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.
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