A closed-loop insulin delivery system has shown to be successful in handling unplanned exercise in children with type 1 diabetes, a study has found.
Also known as an artificial pancreas, a closed-loop system comprises a continuous glucose monitor (CGM) which detects shifts in blood glucose levels and signals adjusted output to an insulin pump.
Previous research has shown it to be safe and effective during a normal day and at night-time, but it had not been proven to work during unexpected physical activity, which could increase or decrease blood glucose levels.
Now, a team of researchers from Slovenia has shown that the closed-loop system stood up to changes in children’s blood sugar levels during unplanned exercising and afterwards.
In this new trial, the closed-loop system was compared to an open-loop system, where children too wore a CGM and insulin pump but the two devices did not communicate.
Children who wore the artificial pancreas had no greater hyperglycemia risk and spent “substantially more time in target range” when compared to youngsters who wore the open-loop system.
“Closed-loop insulin delivery was safe both during and after unannounced exercise protocols in the in-hospital environment, maintaining glucose values mostly within the target range without an increased risk of hypoglycemia,” said the researchers:
The findings were based on studying 20 children with type 1 diabetes, including 11 boys and nine girls, who were aged from ten to 17. They had all been using insulin pumps for more than 12 months beforehand.
The youngsters were divided into two groups, with one set wearing an insulin pump together with a CGM representing an open-loop system and the second group had the artificial pancreas. Then after one day the children swapped systems.
During a whole day in hospital to ensure safety, the youngsters were asked to cycle for a total for 40 minutes at both fast and slow speeds to represent the start and stop pattern of sport and childhood activities.
Type 1 diabetes charity JDRF said: “This study, though small, adds weight to the evidence that closed-loop systems are safe and effective for use in children going about everyday activities. The researchers recommend a larger study be carried out to confirm their findings.”
The study was published in the journal Diabetologia.

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