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A device that some call artificial pancreas has demonstrated that it allows better control of the blood glucose level of hospitalized patients for type 2 diabetes compared to those who receive it. 39 insulin manually, study published this Monday in the New England Journal of Medicine
The device, whose variations were used to treat type 1 diabetes, maintained blood glucose levels at the expected level more consistently than in the control group, Experts believe that this technology could help improve health outcomes in future generations and could reduce the workload of doctors and nurses who manage glucose levels in patients with diabetes who are hospitalized each year.
"The system reacts to the rise and fall of glucose" said author of the study Roman Hovork has, research director of the Metabolic Research Laboratories of the 39, University of Cambridge
Hovorka says that this is the first study to show the effectiveness of the system with type 2 diabetes outside intensive care ] His team showed that this was feasible in a small group of 40 people, half of whom automatically received insulin.
"The blood glucose control at the hospital is not particularly good, and there is definitely a need to solve this problem," said Dr. Steven Russel, an badociate professor of medicine in Mbadachusetts General Hospital and Harvard Medical School. Russell, who was not involved in the new study, is studying automated glucose control in a project called Bionic Pancreas.
These machines "provide information every five minutes, and we can not put a person to make decisions with this frequency" said Russell.
"It's a process that lends itself to automation."
A CLOSED CYCLE
More than 30 million adults in the United States have diabetes, according to the Centers for Disease Control and Prevention (CDC). It is the seventh leading cause of death and the most important cause of kidney failure, says the agency.
Type 1 diabetes is an autoimmune disease in which the pancreas does not produce or insulin, a hormone that your body needs. To balance glucose in your bloodstream.
In type 2 diabetes, which develops over many years and is linked to obesity, the body reacts less to insulin. usually more difficult to control than type 2, as glucose levels change faster than in the first one.
If blood sugar is too high or too low, it can lead to complications such as kidney damage, nerve problems and
"In the field of medical care … you could say that you are receiving the best possible care for all your medical conditions ", said Jennifer Sherr, an endocrine pediatrician and professor at Yale University School of Medicine Associate
Sherr not participated in the new study, but studied similar systems of insulin administration and, as an individual with type 1 diabetes, uses an automatic system.
"Hospital personnel are subject to a large number of patients; it is difficult to ensure that insulin administration is timely when meals arrive in the rooms, and there is has the stress and other factors that come into play, "Sherr said.
The system of insulin administration. " de Havorka, as it is technically known, uses a real-time blood glucose sensor and a pump that releases a fast-acting drug of insulin under the skin .These devices communicate wirelessly with a tablet that uses a predictive algorithm
The system maintained the glucose levels of the 70 patients in the expected range 65.8% of the time, compared to 41.5%.% of the time for the 66 people of the control group, a difference of about 24 percentage points
The study was conducted in two hospitals in Europe : the Addenbrooke Hospital in Cambridge, UK, and University Hospital Bern, Switzerland Patients were followed up to 15 days or until they left the hospital.
When glucose is controlled by insulin , patients have a risk of hypoglycemia or hypoglycemia, according to The Expert Although the new study does not show a statistical difference between how long sugar levels fall too low in one of two groups, Russell says the study may have missed the large and diverse patient population it needed to prove this point Yet, none of the patients in the study experienced severe episodes of hypoglycemia, the authors wrote .
Both groups received about the same amount of insulin on average. Hovorka says that this shows that insulin has been administered more effectively and at a better time, depending on the individual needs of patients.
"The promise of the artificial pancreas in general is to administer insulin when needed and in the right amount" said Russell.
Several patients reported irritated skin from the sensor adhesive and bruises where the tube was inserted, according to the study. The researchers also reported "sensor failures in two patients and a pump check error in one patient"
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