Artificial Pancreas Improves Blood Glucose in Pediatric Patients

In a study funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), researchers determined that an artificial pancreas improved blood glucose control in pediatric patients between two and five years old with type 1 diabetes (T1D).

The study, published in the New England Journal of Medicine, occurred in three pediatric diabetes centers nationwide. The 102 patients took part in a 13-week trial where they were assigned to the experimental or control group.

Two-thirds of the patients, 68 participants, were in the experimental group, treated with a closed-loop treatment, otherwise known as an artificial pancreas. According to the NIDDK, an artificial pancreas is a three-part system, including a continuous glucose monitor, an insulin infusion pump, and a program to monitor and trigger insulin delivery, meant to imitate normal pancreatic function.

The other one-third of the participant population, 34 individuals, were assigned to a standard treatment plan, including an insulin pump or regular insulin injections.

Both patient populations had a hemoglobin A1C ranging from 5.2 to 11.5%. Before the experiment, most patients in the experimental group averaged 56.7% of their time in their target glucose range. Throughout the study, patients spent 12.6% more time in the ideal glucose range, accounting for 69.3% of the patients’ days or three hours per day.

Conversely, the patients receiving standard care spent 54.9% of their time in the appropriate glucose range at baseline. During the study, the patients spent 55.9% of the day in the targeted glucose range, a mere 1% increase in time.

Researchers closely monitored how the glucose control changed throughout the day, finding that the most significant benefit of a bionic pancreas is managing blood glucose in the evening between 10 PM and 6 AM. The study reports that those with a bionic pancreas were in their target glucose range 18% more than the standard patient population throughout the night.

“In this trial involving young children with type 1 diabetes, the glucose level was in the target range for a greater percentage of time with a closed-loop system than with standard care,” concluded researchers in the study.

Although this treatment may be beneficial for pediatric patients with type 1 diabetes, there is a significant barrier impacting widespread use. In addition to the cost of insulin, an article in Healthline estimates that closed-loop pancreatic systems can cost up to $8,000 without insurance.

Although many organizations, including Eli Lilly, Novo Nordisk, and the California Department of Healthcare Services, are working to make insulin more affordable, many individuals need help to afford insulin to begin with. Should closed-loop systems become the standard of care for type 1 diabetes, healthcare professionals and government officials must work toward making them more affordable.