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Closed-loop delivery system reduced hypoglycemia
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It is widely accepted that hypoglycemia remains a barrier in the management of patients with diabetes. According to data from a trial published in the Canadian Medical Association Journal, researchers found that a dual-hormone closed-loop delivery system not only improved glycemic control, but also reduced the risk for hypoglycemia compared with traditional pump treatment.
Ahmad Haidar, Eng MScA, of the Institut de Recherches Cliniques de Montréal and McGill University, and colleagues found that dual-hormone closed-loop delivery increased the percentage of time that patients’ plasma glucose levels were within the target range (median, 70.7% [interquartile range (IQR)=46.1%-88.4%] for closed-loop delivery vs. 57.3% [IQR=25.2%-71.8%] for control; P=.003), according to data. This also decreased the percentage of time in which plasma glucose levels were in the low range, the researchers wrote.
Regarding adverse events, eight patients (53%) experienced one hypoglycemic event (plasma glucose <3 mmol/L) during the standard treatment, whereas only one patient (7%) experienced one hypoglycemic event during closed-loop treatment (P=.02).
This treatment method improved short-term glucose control and reduced the risk for hypoglycemia among 15 adults with type 1 diabetes.
David M. Nathan, MD, and Steven Russell, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, wrote in an accompanying commentary that Haidar and colleagues’ study is the first to compare this type of delivery system to conventional intensive therapy in a randomized design.
“Haidar and colleagues add to a growing body of evidence that glucagon can be used to prevent hypoglycemia in a dual-hormone artificial pancreas that more closely mimics normal pancreatic function,” Nathan and Russell wrote.
The study researchers conclude that closed-loop delivery systems have the potential to improve the management of diabetes safely. However, further research will be needed over time to enhance this outcome.
For more information:
Haidar A. CMAJ. 2013;doi:10.1503/cmaj.121265.
Nathan DM. CMAJ. 2013;doi:10.1503/cmaj.130011.
Disclosure: Several researchers report pending patents, grant funding and additional financial ties with Diabète Québec, Canadian Diabetes Association, AstraZeneca, Boehringer, Eli Lilly, Merck, Novo Nordisk, and Sanofi-Aventis. Nathan and Russell report no relevant financial disclosures.