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Artificial pancreas holds promise for treating diabetes

Washington: Artificial pancreas improved glucose levels and significantly reduced the risk of hypoglycemia as compared with diabetes treatment using an insulin pump, IRCM researchers have found.

Their results can have a great impact on the treatment of type 1 diabetes by accelerating the development of the external artificial pancreas.

The artificial pancreas is an automated system that simulates the normal pancreas by continuously adapting insulin delivery based on changes in glucose levels. The dual-hormone artificial pancreas tested at the IRCM controls glucose levels by automatically delivering insulin and glucagon, if necessary, based on continuous glucose monitor (CGM) readings and guided by an advanced algorithm.

Endocrinologist Dr. Remi Rabasa-Lhoret led the researchers.

"We found that the artificial pancreas improved glucose control by 15 per cent and significantly reduced the risk of hypoglycemia as compared with conventional insulin pump therapy," explained engineer Ahmad Haidar, first author of the study and doctoral student in Dr. Rabasa-Lhoret`s research unit at the IRCM and at the Department of Electrical and Computer Engineering at McGill University.

"The artificial pancreas also resulted in an 8-fold reduction of the overall risk of hypoglycemia, and a 20-fold reduction of the risk of nocturnal hypoglycemia," he added.

People living with type 1 diabetes must carefully manage their blood glucose levels to ensure they remain within a target range. Blood glucose control is the key to preventing serious long-term complications related to high glucose levels (such as blindness or kidney failure) and reduces the risk of hypoglycemia (dangerously low blood glucose that can lead to confusion, disorientation and, if severe, loss of consciousness).

"Approximately two-thirds of patients don`t achieve their target range with current treatments," said Dr. Rabasa-Lhoret, Director of the Obesity, Metabolism and Diabetes research clinic at the IRCM.

"The artificial pancreas could help them reach these targets and reduce the risk of hypoglycemia, which is feared by most patients and remains the most common adverse effect of insulin therapy. In fact, nocturnal hypoglycemia is the main barrier to reaching glycemic targets," she noted.

Dr. Rabasa-Lhoret concluded that the artificial pancreas has the potential to substantially improve the management of diabetes and reduce daily frustrations for patients.

"We are pursuing our clinical trials to test the system for longer periods and with different age groups. It will then probably be introduced gradually to clinical practice, using insulin alone, with early generations focusing on overnight glucose controls," she added.

Their results have been published in the Canadian Medical Association Journal ( CMAJ ).