Artificial pancreas helps hospitalized type 2 diabetics

TUESDAY, June 26, 2018 (HealthDay News) – The use of an artificial pancreas can help inpatients with type 2 diabetes maintain good glycemic control, suggests a new study.

This is important because when diabetes is not well managed, high blood sugar levels can lengthen stays in the hospital and increase the risk of complications and even death, have the researchers said.

The artificial pancreas – an automated insulin pump and a continuous glucose monitor – is still relatively new and more commonly used in people with type 1 diabetes, who must receive insulin several times a day to survive.

But researchers have thought that the device could also be useful in people with type 2 diabetes. People with type 2 diabetes do not always need insulin, but many the do.

The artificial pancreas has "great potential to improve glucose control", while people with type 2 diabetes are in the hospital, said lead author of the Roman Hovorka study . He is Director of Research at the Metabolic Research Laboratories of the University of Cambridge, England.

In this study, Hovorka said the device "dramatically improved glucose control [and didn’t] increase the risk of hypoglycemia [low blood sugar] for hospitalized patients requiring insulin in the general ward. "

In the United States, up to one in four hospitalized patients is diabetic, according to the researchers. And diabetes control at the hospital can be affected by many variables, such as illness and changes in diet and medications. These changes often mean that diabetics need more attention from hospital staff, note the authors of the study.

The artificial pancreas, which uses a computer formula to direct insulin delivery from a pump based on blood glucose readings obtained from a continuous monitor, can automate a large part of the care that should normally be performed by hospital staff.

To see if this could be done safely, researchers recruited 136 adults with type 2 diabetes hospitalized in the UK and Switzerland. Seventy patients were placed on an artificial pancreatic system. Sixty-six received standard insulin injections and periodic blood glucose monitoring.

The artificial pancreas group had blood sugar levels that were in the desired range – 100 milligrams per deciliter (mg / dL) to 180 mg / dL – 66 percent of the time. Meanwhile, the standard care group had blood sugar levels in this range only 42 percent of the time.

Mean glucose levels were 154 mg / dL for the artificial pancreas group and 188 mg / dL for the standard care group.

Neither group experienced severe blood sugar levels.

Hovorka said the researchers "had very positive comments [from patients] According to him, it is not clear if people with type 2 diabetes would be willing to carry the two mechanical components of an artificial pancreas (insulin pump and continuous glucometer) outside of l & # 39; hospital.

The largest inpatient studies are the next step in research on the artificial pancreas for people with type 2 diabetes, and then eventually outpatient testing, he said.

Further studies are also needed to see if the device is a cost-effective option for people with type 2 diabetes.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York, says that he does not plan to use the artificial pancreas for his type 2 hospital patients in the near future because of the spent.

In addition, at present, most hospitals do not have policies for their use because the devices are so new. (The first artificial pancreas was approved by the US Food and Drug Administration in 2016.)

Still, Zonszein noted, "It was a nice study that showed an improvement over conventional diets, and we'd like to see a simpler way to manage patients."

The study was published on June 25 in the New England Journal of Medicine.

More information

Learn more about artificial pancreas systems from the US Food and Drug Administration.