The first trial comparing a new dual-hormone “artificial pancreas” with conventional diabetes treatment using an insulin pump has been completed by researchers at IRCM (Institut de Recherches Cliniques) of Montreal, led by endocrinologist Dr. Rémi Rabasa-Lhoret.
It showed improved glucose levels and lower risks of hypoglycemia.
The artificial pancreas developed at IRCM is an automated system that simulates the normal pancreas by continuously adapting insulin delivery based on changes in glucose levels.
The dual-hormone artificial pancreas controls glucose levels by automatically delivering both insulin and glucagon hormones, when necessary, based on continuous glucose monitor (CGM) readings and guided by an advanced algorithm.
“We found that the artificial pancreas improved glucose control by 15 per cent and significantly reduced the risk of hypoglycemia as compared with conventional insulin pump therapy,” explains engineer Ahmad Haidar, first author of the study and doctoral student in Dr. Rabasa-Lhoret’s research unit at the IRCM and at the Department of Electrical and Computer Engineering at McGill University.
“The artificial pancreas also resulted in an 8-fold reduction of the overall risk of hypoglycemia, and a 20-fold reduction of the risk of nocturnal hypoglycemia.”
People living with type 1 diabetes must carefully manage their blood glucose levels to ensure they remain within a target range. Blood glucose control is the key to preventing serious long-term complications related to high glucose levels (such as blindness or kidney failure) and reduces the risk of hypoglycemia (dangerously low blood glucose that can lead to confusion, disorientation and, if severe, loss of consciousness).
“Approximately two-thirds of patients don’t achieve their target range with current treatments,” says Dr. Rabasa-Lhoret, Director of the Obesity, Metabolism and Diabetes research clinic at the IRCM. “The artificial pancreas could help them reach these targets and reduce the risk of hypoglycemia, which is feared by most patients and remains the most common adverse effect of insulin therapy. In fact, nocturnal hypoglycemia is the main barrier to reaching glycemic targets.”
“Infusion pumps and glucose sensors are already commercially-available, but patients must frequently check the sensor and adjust the pump’s output,” says Haidar. “To liberate them from this sizable challenge, we needed to find a way for the sensor to talk to the pump directly.