Artificial Pancreas Provides Better Nighttime Blood Sugar Control Than the Pump


The artificial pancreas is better at controlling night time blood sugar levels than conventional pump therapy according to two knew studies carried out at the Wellcome Trust clinical research facility at Addenbrooke’s Hospital in England.

The studies compared the the overnight closed loop delivery of insulin (artificial pancreas) with conventional insulin pump (continuous subcutaneous insulin infusion) therapy. The patients were randomly assigned to be treated overnight with either closed loop delivery of insulin or conventional insulin pump therapy during two study nights, separated by an interval of one to three weeks. Patients assigned to the closed loop delivery system group were attached to a FreeStyle Navigator continuous glucose monitor (CGM) and an insulin pump. The CGM sensor measurements of glucose were fed into a computer algorithm, which advised on insulin pump infusion rates at 15 minute intervals, and the insulin pump was adjusted  according to the basal infusion rate calculated by the algorithm.
The studies mimicked the two common scenarios of “eating in” and “eating out” in preparation for testing as an outpatient. An initial study evaluated closed loop delivery after a medium sized evening meal, mimicking an evening at home when closed loop delivery could be conveniently started with the meal. A second, more challenging study mimicked an evening out.  The meal was larger, was consumed later, and was accompanied by wine. Closed loop delivery was started later and continued until noon the next day.

The researchers concluded that closed loop delivery of insulin can significantly improve the control of glucose levels overnight and reduce the risk of nocturnal hypoglycemia in adults with type 1 diabetes. The closed loop system has the potential to improve safety and efficacy of insulin delivery and may in future allow more flexible lifestyles in conjunction with improved glycemic control for people with type 1 diabetes.

Source: British Journal of Medicine

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