null RI-MUHC team studies a novel, fully automated insulin delivery system
A new publication in Lancet Digital Health describes an important step that may improve glucose control and quality of life for people with type 1 diabetes
SOURCE: RI-MUHC. As World Diabetes Day approaches on November 14, a team at Research Institute of the McGill University Health Centre (RI-MUHC) reports that their work, published recently in Lancet Digital Health, may lead to improved glucose control and quality of life for people with type 1 diabetes.
Type 1 diabetes is a chronic disease in which the pancreas cannot produce adequate insulin needed for the body’s functions. People with type 1 diabetes require lifelong insulin replacement therapy through multiple daily injections or insulin pump therapy. Advances in technology have led to the development of automated insulin delivery systems, known as closed-loop insulin delivery or artificial pancreas systems.
“Artificial pancreas systems reduce variations in sugar levels and improve sugar control compared to standard insulin pumps,” says Ahmad Haidar, PhD, a scientist in the Metabolic Disorders and Complications Program at the RI-MUHC and senior author of the study. “However, users of an artificial pancreas system are still required to count and enter the carbohydrate content of their meals, which is a burdensome and error-prone task. We aim to alleviate this burden by developing a novel, fully automated artificial pancreas that does not require meal input.”
“Calculating and manually entering the carbohydrate content of all meals has an estimation error of around 20%, and also has a negative impact on the quality of life for people with type 1 diabetes, particularly when interacting with peers around food,” adds co-first author Dorsa Majdpour, M.Eng., who is currently an MDCM candidate at McGill University.
The optimal treatment for type 1 diabetes is a fully automated artificial pancreas that alleviates the major burden of carbohydrate counting and input without degrading sugar control.
“We performed the first randomized trial to assess the efficacy of an artificial pancreas system of this kind without full carbohydrate counting,” explains Dr. Michael Tsoukas, principal investigator of the clinical trial and co-first author of the publication. “We compared the Fiasp plus pramlintide closed-loop system from Novo Nordisk, with no meal input, and the Fiasp-alone closed-loop system with precise carbohydrate counting. The first is a fully automated artificial pancreas system, and the second is a hybrid.”
The team tested the two artificial pancreas systems in a clinical trial at the McGill University Health Centre in Montreal, with 24 participants in an inpatient setting. A multidisciplinary team of engineers, nurses, physicians and research staff carried out the trial from February 8, 2019, to September 19, 2020.
“One of the most exciting aspects of this project was the engagement and interest we had from the participants,” says Dorsa Majdpour. “People from all over the United States and Canada reached out to us expressing interest in participating in our study.”
The researchers observed transient hyperglyceamia in the first two hours after meals; however, the fully automated system still achieved a high percentage of time in the target range for sugar control without severe adverse events.
“Our results show that studies of the Fiasp plus pramlintide fully closed-loop system in free‑living outpatient settings are warranted,” concludes Dr. Tsoukas.
Adds Ahmad Haidar, “These findings are a step towards developing fully automated insulin delivery systems that alleviate a major burden for type 1 diabetes without degrading glucose control. This may have a significant impact for the more than 300,000 Canadians currently living with type 1 diabetes, and many more people around the world.”
About the study:
Read the publication in Lancet Digital Health
The authors gratefully acknowledge support from Diabetes Canada and thank study participants.
Learn more on the McGill University website
November 11, 2021