Saturday, February 4, 2023

First success of artificial pancreas in patients with type 2 diabetes

US scientists have successfully tested an artificial pancreas for patients with type 2 diabetes. The device, powered by an algorithm developed at the University of Cambridge, doubled the amount of time it took to keep patients’ blood sugar levels (glucose) in the right range compared to a standard. treatment, plus it cut in half the time they had spikes in their high glucose levels.

study is novel, explains George Bondiafrom the University of Valencia and member of the Applied Diabetes Technologies group of the Spanish Diabetes Society (SED), “because it is something that is done in type 1 diabetes, but although it has been done in type 2 diabetes, not in out-of-hospital studies setting. They did it on patients who are hospitalized or on dialysis, but it is one thing that when a patient is hospitalized the system of controlling blood sugar is on for a few days and another that they do it continuously , At home, wear your normal way of life. These are very different contexts.”

It is estimated that around 415 million people worldwide are living with type 2 diabetes. In Spain it affects about 6 million people. Data collected by national and European health surveys show a rate of 7.51 out of every 100 people. 90% of whom have type 2 diabetes.

Type 2 diabetes causes glucose levels to become too high. Normally, blood sugar levels are regulated by the release of insulin, but in type 2 diabetes, insulin production is disrupted. Over time, this can cause serious problems including eye, kidney, and nerve damage, and heart disease.

The disease is usually managed through a combination of lifestyle changes (eg better diet and more exercise) and medication, with the goal of keeping glucose levels low.

A new device developed by researchers at the Wellcome-MRC Institute of Metabolic Sciences at the University of Cambridge may help maintain healthy glucose levels. The device combines a standard glucose monitor and insulin pump with an app developed by the team, called CamApps HX, This app works with an algorithm that predicts how much insulin is needed to keep glucose levels in the target range.

The researchers previously showed that an artificial pancreas powered by a similar algorithm is effective for patients with type 1 diabetes, from adults to very young children. They also successfully tested the device in patients with type 2 diabetes who require kidney dialysis.

,The artificial pancreas automates a process that is now mostly done manually; That is to say, the type 2 patient regulates his insulin by pricking his finger to measure the insulin value and, if necessary, injects himself”, explains Bondia.

The study published today in “Nature Medicine” marks the first trial of an artificial pancreas in a broad population living with type 2 diabetes (which does not require kidney dialysis).

Frees the patient from controlling carbohydrates or wondering how much insulin they need

George Bondia

University of Valencia

Unlike the artificial pancreas used for type 1 diabetes, the researchers point out, this new version is a completely closed-loop system, requiring patients with type 1 diabetes to tell their artificial pancreas when they need to make insulin adjustments. There are eaters to allow, eg. In this edition. They can let the device work fully automatically.

A total of 26 patients participated in the study., Each was randomly assigned to one of two groups: The first would try the artificial pancreas for eight weeks and then switch to standard therapy of multiple daily insulin injections; The other will start this control therapy and then after eight weeks switch to an artificial pancreas.

“This system, notes Bondia, administers as-needed insulin every 5 minutes. You don’t need prior notification. It frees the patient from controlling carbohydrates or thinking about how much insulin they need, which the patient It’s all done automatically by the system, which is a relief to the patient.”

The study is the first trial of an artificial pancreas in a broad population living with type 2 diabetes.

To assess the device’s effectiveness, the researchers applied a variety of measures. For example, the proportion of time patients spent with their glucose level within the target range between 3.9 and 10.0 mmol/L. On average, people using the artificial pancreas spent two-thirds (66%) of their time within the target range, which was achieved on controls (32%).

A second endpoint was the proportion of time spent with glucose levels above 10.0 mmol/L. Over time, high glucose levels increase the risk of potentially serious complications. Patients on controller therapy spent two-thirds (67%) of their time with high glucose levels; This was halved to 33% when an artificial pancreas was used.

In addition, the researchers observed that average glucose levels fell: from 12.6 mmol/L when taking the controller therapy to 9.2 mmol/L when using the artificial pancreas.

But the most important thing for the Spanish specialist is that it gives better control. Bondia explains that the goal is to keep glucose between 70 and 180 for as long as possible. ,If it is below the limit then it is called hypoglycemia, which is serious because it has consequences that even if you do not treat it, you can die., But if you’re also above the limit, you’ll get these complications over the years. But it is normal for insulin to increase while eating food. But with this system it is possible to increase control and reduce hypoglycemia by half. This expert acknowledges that the aim would be to be in range one hundred percent of the time, which is impossible.

In addition, the device also reduced levels of a molecule called glycosylated hemoglobin, or HbA1c.

Glycosylated hemoglobin develops when hemoglobin, a protein inside red blood cells that carries oxygen throughout the body, binds to glucose in the blood and becomes “glucose,” he explains. By measuring HbA1c, doctors can get a general picture of what a person’s average blood sugar level has been over a period of weeks or months. PFor people with diabetes, the higher the HbA1c, the higher the risk of developing diabetes complications., After control therapy, mean HbA1c levels were 8.7%, compared to 7.3% after using the artificial pancreas.

Bondia concluded that this would be the ideal treatment. ,Iobjective is automated system,

But remember that the patient is not accustomed to the technique. «It is one of the obstacles that must be overcome, but it is really the direction that must be taken, at least for patients with very advanced type 2 diabetes, because it cannot be applied to the approximately 6 million patients with diabetes. Is.

Another factor to take into account would be Cost, An artificial pancreas is much more expensive, we are talking about several thousand euros for each device.

Nation World News Desk
Nation World News Deskhttps://nationworldnews.com
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