Hybrid insulin pumps work well for type 1 diabetes

Blood sugar levels improve when adults with type 1 diabetes use modern insulin pumps, according to a recent study conducted by the University of Gothenburg and Sahlgrenska University Hospital Östra. Patients are also overwhelmingly positive about the treatment, as described in the Journal of Diabetes Science and Technology.

So-called advanced hybrid closed loop (AHCL) insulin pumps are designed to constantly measure blood sugar levels, using specific algorithms to dose insulin and automatically keep blood sugar levels in check. The pump delivers insulin around the clock via a tube connected to a thin cannula in the subcutaneous fatty tissue. In Sweden, these pumps have been available for the treatment of type 1 diabetes for some years.

In a study to evaluate the pumps, 142 randomly selected adults with type 1 diabetes were treated with one of two different AHCL pumps at six diabetes clinics in Sweden. The mean age of the study participants was 42 years old, and they had been using their AHCL pump for just over one and a half years on average.

The aim of insulin treatment is to keep blood sugar levels steady, between 3.9 and 10 mmol/L. On average, the time where patients had their blood sugar within this range was found to increase by about three and a half hours per day. Before the pump was inserted, the blood sugar of the patients was within this range for 57% of the time on average. With the hybrid pump, the average percentage of time with a target blood sugar increased to 71.5%.

“It is a significant improvement that patients on average increase their time within the target area by as much as three and a half hours,” said Gothenburg’s Ramanjit Singh, the lead author of the study. “Guidelines consider that improvements of about one hour within the target area have an important role in reducing the risk of organ damage.”

The new treatment also reduced the time spent with excessively low blood sugar levels, from 0.7% to 0.3% of the time during the day. More severe blood sugar dips did not seem to be more common in patients on hybrid pump therapy.

The study also asked participants to indicate how satisfied they were with the advanced pump compared to their previous diabetes treatment. The results of the research survey were clear: on a scale from -18 (worst) to +18 (best), the average score was +14.8. That said, the researchers acknowledged that there is potential for further development, noting that as many as one in three patients had skin reactions to the adhesive used in the dressing of infusion sets or sensors.

“We believe that blood sugar levels will further improve as more patients receive the new treatment,” said Professor Marcus Lind, who leads the work at the diabetes research unit at Sahlgrenska University Hospital Östra. “This will reduce organ damage and improve prognosis.

“Development of more tolerable products for the skin is important, along with the treatment, and further larger studies to assess the safety of the treatment are of value.”

Image caption: The MiniMed 780G is one of the insulin pumps that was used in the study. Image courtesy Medtronic.