July 21, 2010 -- Encouraging research raises new hopes that a long awaited "artificial pancreas" to treat patients with type 1 diabetes could be available in the U.S. within the next few years, experts say.
In the largest and longest study ever of an insulin pump with a continuous glucose sensor, patients who used the device achieved better control of their blood sugar than patients taking insulin injections.
Those in the study who used the insulin pump marketed by medical device maker Medtronic Inc., had to adjust their insulin levels manually, just as patients who give themselves insulin injections do.
But Medtronic and other companies are working on a closed-loop system -- often referred to as an artificial pancreas -- which will continuously monitor blood sugar levels and adjust insulin delivery automatically.
Study researcher Richard M. Bergenstal, MD, says the new study proves that combining an insulin pump and sensor can help patients achieve optimal blood sugar control even without the automatic insulin delivery.
Bergenstal is executive director of the International Diabetes Center at Park Nicollet as well as president for medicine and science with the American Diabetes Association.
"We were able to get blood sugar down into the range where we can prevent long-term complications and we did it without causing it to drop too low," he tells WebMD. "These are probably the best results in terms of balancing the two of any study done to date."
In healthy people, insulin is produced in the pancreas to help the body convert glucose from the diet into energy. People with type 1 diabetes lose the ability to make their own insulin and most take insulin injections throughout the day.
Poorly controlled frequent high blood sugar leads to the long-term complications of diabetes, including possible blindness, amputation, and kidney failure.
But Bergenstal explains that low blood sugar, known medically as hypoglycemia, is the bigger concern in people who tightly manage their disease with insulin.
"Current treatments are increasingly helping people avoid high blood sugar, but this has resulted in low blood sugar," he says.
The study included 485 people with type 1 diabetes, ranging in age from 7 to 70, who had been unable to achieve optimal blood sugar control with insulin injections.
Half the patients received standard treatment, which involved testing their blood sugars throughout the day and taking insulin injections when needed. The other half used the pump and glucose sensor device, which delivered insulin through a small catheter inserted under the skin.
The sensor was added only after the patients had become comfortable with the pump, usually after two to five weeks. Patients in both treatment groups also received training to help them better manage their diabetes.
Hemoglobin A1c was monitored to assess blood sugar control. Normal hemoglobin A1c in people without diabetes ranges from 4% to 6%, and the goal for avoiding complications in people with the disease is less than 7%.
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