A clinical trial, carried out by the University of Montreal (Université de Montréal) and Institut de recherches cliniques de Montreal (IRCM), has compared three alternative treatment options for type 1 diabetes. Results confirm that external artificial pancreas reduces risks of hypoglycemia and improves glucose control compared to traditional diabetes treatments.
Led by Dr. Rémi Rabasa-Lhoret, the clinical trial can have a dramatic impact on type 1 diabetes treatment as it identifies the most effective one at the moment. The findings were published in the journal The Lancet Diabetes & Endocrinology, comparing the external artificial pancreas in two configurations and a conventional insulin pump.
According to Dr. Rabasa-Lhoret, the clinical trial was the first in the world to compare two configurations of an artificial pancreas. The first, the single-hormone variant, delivers insulin, while the second, the dual-hormone version of an artificial pancreas, provides both glucagon and insulin.
Glucagon has an opposite effect from insulin, raising glucose levels when it is administered. Researchers wanted to determine if it would be useful in artificial pancreas, especially as a means of preventing hypoglycemia, which remains a major hindrance in achieving desired blood sugar levels.
Treating type 1 diabetes typically focuses on keeping blood sugar levels down and this increases risks of hypoglycemia. Low blood sugar is a concern because it leads to disorientation, confusion, and when severe enough, even loss of consciousness, seizures, and coma.
Blood sugar levels usually drop during the night so concerns over hypoglycemia happening during the evening are high, most especially in parents with young diabetic children.
Dr. Laurent Legault, the study's co-author and a pediatric endocrinologist from the Montreal Children's Hospital, said that the artificial pancreas holds immense potential in substantially improving diabetes management for patients, thus improving quality of life as well for their families.
The clinical trial involved 30 adults and adolescents who have been using insulin pumps for at least three months. Participants were admitted three times at the IRCM clinical research facility, with each visit including an overnight stay, meals, physical activity at night, the patient's chosen social activity and a snack before bedtime. Throughout each visit, blood sugar levels were being monitored.
Funding support for the clinical trial was provided by the Canadian Diabetes Association, Dr. Rabasa-Lhoret's J.A. De Sève Chair in clinical research, and Haidar's postdoctoral fellowship from JDRF. Other authors include Tina Maria Mitre, Catherine Leroux, Virginie Messier, and Ahmad Haidar.
