Use of an artificial pancreas, closed-loop, automated insulin delivery, or bihormonal bionic pancreas (BP) system, may provide significant improvements in managing diabetes and better clinical outcomes in adults with type 1 diabetes (T1D), according to a multicenter, randomized, real-world, outpatient study published in Diabetes Technology & Therapeutics.
Using a 2-arm crossover design, researchers followed 39 patients with type 1 diabetes (mean age: 33; mean diabetes duration: 17 years) treated for 11 days with a BP and 11 days with their usual care.
According to psychosocial questionnaires administered before the study, at the end of the first study arm, and at the end of the second study arm, significantly greater improvements were reported with using a BP compared with usual care, including diabetes-related distress (P <.001) and treatment satisfaction (P <.05).
In addition, patients had a reduction in worry about low and high blood sugars, trusted the device, and felt less burdened by the BP than with their usual care. However, concerns with using a BP included the burden of carrying the equipment around, the need to change glucagon daily, wearability, discomfort, time needed to correct out-of-range numbers, and system malfunctions.
One of the study limitations was that the BP used was an engineering prototype and the investigators stated that the next generation BP devices will be easier to use, which may alleviate some of these concerns.
While participants reported an overall psychosocial benefit of using a BP compared with their usual care for T1D, the investigators concluded that “future versions of the BP device should be designed with the goal of addressing these concerns, and studies with larger, more diverse samples, and with more technology-naive participants are needed.”
Weissberg-Benchell J, Hessler D, Fisher L, Russell SJ, Polonsky WH. Impact of an automated bihormonal delivery system on psychosocial outcomes in adults with type 1 diabetes [published online November 6, 2017]. Diabetes Technol Ther. doi:10.1089/dia.2017.0174