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About the research

The development of closed loop systems, or an artificial pancreas for Type 1 Diabetes, is made up of an insulin pump, continuous glucose monitor and a maths program or algorithm. The algorithm collects data from both the insulin pump and the continuous glucose monitor and then triggers the insulin pump to adjust the insulin dose automatically in an effort to maintain normal blood glucose levels. This is an exciting and rapidly advancing area of research.

Closed-loop outpatient trial

Participants are still needed for the largest at-home trial of a hybrid closed-loop insulin pump system, led by Children’s Diabetes Centre researchers.

The national Hybrid Closed-Loop Outpatient Trial will test the use of an automated insulin delivery system to see if it is better at optimising blood glucose levels than standard therapy.

It will include 160 participants aged 12 to 25 and 120 adults aged 26 to 65 years.

The young people’s team is being led by Princess Margaret Hospital’s Professor Tim Jones, co-director of the Children’s Diabetes Centre, while Associate Professor David O’Neal, from Melbourne’s St Vincent’s Hospital, heads up the adult trial. 

Professor Jones said researchers wanted to understand how hybrid closed-loop systems affected the quality of life of Type 1 diabetics, in addition to its potential savings to the healthcare system.

“The hybrid closed-loop system consists of an insulin pump, sensor with transmitter attached and a maths program (an algorithm) within the pump that automatically works out how much insulin is needed and is adjusted every five minutes,” Professor Jones said.

“This study will tell us if using an artificial pancreas is better than either insulin injections or normal insulin pump therapy at keeping blood glucose levels within the normal range. 

“Researchers will also explore how this technology affects how people feel about managing diabetes, specifically through improving their blood glucose levels, reducing diabetes complications and making treatment easier — which all goes towards reducing the burden of diabetes.”

The Hybrid Closed-Loop Outpatient Trial is a multi-centre study involving a number of Australian hospitals, and is funded by the Type 1 Diabetes Clinical Research Network, an innovative clinical research program led by JDRF Australia and funded by a Special Research Initiative through the Australian Research Council.

For more information, email diabetes.research@health.wa.gov.au

Are you hypo unaware?

A part of the Hybrid Closed-Loop Outpatient Trial will examine if an artificial pancreas can be used to treat hypoglycaemia (low blood sugar) unawareness.

This occurs when the body cannot detect dangerously low blood sugar levels and can affect one in five people living with Type 1 Diabetes.

Study lead Dr Marie-Anne Burckhardt, from Princess Margaret Hospital, said researchers were hoping to recruit people aged 12 to 55 years who were already on an insulin pump and who have difficulty detecting when they were having a hypo.

“We already know that by avoiding hypos for several weeks we can improve hypoglycaemic awareness but this often means running the blood glucose levels quite high for a while,” Dr Burckhardt said.

“We want to test the use of a hybrid closed-loop insulin delivery system, which has been shown to cause less hypos but without running blood glucose levels high and see if the awareness improves.”

For more information, contact Dr Burckhardt on 6229 3317 or Marie-Anne.Burckhardt@health.wa.gov.au

Android-based systems

The maths program, or algorithm, can be stored on a smartphone, which then can override the insulin pump to deliver insulin. In partnership with St Vincent's Hospital in Melbourne, we are currently trialling this system for overnight blood glucose control. Not only are we monitoring quality of  blood glucose but we are monitoring how a good night of glucose control can effect other factors such as sleep quality and cognitive function. This trial will produce valuable data to compare with the results produced when a patient uses this system at home.

Professor Tim Jones with a participant in one of the Centre's smartphone algorithm trials.

Safety studies

The algorithm can also be loaded on to an insulin pump itself, so there is no need to carry an extra smartphone. We are currently testing a new pump by Medtronic to see how well the system copes when we try to induce a hypoglycaemic episode. This test is based on the knowledge that the greatest fear diabetics have is hypoglycaemia, which is exacerbated if you lose control of your insulin delivery. In this study, patients stayed in the research facility for four days and three nights. To test the system and its ability to prevent hypoglycaemia, we asked participants to wear the system during a range of hypoglycaemia-inducing scenarios. This included exercising for 45 minutes or over calibrating the glucose sensor to detect 'artificially-inflated' glucose levels and in turn, deliver more insulin. Preliminary results are encouraging. None of the patients on the trial experienced any overnight hypoglycaemia despite the exercise and inflated glucose levels.

For general inquiries including collaborations, please contact senior program manager Tanyana Jackiewicz:

Phone: (08) 9340 3322
Fax: (08) 9489 7700
Email: tanyana.jackiewicz@health.wa.gov.au

Postal address

Children's Diabetes Centre
Telethon Kids Institute
PO Box 855
West Perth Western Australia 6872
Australia