Thursday, January 12, 2023

Cambridge researchers successfully test an artificial pancreas for people with Type 2 diabetes


An "artificial pancreas" was tested successfully on 26 type 2 diabetics by Cambridge University researchers.

Type 2 diabetes treated with an artificial pancreas: An artificial pancreas trial on 26 type 2 diabetics has been completed successfully by Cambridge University researchers. Researchers discovered that the device doubled the amount of time patients spent within the target glucose range compared to conventional treatment during the trial. Additionally, it reduced by half the time the patients experienced high glucose levels.

In 2019, an estimated 77 million Indians had type 2 diabetes, according to a study published in the Indian Journal of Ophthalmology. By 2045, it is anticipated that number will rise to 134 million. Normally, insulin production in the body controls blood sugar levels. However, its production is disrupted in patients with type 2 diabetes.

This can result in serious health problems over time, such as damage to the eyes, kidneys, nerves, and heart, among other things. Most of the time, type 2 diabetes can be controlled with a combination of changes to one's lifestyle and medication to keep blood sugar levels low.

“The artificial pancreas consists of an algorithm-controlled insulin pump that anticipates and automatically adjusts the amount of insulin required in response to glucose levels. “In contrast to a standard insulin pump, users with the “artificial pancreas” do not need to manually adjust the pump settings depending on the glucose levels,” according to Charlotte Boughton, who co-led the study that was published in Nature Medicine. “The device combines an off-the-shelf glucose sensor and insulin pump with an app that we developed, which is known as CamAPS HX.” However, the CamAPS HX smartphone app enabled the patients to monitor the device.

Boughton added, "The app is designed to be interoperable and work with various approved insulin pumps and glucose sensors." The app learns to anticipate how much insulin each patient will require to maintain a glucose target range and automatically adapts to the patients' changing lifestyles.

The same research team had previously demonstrated that adults and young children with type 1 diabetes can benefit from an artificial pancreas controlled by a similar algorithm prior to the trial. In the past, they had also successfully tested the device on dialysis patients with type 2 diabetes.

Trial of an artificial pancreas The researchers recruited 26 patients from the Wolfson Diabetes and Endocrine Clinic in Cambridge and a group of general practitioners in the area. The patients were divided into two groups at random. After eight weeks of using the device, the first group switched to standard therapy, while the second group started with control therapy and then switched to the artificial pancreas eight weeks later.

The teams evaluated the effectiveness of the artificial pancreas using a variety of metrics. One measure was how much time the patients spent with their glucose levels within a predetermined range of 3.9 to 10.0 millimoles per liter. Patients who used the device spent an average of two-thirds of their time within the target range, which is almost twice as much as when they received the control treatment.

The proportion of time spent by patients with high glucose levels above 10 millimoles per liter was the next parameter that the team measured. While those who used the artificial pancreas device only experienced one third of the time high glucose levels, patients who received the control therapy experienced high glucose levels for two-thirds of the time.

Additionally, the artificial pancreas system was able to lower glycated hemoglobin levels. Glycated haemoglobin is produced when the oxygen-carrying protein in red blood cells, haemoglobin, binds to the blood's glucose and becomes "glycated."

During the artificial pancreas treatment, the patients' average glycated hemoglobin levels were 7.3% and 8.4%, respectively.

More importantly, none of the participants in the trial had dangerously low blood sugar levels or hypoglycemia. The fear of severe hypoglycemia is one of the barriers to further widespread adoption of insulin therapy, according to co-author Aideen Daily. Although no patients experienced severe hypoglycemia, an abscess at the pump cannula site necessitated the hospital admission of one patient with an artificial pancreas.

Response from the patients and future research The researchers say that the feedback from the patients who participated in the trial suggests that they were pleased with the automatic control of their glucose levels. When using the device, as many as 89% of patients stated that they spent less time managing their diabetes. The patients' increased anxiety about hypoglycemia was a major drawback.

“To build on the findings, we now plan to conduct a much larger multicenter study. While describing the plans for future research, Boughton said, "We do not anticipate any new potential risks in future studies or in the potential commercial application of this technology. However, wider use will confirm safety in a broader population." Additionally, the research team has submitted the device for regulatory approval, with the intention of making it commercially available to type 2 diabetes patients.

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