Artificial pancreas effectively controls type 1 diabetes in children age 6 and up
Reporter: Irina Robu, PhD
A new trial funded by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institute of Health created a clinical trial at four pediatric diabetes centers in the US of a new artificial pancreas system, which monitors and regulates blood glucose levels automatically. The artificial pancreas technology, the Control-IQ system has an insulin pump programmed with advanced control algorithms based on a mathematical model using the person’s glucose monitoring information to automatically adjust the insulin dose, and it was originally developed at University of Virginia (UVA), Charlottesville with funding support from NIDDK.
The artificial pancreas closed-loop control is all in one diabetes management system which monitors and tracks blood glucose levels using a continuous glucose monitor and at the same time delivers the insulin when needed via an insulin pump. The system is not only useful in children age 6 and up, but it also replaces reliance on testing by fingerstick or delivering insulin via injection multiple times a day.
The study contains 101 children between ages of 6 and 13 and the children are assigned either to the control or experimental group. The control group uses a standard injection method and separate insulin pump and the experimental uses the artificial pancreas system. Data was conducted every week for four months, while the participants continue on daily lives.
The results of the study showed that using an artificial pancreas system has a 7% improvement in keeping blood glucose in range during the daytime, and a 26% improvement in nighttime control compared to the control group. However, night time control group is important in people with type 1 diabetes, since unchecked hypoglycemia can lead to seizure, coma or even death. The artificial pancreas system shows about 11 % improvement to the standard method and it shows that the improvement in blood glucose control is impressive and safer for kids. No severe case of hypoglycemia or diabetic ketoacidosis occurred during the study, only some minor issues with the equipment.
After the clinical trial and based on the data received, Tandem Diabetes Care has received clearance from the U.S. FDA for use of the Control-IQ system in children as young as age 6 years.
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This is very insightful. There is no doubt that there is the bias you refer to. 42 years ago, when I was postdocing in biochemistry/enzymology before completing my residency in pathology, I knew that there were very influential mambers of the faculty, who also had large programs, and attracted exceptional students. My mentor, it was said (although he was a great writer), could draft a project on toilet paper and call the NIH. It can’t be true, but it was a time in our history preceding a great explosion. It is bizarre for me to read now about eNOS and iNOS, and about CaMKII-á, â, ã, ä – isoenzymes. They were overlooked during the search for the genome, so intermediary metabolism took a back seat. But the work on protein conformation, and on the mechanism of action of enzymes and ligand and coenzyme was just out there, and became more important with the research on signaling pathways. The work on the mechanism of pyridine nucleotide isoenzymes preceded the work by Burton Sobel on the MB isoenzyme in heart. The Vietnam War cut into the funding, and it has actually declined linearly since.
A few years later, I was an Associate Professor at a new Medical School and I submitted a proposal that was reviewed by the Chairman of Pharmacology, who was a former Director of NSF. He thought it was good enough. I was a pathologist and it went to a Biochemistry Review Committee. It was approved, but not funded. The verdict was that I would not be able to carry out the studies needed, and they would have approached it differently. A thousand young investigators are out there now with similar letters. I was told that the Department Chairmen have to build up their faculty. It’s harder now than then. So I filed for and received 3 patents based on my work at the suggestion of my brother-in-law. When I took it to Boehringer-Mannheim, they were actually clueless.