MedicalResearch.com Interview with:
Apostolos Tsapas, MD PhD MSc(Oxon)
Associate Professor of Medicine
Director of the Second Medical Department | Aristotle University Thessalonik
Cruddas Link Fellow
Harris Manchester College
University of Oxford
MedicalResearch.com: What is the background for this study?
Response: Artificial pancreas treatment, also referred to as closed loop glucose control, is an emerging treatment option combining a pump and continuous glucose monitoring with a control algorithm to deliver insulin (and potentially glucagon) in a glucose responsive manner. Compared with insulin pumps or sensor augmented pumps, artificial pancreas use can reduce the burden for patients by automatically adjusting the amount of insulin entering the body on the basis of sensor glucose levels. The US Food and Drug Administration has recently approved the first artificial pancreas system for use by people with type 1 diabetes over 14 years of age, based on a safety outpatient study.
MedicalResearch.com: What are the main findings?
Response: 40 studies including 1027 outpatients with type 1 diabetes were synthesised in the meta-analysis. Artificial pancreas was associated with almost two and a half additional hours in normoglycaemia compared with other types of treatment when used overnight or over a 24 hour period. Use of the artificial pancreas also reduced time spent in hyperglycaemia by approximately two hours – and in hypoglycaemia (20 minutes less) – compared to other types of therapy. Robustness of findings was verified by sensitivity analyses. The main limitations of current research evidence on artificial pancreas systems are related to inconsistency in outcome reporting, small sample sizes, and short follow-up duration of individual trials.
MedicalResearch.com: What should readers take away from your report?
Response: Artificial pancreas treatment significantly improves glycaemic control while reducing the burden of hypoglycemia in outpatients with type 1 diabetes. Results were verified for all types of artificial pancreas.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Upcoming trials should clarify the differences between single and dual hormone systems, and explore artificial pancreas use in inpatients and patients with type 2 diabetes. Finally, they should explore the cost-effectiveness of artificial pancreas systems and their effect on patient important outcomes, including quality of life.
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