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New research funded by JDRF’s T1DCRN has found a pump that suspends insulin delivery when blood glucose levels fall can halve time spent in hypoglycaemia (low blood sugar) in young people living with type 1 diabetes (T1D).

Integrating real-time continuous glucose monitoring systems (CGM) and pump therapy has been an important milestone in the management of T1D. In T1D, hypoglycaemia, or ‘hypos’, must be treated immediately, to avoid becoming unconscious. Hypos play constantly on the mind of people with T1D, and some prefer to stay in a state of hyperglycaemia (high blood glucose) to avoid them. This increases the risk of long-term complications.

Professor Tim Jones, who led the Predictive Low Glucose Management (PLGM) study, said the finding was good news for people living with diabetes, many of whom lived with the constant fear of hypos.

Professor Jones (below) said that while there was evidence that PLGM systems reduce hypos in in-clinic conditions and short outpatient studies, the effectiveness and safety had never been tested in real-life, at-home settings over long periods.

Professor Tim Jones

The PLGM pump used in the study in conjunction with a relevant CGM and transmitter has a ‘suspend before low’ feature, which halts insulin infusion when blood glucose levels are predicted to drop dangerously low.

This PLGM study, involving several Australian hospitals, tested the effectiveness of PLGM over six months in 154 young people aged eight to eighteen. The primary objective was to compare average percentage of time spent in hypoglycaemia  (where blood glucose levels were below 3.5mmol/L) with PLGM versus standard pump therapy.

Results showed the use of PLGM halved the time spent in hypoglycaemia, both at night and in the day, compared to the standard pump alone.  The reduction was persistent across the entire six months. The PLGM group also experienced fewer episodes of low blood glucose levels.

“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.”

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”.

T1DCRN funding is now taking this technology to new heights, trialling a hybrid closed loop system in both young people and adults with T1D. The hybrid closed loop system uses a similar pump, but with a more complex algorithm to automate basal insulin delivery through the day and night when linked to a CGM.

The hybrid closed loop trials are currently taking place in many major hospitals. For more information head to the clinical trial finder to see what is happening in your state.

About the Australian Type 1 Diabetes Clinical Research Network:

The Type 1 Diabetes Clinical Research Network (T1DCRN) is an innovative clinical research program led by JDRF Australia and funded by the Australian Government through the Australian Research Council (ARC) Special Research Initiatives scheme. The T1DCRN’s goal is to accelerate patient benefit through supporting the most promising research projects, promoting and retaining outstanding scientists and attracting new researchers to the field of Type 1 Diabetes research.

 

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