The KidsAP02 study, developed by Roman Hovorka’s group (Department of Paediatrics and Wellcome-MRC Institute of Metabolic Science), compares an artificial pancreas with current sensor-augmented pump therapy for treatment of type 1 diabetes in very young children. Published in the New England Journal of Medicine, they led an international team of researchers and recruited 74 children aged one to seven for a 16 week crossover trial.
Management of type 1 diabetes is challenging in very young children due to their high variability of insulin requirements and unpredictable eating and activity patterns, increasing their risk of significant hypoglycaemia and hyperglycaemia. In particular, prolonged hyperglycaemia has been linked to lower IQ scores and slower brain growth. The need for constant manual adjustments to insulin delivery with currently available therapies also leads to significant management burden for families.
A control algorithm hosted on a phone App – CamAPS FX – works alongside a glucose sensor and insulin pump to automate the administration of insulin so that input from the child’s parent or carer is required at mealtimes only. The new technology was shown to be both safe and more effective than current approaches. On average, children spent 71.6% in the target glucose range with CamAPS FX – almost 9% higher than for the control period, equating to 2.1 extra hours per day. Importantly, this did not lead to an increase in time spent in hypoglycaemia. Using closed-loop therapy reduced average blood sugar levels, based on measurements of HbA1c, from 7.3% to 6.6% – noteworthy as it is often hard to improve glucose control without having more low blood glucose events.
First author Julia Ware (PhD Student, Department of Paediatrics) said: “Parents have described our artificial pancreas as ‘life-changing’ as it meant they were able to relax and spend less time worrying about their child’s blood sugar levels, particularly at night time”.
Read the full paper: Randomized Trial of Closed-Loop Control in Very Young Children with Type 1 Diabetes.
CamAPS FX: https://camdiab.com/
KidsAP study: http://kidsap.mrl.ims.cam.ac.uk/
Further reading: https://www.cam.ac.uk/stories/KidsArtificialPancreas