Artificial Pancreas Systems Safe, Effective in Type 1 Diabetes

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Artificial pancreas treatment, also known as closed loop glucose control, is an emerging treatment option for type 1 diabetes management.
Artificial pancreas treatment, also known as closed loop glucose control, is an emerging treatment option for type 1 diabetes management.

Artificial pancreas systems are safe and effective treatments for patients with type 1 diabetes (T1D), according to a study published in the BMJ.

Eleni Bekiari, MD, PhD, of the Clinical Research and Evidence Based Medicine Unit at Aristotle University of Thessaloniki in Greece, and colleagues conducted a systematic review and meta-analysis of randomized, controlled trials to understand the efficiency and security of artificial pancreas treatments in patients with T1D.

The meta-analysis consisted of 1027 eligible, non-pregnant outpatients with T1D and compared insulin-based treatments with artificial pancreas systems. The main outcome measured was the amount of time (%) that sensory glucose levels were normoglycemic, ranging from 3.9 to 10 mmol/L. Levels below or above the normoglycemic range, low blood glucose index overnight, average sensor glucose levels, total daily required insulin, and glycated hemoglobin were all secondary outcomes measured.

A total of 40 studies were used to assess 44 comparisons, of which 35 analyzed a single hormone artificial pancreas system and 9 paralleled a dual hormone system. Nine of the 40 studies had a low bias risk.

Artificial pancreas treatments resulted in significantly higher proportions of time compared with controls for overnight and 24-hour durations: weighted average difference 15.15% and 9.62%, respectively. Artificial pancreas use was also associated with less normoglycemic deviation (-8.52% above 10 mmol/L and -1.49% below 3.9 mmol/L).  For single and dual hormone artificial pancreas systems, results were constant.

“Artificial pancreas systems are an efficacious and safe approach for treating outpatients with type 1 diabetes. The main limitations of current research evidence on artificial pancreas systems are related to inconsistency in outcome reported, small sample size, and short follow-up duration of individual trials.

Reference

Bekiari E, Kitsios K, Thabit H, et al. Artificial pancreas treatment for outpatients with type 1 diabetes: systemic review and meta-analysis. BMJ. 2018;361:K1310
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