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Artificial pancreas more effective than sensor-augmented pump in young children
Young children in a camp setting spent less time in hypoglycemia while using a single-hormone artificial pancreas system than when using a sensor-augmented pump, according to study results.
In the randomized, open-label, crossover study, Claudio Cobelli, PhD, of the department of information engineering at the University of Padua, Italy, and colleagues evaluated 30 children aged 5 to 9 years with type 1 diabetes who were assigned to 3 days with an artificial pancreas and 3 days of parent-managed sensor-augmented insulin pump. Participants were attending a pediatric artificial pancreas camp, and data were collected comparing sensor-augmented pump therapy with the child-specific version of the modular model predictive control algorithm that runs on the wearable Diabetes Assistant platform. Both groups used diluted Novolog (rapid-acting insulin aspart, Novo Nordisk). There was a 24-hour washout between each treatment period.
Nighttime time-in-hypoglycemia decreased from 2.2% with sensor-augmented pump to 0% with the artificial pancreas (P = .002). At least one treatment for hypoglycemia was required by 43% of participants during the sensor-augmented pump period compared with 16% during the artificial pancreas period. During nighttime no significant differences were found between the two study periods for time-in-target and time-in-tight-target.
Overall, the time in hypoglycemia was reduced more than three times with the artificial pancreas (2%) compared with the sensor-augmented pump (6.7%; P < .001).
“The study shows that outpatient closed-loop glucose control using the [Diabetes Assistant] wearable platform is feasible in young children, complementing the evidence collected in adults and adolescents,” the researchers wrote. “Furthermore, this study reinforces the evidence of diluted-insulin usability in [an artificial pancreas], as previously reported.” – by Amber Cox
Disclosure: Cobelli reports various financial ties with Adocia, Dexcom Inc., Roche Diagnostics and Sanofi. Please see the full study for a list of all other authors’ relevant financial disclosures.
Editor's Note: On May 16, 2016, a paragraph was removed for clarification. The editors regret this error.