Sue Marshall blogs about diabetes for Desang

Diabetes experts welcome artificial pancreas study – but urge more research before it can be adapted widely | March 9, 2010

Results of a study using manual closed-loop insulin delivery  ‘ the artificial pancreas’ in children and adolescents with Type 1 diabetes have been welcomed by Britain’s leading diabetes specialists.

The Association of British Clinical Diabetologists (ABCD) described the initial findings published this week in The Lancet as “encouraging” – creating a platform for further research into its safety and clinical effectiveness to take place.

ABCD is the national organisation representing more than 500 consultant physicians and senior registrars in Britain who specialise in diabetes mellitus – an increasingly common condition that is known to affect more than two million of the population, although the actual figure is feared to be far higher.

People with type 1 diabetes are required to keep their blood glucose in the near normal range by injecting insulin up to four times per day, or by insulin infusion pump. The dose of insulin is adjusted by frequent testing of blood glucose  – by pricking fingers.

Dr Ian Gallen, Honorary Secretary of ABCD and a consultant physician and endocrinologist at Buckinghamshire Hospitals NHS Trust, said: “This process can be arduous and painful. People with diabetes also frequently suffer from the effect of abnormally low blood glucose (hypo) which may be unpleasant, or even cause loss of consciousness.

“The prospect of any technological development which may help the person without diabetes control blood glucose with fewer hypos will be welcomed by people with diabetes and their carers.”

ABCD said it was important that all young people with type 1 diabetes received specialist clinical care from a consultant, so that their complex insulin needs could be managed effectively by drawing upon the latest clinical advances.  Pumps and open loop glucose sensors were already used in selected cases to achieve this.

The reported study involved 19 patients aged 5—18 years with type 1 diabetes. Treatment with standard insulin infusion via an insulin pump was compared with changes in insulin dose guided by results from a glucose sensing device which were modified by a mathematically derived model. The adjustment in insulin delivery rates were made manually, by a nurse.

The results of the study are that blood glucose control overnight was more normal, and there were fewer episodes of hypoglycaemia.

Dr Gallen added: “These early results are very encouraging  – however a good deal of further work is required before this is clinically applicable.

“Further development with automatic changes in insulin infusion rate guided from the sensor need to be tested and demonstrated to be safe and effective, before this technology can be widely adapted.”

ABCD and its charity, the Diabetes Care Trust, are dedicated to the development and implementation of best practice for people with diabetes. This artificial pancreas technology when developed offers the promise of improved long-term health with less discomfort and hypos. Diabetes specialists will be required to support the implementation of these new treatments, and ABCD will spearhead the training of these specialists.

This is potentially great news for Type 1 diabetes sufferers.


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