At this year’s meeting of the European Association for the Study of Diabetes, researchers reported that use of a hybrid day-night closed-loop insulin delivery system is better than sensor-augmented pump therapy for blood sugar control in people with poorly controlled Type 1 diabetes.
The JDRF-funded study included 44 men and 42 women with Type 1 diabetes and randomly assigned them to receive treatment with an insulin pump and a continuous glucose monitor or a closed-loop insulin delivery system.
Participants who used the insulin pump and a continuous glucose monitoring sensor were responsible for making insulin-dosing decisions. But closed-loop insulin delivery systems are designed to integrate the data collected by CGMs directly with an insulin pump, automating insulin delivery using an algorithm.
Over the 12 weeks of the study, people in the closed-loop group spent significantly more time in the target blood sugar range compared to those in the control group. The researchers also noted that participants in the closed-loop group had significant reductions in HbA1c levels compared to the control group.
The time that participants spent with very low blood sugar levels (hypoglycemia) was a median of 12 minutes lower in the closed-loop group and the time spent with very high blood sugar levels (hyperglycemia) was a median of 2 hours and 24 minutes lower in the closed-loop group, according to the researchers.
The study also found that the proportion of time spent in dangerous conditions overall fell from 3.5% at baseline to 2.6% after the study in the closed-loop group. Meanwhile, in the sensor-augmented pump group, this value rose from 3.3% at baseline to 3.9% after the study.
“The use of day-and-night hybrid closed-loop insulin delivery improves glycaemic control while reducing the risk of hypoglycemia in adults, adolescents and children with Type 1 diabetes compared to conventional pump therapy or sensor-augmented pump therapy. Results from our study together with those from previous studies support the adoption of closed-loop technology in clinical practice across all age groups,” the researchers wrote in The Lancet.
“Dr. Hovorka’s study is significant in that it adds to the ever-growing body of evidence showing that closed-loop insulin delivery systems improve outcomes and reduce burden for people with Type 1 diabetes,” Daniel Finan, research director at JDRF, added. “In particular, this study demonstrates that people with diabetes who have sub-optimal control can benefit greatly from such technology.”
“These are great results. I congratulate Professor Hovorka on the vital work he is doing. Type 1 diabetes is a challenging condition, but these results take us a step closer to changing the lives of the millions of people that live with the condition across the world,” Rachel Connor, director of research partnerships at JDRF, said.