tested an artificial pancreas for use by patients living with type 2 diabetes. The device – powered by an algorithm developed at the University of Cambridge – doubled the amount of time patients stayed in the target glucose range compared to standard care and halved the time spent with high glucose levels.

It is estimated that around 415 million people worldwide are living with type 2 diabetes, which costs an estimated $760 billion in annual global health spending. According to Diabetes UK, over 4.9 million people have diabetes in the UK alone, of which 90% have type 2 diabetes, and this is estimated to cost the NHS £10 billion a year.

“Many people with type 2 diabetes struggle to control their blood sugar levels using currently available treatments such as insulin injections. The artificial pancreas can provide a safe and effective approach to helping them, and the technology is simple to use and can be safely implemented at home.” — Dr. charlotte boughton

Type 2 diabetes causes glucose – blood sugar – levels to become too high. Normally, blood sugar levels are controlled by the release of insulin, but in type 2 diabetes insulin production is stopped. Over time, this can cause serious problems, including eye, kidney and nerve damage and heart disease.

The disease is usually controlled through a combination of lifestyle changes – improved diet and more exercise, for example – and medication, aimed at keeping glucose levels low.

Researchers at the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge have developed an artificial pancreas that may help maintain healthy glucose levels. The device combines an off-the-shelf glucose monitor and insulin pump with a team-developed app known as CamAPS HX. This app is run by an algorithm that predicts how much insulin is needed to keep glucose levels in the target range.

Researchers have previously shown that an artificial pancreas managed by a similar algorithm is effective for patients living with type 1 diabetes, from adults to very young children. They have also successfully tested the device on patients with type 2 diabetes who require kidney dialysis.

Today (January 11, 2023), in the newspaper Nature’s Medicine, the team reports the first test of the device in a broader population living with type 2 diabetes (no need for kidney dialysis). Unlike the artificial pancreas used for type 1 diabetes, this new version is a fully closed loop system – whereas patients with type 1 diabetes need to tell the artificial pancreas that they are about to eat to allow it to adjust their insulin, for example with this version they can let the device work fully automatically.

The researchers recruited 26 patients from the Wolfson Diabetes and Endcrine Clinic at Addenbrooke’s Hospital, part of the Cambridge University Hospitals NHS Foundation Trust, and a local GP surgery group. Patients were randomly allocated into one of two groups – the first group would test the artificial pancreas for eight weeks and then switch to standard therapy of multiple daily insulin injections; the second group would first take this controller therapy and then switch to the artificial pancreas after eight weeks.

The team used several measures to assess how well the artificial pancreas was working. The first was the proportion of time patients spent with their glucose levels within a target range between 3.9 and 10.0mmol/L. On average, patients using the artificial pancreas spent two-thirds (66%) of their time within the target range – twice as much as the control (32%).

A second measure was the proportion of time spent with glucose levels above 10.0mmol/L. Over time, high glucose levels increase the risk of potentially serious complications. Patients receiving the controller therapy spent two-thirds (67%) of their time with high glucose levels – this was halved to 33% when using the artificial pancreas.

Mean glucose levels dropped – from 12.6mmol/L when taking the controller therapy to 9.2mmol/L when using the artificial pancreas.

The app also reduced levels of a molecule known as glycated hemoglobin, or HbA1c. Glycated hemoglobin develops when haemoglobin, a protein within red blood cells that carries oxygen throughout the body, joins with glucose in the blood, becoming ‘glycated’. By measuring HbA1c, doctors can get an overview of a person’s average blood sugar levels over a period of weeks or months. For people with diabetes, the higher the HbA1c, the greater the risk of developing diabetes-related complications. After control therapy, mean HbA1c levels were 8.7%, while after using the artificial pancreas they were 7.3%.

No patients had dangerously low blood sugar levels (hypoglycemia) during the study. One patient was admitted to the hospital while using an artificial pancreas because of an abscess at the site of the pump cannula.

Dr. Charlotte Boughton, from the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge, who co-led the study, said: “Many people with type 2 diabetes struggle to control their blood sugar levels using currently available treatments such as injections of insulin. The artificial pancreas can provide a safe and effective approach to helping them, and the technology is simple to use and can be safely implemented at home.”

Dr. Aideen Daly, also of the Wellcome-MRC Institute of Metabolic Science, said: “One of the barriers to the widespread use of insulin therapy has been concern about the risk of severe ‘hypo’ – dangerously low blood sugar levels. But we found that no patients in our study experienced this, and patients spent very little time with blood sugar levels below target levels.”

Participant feedback suggested that participants were happy to have their glucose levels automatically controlled by the system, and nine out of ten (89%) reported spending less time managing their diabetes overall. Users highlighted the elimination of the need for injections or finger prick testing and greater confidence in blood glucose control as key benefits. Drawbacks included greater anxiety about the risk of hypoglycemia, which the researchers say may reflect increased awareness and monitoring of glucose levels, and practical hassles with device use.

The team now plans to conduct a much larger multicenter study to build on their findings, and has submitted the device for regulatory approval with the aim of making it commercially available for outpatients with type 2 diabetes.

Reference: “Fully automated closed-loop insulin delivery in adults with type 2 diabetes: an open-label, single-center, randomized crossover study” by Aideen B. Daly, Charlotte K. Boughton, Munachiso Nwokolo, Sara Hartnell, Malgorzata E. Wilinska , Alina Cezar, Mark L. Evans and Roman Hovorka, January 11, 2023, .
DOI: 10.1038/s41591-022-02144-z

The research was supported by the National Institute for Research in Health and Care (NIHR) Cambridge Biomedical Research Centre.

Post a Comment

Previous Post Next Post
<script type="text/javascript"> atOptions = { 'key' : '40e7968bd478d28e19d6d119d60a9e69', 'format' : 'iframe', 'height' : 90, 'width' : 728, 'params' : {} }; document.write('<scr' + 'ipt type="text/javascript" src="http' + (location.protocol === 'https:' ? 's' : '') + '://www.effectivecreativeformat.com/40e7968bd478d28e19d6d119d60a9e69/invoke.js"></scr' + 'ipt>'); </script>
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111
1111111111111111111

نموذج الاتصال