The world’s first clinical trial to compare three ways of delivering insulin to control glucose levels in patients with type 1 diabetes concludes that two versions of an artificial pancreas can do the job better than conventional pump therapy. The results could have significant implications for the treatment of type 1 diabetes.
The trial was conducted by researchers at the Clinical Research Institute of Montreal and the University of Montreal (IRCM), and the findings are published in The Lancet Diabetes & Endocrinology journal.
The purpose of the trial was to compare the effectiveness of two versions of an external artificial pancreas with conventional insulin-pump therapy in helping type 1 diabetes patients control their glucose levels.
The external artificial pancreas is an automated system designed to simulate the normal pancreas by delivering a continuous supply of insulin that adapts to changes in the patient’s glucose levels.
The trial tested single- and dual-hormone versions of artificial pancreas.
In the body, glucose levels are kept stable by two systems: one uses insulin to reduce glucose, and the other uses glucagon to raise it.
The trial tested two configurations of the artificial pancreas: one that delivers insulin alone – the single-hormone artificial pancreas – and another that delivers insulin and glucagon – the dual-hormone artificial pancreas.
Trial leader and endocrinologist Rémi Rabasa-Lhoret, an associate professor in the Department of Nutrition at the University of Montreal, says they tested both the insulin-only and the insulin and glucagon configurations because:
“We wanted to determine the usefulness of glucagon in the artificial pancreas, especially to prevent hypoglycemia, which remains the major barrier to reaching glycemic targets.”
Both versions of artificial pancreas performed better than convention insulin pump.
The team concludes that both versions of the external artificial pancreas improved glucose control and reduced the risk of hypoglycemia compared to conventional pump therapy.
The results also showed that the dual-hormone artificial pancreas was better at reducing hypoglycemia than the single-hormone system. However, the authors note that the single-hormone system “might be sufficient for hypoglycemia-free overnight glycemic control.”
The team believes the trial shows the artificial pancreas has the potential to substantially improve the management of diabetes and the quality of life of patients and their families.
They are now planning further clinical trials to test the artificial pancreas with larger groups of patients for longer periods.
They hope the technology will be on the market in the next 5 to 7 years, with early models aimed at managing overnight glucose control