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(CNN) – A device that some people call artificial pancreas has shown better control of blood sugar levels in hospitalized patients with type 2 diabetes compared to those who receive insulin manually According to a study published Monday 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 regularly than in the control group, none of which Received critical care 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 every year.
"The system reacts to the rise and fall of glucose," said study author Roman Hovorka, director of research of the Metabolic Research Laboratories at the University of Michigan. University of Cambridge. Hovorka says it's the first study to show the system's effectiveness with type 2 diabetes outside of a critical care setting. His team has already shown that this was feasible in a small group of 40 people, half of whom automatically received insulin.
The United States Food and Drug Administration (FDA) approved the artificial pancreas in 2016 for patients with type 1 diabetes.
"Blood glucose control at the hospital does not occur. is not particularly good, and it is absolutely necessary to solve this problem, "said Dr. Steven Russel, associate professor of medicine at the hospital. General of Massachusetts 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 as often," said Russell.
"It's a process that lends itself to automation," he added.
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A closed cycle
More than 30 million adults in the United States suffer from 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.
Type 1 diabetes is usually more difficult to control than type 2 diabetes, and they change faster than in the first type.
If blood glucose is too high or too low, it could lead to complications such as kidney damage, nerve problems and diabetic comas.
"In the field of medical care … you could say that you are getting the best possible care for all your medical conditions," said Jennifer Sherr, an endocrine pediatrician and associate professor at the School of Medicine. Yale University Sherr did not participate in the new study, but studied similar insulin delivery systems and, as a person with type 1 diabetes, uses an automatic system
"Hospital staff is 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 stress and other factors come into play, "Sherr said.
Havorka's "Closed Insulin Cycle" system. As it is technically known, it uses a real-time blood glucose sensor and a pump that releases a fast-acting drug under the skin, which communicates wirelessly with a tablet that runs a predictive algorithm
The system has maintained 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 in the control group, a difference of about 24 points Percentage
L & # 39; study was conducted in two hospitals in Europe: the Addenbrooke Hospital in Cambridge, UK, and the University Hospital in Bern, Switzerland, patients were followed for 15 days. or until they are out of the hospital.
When glucose is controlled with insulin, patients are at risk for hypoglycemia or hypoglycemia, according to experts. 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 population of patients she needed to prove that point. Yet, none of the patients in the study had 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, meeting the individual needs of patients.
"The promise of the artificial pancreas in general is to administer insulin when needed and in the right amount," Russell said.
Several patients reported irritated skin of the sensor adhesive and bruising 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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