The use of an artificial pancreas system reduced hypoglycemia in patients with well-controlled type 1 diabetes, a study shows.
The hybrid closed-loop insulin delivery system, which includes manual administration of meal-time bolus insulin, was tested during the day and night.
“We showed that, in adults with type 1 diabetes and an HbA1c below 7.5%, day-and-night hybrid closed-loop insulin delivery significantly improved overall glucose control while reducing hypoglycemia progressively by 50% to 75% at lower glucose thresholds compared with usual insulin pump therapy,” said study author Lia Bally, MD, of the Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge.
Bally and colleagues analysed data between March and June 2016 from 29 people with type 1 diabetes treated with insulin pump therapy. All participants had an HbA1c below 7.5%.
They were randomly assigned to either day-and-night closed-loop insulin delivery or standard insulin pump therapy with masked continuous glucose monitoring, or vice versa. After four weeks, participants then switched to the other treatment.
The artificial pancreas system improved the amount of time participants spent in target blood glucose range – 10.5 per cent higher than those who used insulin pump therapy.
Night-time artificial pancreas use also increased time spent in range, and there were no serious adverse events experienced with treatment generally well tolerated.
“In adults who are actively engaged with [diabetes] self-management, closed-loop insulin delivery might provide additional benefits, justifying its use in this particular population,” the researchers wrote.
“The overall positive feedback from participants reflected the acceptance of closed-loop technology during daily diabetes management, albeit with some limitations to its use, which might affect user adherence and experience.”

The study was published online in The Lancet.

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