Type 1 diabetes: Artificial pancreas regulates blood sugar levels in children

An app that wirelessly links to an implanted glucose sensor and insulin pump can automatically regulate blood sugar levels in children better than the current standard therapy

By Carissa Wong

An artificial pancreas made of a mobile phone app wirelessly linked to an implanted glucose sensor and insulin pump can monitor and control the blood sugar levels of young children with Type 1 diabetes more effectively than the current standard therapy.

Type 1 diabetes is caused by the destruction of cells in the pancreas, which normally produce the hormone insulin to regulate blood glucose levels. A lack of regulation in blood glucose can be life-threatening.

Treating young children with diabetes can be especially challenging because they have less predictable eating and exercise patterns, and therefore more variable insulin requirements, says Julia Ware at the University of Cambridge.

The standard treatment for young children with Type 1 diabetes is called sensor-augmented pump therapy, which uses a sensor to track blood glucose levels and requires carers to manually input how much insulin to release, both at meal times and when the child is not eating.

To simplify this process, Ware’s colleagues previously spent years developing an app called CamAPS FX, which links to a glucose sensor under the skin and an insulin pump that feeds into a fat layer in the abdomen. An algorithm automatically calculates how much insulin should be delivered based on the measured glucose levels. Before meals, extra insulin doses must still be manually entered.

Now, the team has compared their app-powered artificial pancreas to the standard sensor-augmented pump therapy in children aged one to seven years. Over 32 weeks, the team trialled each treatment for 16 weeks in 74 children.

The researchers found that, on average, children spent around three-quarters of their day within their target blood sugar range when using the artificial pancreas – roughly two hours more per day compared to the standard therapy.

The children also spent less than a quarter of each day with high blood sugar levels, called hyperglycaemia, when using the artificial pancreas. This was nearly 10 per cent less time than under standard therapy. Meanwhile, the children experienced low glucose levels for a similar amount of time each day when using both treatments. “The benefits were even greater than we expected,” says Ware.

“Parents described the [artificial pancreas] as life-changing, as it meant they were able to relax and spend less time worrying about their child’s blood sugar levels, particularly at nighttime,” says Ware.

Journal reference: Science Advances, DOI: 10.1056/NEJMoa2111673

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