JDRF - Juvenile Diabetes Research Foundation

Real life use of an artificial pancreas

For the first time ever in parallel experiments in both France and Italy, two participants with type 1 diabetes were able to control their diabetes using an artificial pancreas system in a real-life setting. Participants spent a night at a hotel and eating at a restaurant while using the device, and attained near-normal glucose levels. The research team used approved insulin pumps and continuous glucose monitors, which were controlled by a hand-held device and monitored by the investigators to ensure safety.

These were the first outpatient trials using an approach developed by the JDRF-supported International Artificial Pancreas Study Group, an international research group. Previous trials have all been conducted in an in-patient setting. Eight more patients enrolled in the trial will begin outpatient testing in coming weeks.

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A summary of three highlights of research progress from around the world:

1. Joslin 50-year Medallist study uncovers protective factors against diabetes complications
2. Clinical trials of an overnight artificial pancreas system improve glycemic control
3. Transplantation of encapsulated stem cells reduces glucose levels in diabetic mice

Joslin 50-year Medallist study uncovers protective factors against diabetes complications

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Results from one of the largest studies of new diabetes management systems shows that using a combination of insulin pump and continuous glucose monitor results in significantly better long term blood glucose control compared to people using insulin injections alone.

Whilst it has long been known that insulin pump therapy can provide both a physical and psychological benefit to users, results from the recent Sensor-Augmented Pump Therapy for A1C Reduction trial (otherwise known as STAR 3) have shown that using an insulin pump in combination with a continuous glucose monitor can significantly reduce blood sugar fluctuations.

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The JDRF Artificial Pancreas Consortium has made significant advancements in their quest to develop a safe and effective automated diabetes management system, with trials already showing it is possible to maintain healthy blood glucose levels in people with type 1 diabetes without the need for human intervention.

To date, the closed-loop systems tested have combined an insulin pump with glucose monitoring and complex computer programs designed to predict and activate insulin release as required. Whilst results of these trials have been overwhelmingly positive, researchers have found it to be more difficult than first anticipated to finely tune blood glucose levels – particularly when protecting patients against potentially dangerous hypoglycemia caused by too much insulin.

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JDRF funded trails at Cambridge University have shown that an artificial pancreas dramatically reduces the risk of potentially deadly hypoglycemia.

Published today in the respected journal The Lancet, JDRF-funded researchers developed and successfully tested an automated management system, which was able to predict and prevent blood sugar fluctuations. Dramatic blood sugar drops, or hypoglycemia, have immediate and often devastating consequences and have an enormous impact on both individuals and families living with type 1 diabetes.

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In a significant breakthrough for people with diabetes, JDRF has formed a partnership with two international companies to produce an automated diabetes management system to eliminate the need for insulin injections and dramatically reduce the risk of life threatening health complications.

The Juvenile Diabetes Research Foundation has today announced an innovative partnership to develop an automated system to help people with type 1 diabetes better control their disease – the first step on the path to what would be among the most revolutionary advancements in treating type 1 diabetes: the development of an artificial pancreas, a fully automated system to dispense insulin to patients based on real-time changes in blood sugar levels.

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Two major JDRF-funded studies in the US have shown that continuous glucose monitors (CGMs) deliver better diabetes control with regular use for all age groups, while also reducing the frequency of hypoglycemia, or dangerously low blood glucose levels that can lead to coma or death.

The first study showed that regular use of CGMs is the main factor in achieving better diabetes control, rather than the age of people using the monitors, or other demographic, clinical, or psychosocial factors.  The second study showed that people using CGMs were able to achieve good diabetes control while at the same time actually lowering the incidence of hypoglycemia.

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A JDRF trial shows that continuous glucose monitor (CGM) devices help to maintain tight blood sugar levels whilst lowering the risk of dangerously low blood sugar.

There is extensive research to show that tight blood glucose control is the best way to prevent the onset of type 1 diabetes complications such as kidney failure, retinopathy and heart disease. According to results from the Diabetes Complications and Control Trial, every one point reduction in HbA1C reduces the risk of long-term complications by approximately 40%.

Unfortunately, research has also shown that one of the hurdles to tight blood sugar control is the risk of hypoglycemia – both real and perceived.

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