British scientists claim to have made a significant breakthrough towards developing a so-called "artificial pancreas" system for managing type 1 diabetes in children.
A team at Cambridge University has developed and even tested a new algorithm, providing a "stepping stone" to home testing for the artificial pancreas, British medical journal 'The Lancet' reported.
Their study shows that using an artificial pancreas system overnight can significantly reduce the risk of hypoglycemia, when blood glucose levels drop dangerously low, while sleeping. These so-called "hypos" are major concern for children and adults with type 1 diabetes.
As well as obviating the need for multiple daily finger prick tests and insulin injections, the artificial pancreas should offer better control of blood glucose levels overnight, say the scientists.
In their study, 17 children and teenagers aged between 5 and 18 with type 1 diabetes were studied during 54 nights in hospital.
The team measured how well the artificial pancreas system controlled glucose levels compared with the children's regular continuous subcutaneous insulin infusion (CSII) pump, which delivers insulin at preselected rates.
The study included nights when the children went to bed after eating a large evening meal or having done early evening exercise.
Both are challenging to manage, a large evening meal because it can lead to so-called "insulin stacking" and, as a result, a potentially dangerous drop in blood glucose levels later in the night, and late afternoon or early evening exercise because it increases the body's need for glucose in the early morning and can therefore increase the risk of night time hypoglycaemia.
The pooled results showed the artificial pancreas kept blood glucose levels in the normal range for 60% of the time, compared with 40 per cent for the CSII.
The artificial pancreas halved the time that blood glucose levels fell below 3.9mmol/l -- the level considered as mild hypoglycaemia.
According to lead author Dr Roman Hovorka, "Our results show that commercially-available devices, when coupled with the algorithm we developed, can improve glucose control in children and significantly reduce risk of hypos overnight.
"This is the first randomised study showing the potential benefit of the artificial pancreas system overnight using commercially-available sensors and pumps. Our study provides a stepping stone for testing the system at home."
