Artificial pancreas achieves glycaemic control in type 2 diabetes says study
A closed-loop insulin-delivery system in inpatients with type 2 diabetes receiving noncritical care achieves “significantly better” glycaemic control than conventional insulin therapy, a study published in The New England Journal of Medicine has concluded.
The findings also showed this was achieved without a higher risk of hypoglycaemia. The study, part funded by Diabetes UK, aimed to build on evidence highlighting the benefits of a closed-loop delivery system (artificial pancreas) in type 1 diabetes by exploring its use in people with type 2 diabetes receiving noncritical care.
The researchers conducted a randomised, open-label trial conducted on general wards in two tertiary hospitals located in the UK and Switzerland. A total of 136 adults with type 2 diabetes on insulin participated in the study, with 70 assigned to receive the closed-loop insulin delivery and 66 continuing with their insulin therapy, according to local clinical practice.
The primary end point was the percentage of time that the sensor glucose measurement was within the target range of 100 to 180 mg per decilitre (5.6 to 10.0 mmol per litre) for up to 15 days or until hospital discharge.
Summarising the results, the researchers said: “The mean (±SD) percentage of time that the sensor glucose measurement was in the target range was 65.8±16.8 per cent in the closed-loop group and 41.5±16.9 per cent in the control group, a difference of 24.3±2.9 percentage points (95 per cent confidence interval [CI], 18.6 to 30.0; P<0.001); values above the target range were found in 23.6±16.6 per cent and 49.5±22.8 per cent of the patients, respectively, a difference of 25.9±3.4 percentage points (95 per cent CI, 19.2 to 32.7; P<0.001).
“The mean glucose level was 154 mg per deciliter (8.5 mmol per litre) in the closed-loop group and 188 mg per deciliter (10.4 mmol per litre) in the control group (P<0.001). There was no significant between-group difference in the duration of hypoglycemia (as defined by a sensor glucose measurement of <54 mg per decilitre; P=0.80) or in the amount of insulin that was delivered (median dose, 44.4 U and 40.2 U, respectively; P=0.50). No episode of severe hypoglycaemia or clinically significant hyperglycaemia with ketonemia occurred in either trial group.”
The researchers concluded: “Among inpatients with type 2 diabetes receiving noncritical care, the use of an automated, closed-loop insulin-delivery system resulted in significantly better glycaemic control than conventional subcutaneous insulin therapy, without a higher risk of hypoglycaemia.”
To access the study, click here.