New research from the Children’s Diabetes Centre has found a pump that suspends insulin delivery when blood glucose levels fall can halve the incidence of hypoglycaemia in young people living with Type 1 Diabetes.
Professor Tim Jones, co-director of the Children’s Diabetes Centre and paediatrician at Princess Margaret Hospital, said the finding was good news for people living with diabetes, many of whom lived with the constant fear of ‘hypos’.
“Avoiding hypos is a top priority for people living with Type 1 Diabetes, and many prefer to stay in a state of hyperglycaemia (high blood sugar) because of this, increasing the risk of long-term complications,” Professor Jones, who led the Predictive Low Glucose Management (PLGM) study, said.
Professor Jones said while PLGM systems had already been shown to reduce hypos in in-clinic conditions and short outpatient studies, its effectiveness and safety had never been tested in real-life, at-home settings over long periods.
“The pump, when used in conjunction with a sensor and transmitter, has a ‘suspend before low’ feature which suspends insulin delivery when blood sugar levels are predicted to go dangerously low — it’s kind of like a driverless car in that it does the work for you,” Professor Jones said.
“The primary objective of the study was to compare the average percentage of time spent in hypoglycaemia with PLGM versus sensor-augmented pump therapy (SAPT) alone.”
Professor Jones said both study groups demonstrated a reduction in hypoglycaemia, although the magnitude of reduction was far greater with PLGM.
“The use of SAPT did not significantly reduce the time spent in hypoglycaemia during the day but showed a mild reduction at night. In contrast, PLGM was associated with reduced day and night time hypoglycaemia, with greater reduction at night,” Professor Jones said.
“Children and adolescents spent approximately half the time in hypoglycaemia with fewer hypoglycaemic episodes with PLGM as compared with SAPT alone.”
Professor Jones said the results would help to make diabetes management easier, and reduce the burden of the disease on both individuals and their families.
“The integration of real-time continuous glucose monitoring systems and pump therapy has been an important milestone in the management of Type 1 Diabetes and the incorporation of control algorithms has offered potential to further improve outcomes,” Professor Jones said.
“This study provides evidence of the efficacy and safety of the PLGM system in the prevention of hypoglycaemia in real-life situations and is an important technological device to reduce hypos in individuals’ day-to-day lives.”
The six-month study was a multi-centre trial involving a number of Australian hospitals, and was funded by the Type 1 Diabetes Clinical Research Network (T1DCRN), an innovative clinical research program led by JDRF Australia, initially funded by the Department of Health and Ageing, and now funded through a Special Research Initiative of the Australian Research Council. It included 154 participants, ranging in age from eight to 18 years (mean 13.2 years).
Dr Dorota Pawlak, Head of Research Development and Director, T1DCRN said: “Advances in new technology are showing great potential to improve the lives of people living with Type 1 Diabetes, and are bringing us closer towards the development of an artificial pancreas”.
Children’s Diabetes Centre researchers are recruiting for the next stage in insulin pump development. For more information or to discuss taking part in the trial, please email firstname.lastname@example.org.
Members of the PLGM study team L-R: Dr Mary Abraham, Professor Tim Jones, Dr Charles Czank, Professor Liz Davis and Ms Jennifer Nicholas.