Insulin Pump Vs. Artificial Pancreas: Which is More Effective?

Artificial pancreas systems are more effective at maintaining glycemic control in patients with type 1 diabetes than conventional insulin pump therapy, according to a recent study.

Over time, 2 versions of the artificial pancreas system have been developed: single-hormone (insulin) and dual-hormone (insulin and glucagon). In order to establish which of these systems is more effective, researchers conducted a randomized crossover trial involving 30 patients with type 1 diabetes who had achieved good glycemic control with conventional insulin pump therapy.
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Participants attended three 24-hour clinic visits, receiving insulin pump therapy, dual-hormone artificial pancreas therapy, or single-hormone artificial pancreas therapy. Visits were 2 weeks apart and the order of the treatments administered was randomized in all participants.

The primary outcome of the study was the time that blood glucose levels remained in the target range.

Overall, 52 events of hypoglycemia with conventional insulin pump therapy—13 with single-hormone artificial pancreas and 9 with dual-hormone artificial pancreas were reported.

Researchers found that the time spent within the target range was significantly higher with both of the artificial pancreas systems (62% with single-hormone and 63% with dual-hormone) than with conventional insulin pump therapy (51%).

“Single-hormone and dual-hormone artificial pancreas systems both provided better glycemic control than did conventional insulin pump therapy,” researchers concluded.

“The single-hormone artificial pancreas might be sufficient for hypoglycemia-free overnight glycemic control.”

—Michael Potts

Reference:

Haidar A, Legualt L, Messier V, et al. Comparison of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy for glycaemic control in patients with type 1 diabetes: an open-label randomised controlled crossover trial. Lancet Diabetes Endocrinol. 2014 November 27 [epub ahead of print]. doi:10.1016/S2213-8587(14)70226-8