Artificial pancreas could ‘transform’ type 2 diabetes hospital care
The ‘artificial pancreas’ could transform the care some people with type 2 diabetes receive during hospital stays, according to a new study.
The trial, which involved 136 people with the condition who needed insulin, showed that using the pioneering closed-loop insulin delivery system helped improve blood glucose control without increasing the risk of hypos.
The artificial pancreas continuously monitors blood glucose levels, calculates the amount of insulin required (through a device such as a tablet or mobile phone), and automatically delivers insulin through a pump.
Most research to date has focused on the development of the artificial pancreas for people with type 1 diabetes.
Lead researcher, Dr Roman Hovorka from the University of Cambridge, said: “The results surpassed our expectations. We did not realise the difference the artificial pancreas can make for people on insulin staying in hospital. Further research is needed to understand the wider benefits of improved glucose control during hospital stay.”
Compared to conventional therapy, closed-loop can address rapidly changing insulin needs in hospitalised patients without intensification of nursing care
People using the artificial pancreas spent an average of 24.2 per cent more time with blood glucose levels in the target range (5.6 to 10.0mmol/l), compared to those receiving insulin injections. They also had lower average blood glucose levels (8.5 vs 10.5mmol/l). This was achieved without increasing their daily insulin dose and without an increased risk of hypoglycaemia (dangerously low blood glucose levels), also known as hypos.
Randomly assigned
The trial, funded by Diabetes UK, took place at two hospitals in the UK and Switzerland. The participants were randomly assigned to receive their insulin therapy via the artificial pancreas or via standard insulin injections for up to 15 days (or until they were discharged from hospital). The two groups were matched for age, blood glucose control and body mass index (BMI).
The research comes as recent figures from the National Diabetes Inpatient Audit 2017 show that hospital care for people with diabetes in England and Wales is falling short of expectations. Latest figures show that a third of inpatients with diabetes (31 per cent) experienced a medication error, and around one in five (18 per cent) had a hypo during a hospital stay. This can prolong hospital stays and increase the risk of associated health problems, such as infections.
The trial findings will be published in the New England Journal of Medicine and presented at the American Diabetes Association’s 78th Scientific Sessions in Orlando on Monday, July 26 by one of the researchers.
Dr Lia Bally from Inselspital, Bern University Hospital and the University of Bern, who will be presenting the findings, said: “Compared to conventional therapy, closed-loop can address rapidly changing insulin needs in hospitalised patients without intensification of nursing care.”
Dr Elizabeth Robertson, director of research at Diabetes UK, said: “We know that people living with type 2 diabetes experience poorer outcomes and longer stays in hospital compared to people who do not have type 2 diabetes. Type 2 diabetes is a serious condition that needs to be carefully managed, so it is vital that people with the condition receive first-class care in hospital.
“This important study shows that the artificial pancreas system could can help people with Type 2 diabetes to manage their condition while they’re in hospital, building the evidence needed to offer this type of support to people in hospitals in the future.”