People with type 2 diabetes who take insulin stand to benefit from a fully closed-loop insulin delivery system, with more time spent in their target blood glucose range, according to a new study published in the journal Nature Medicine.
Most automated insulin delivery systems — which use real-time data from a glucose sensor to determine how much insulin someone receives — are what’s known as a hybrid closed-loop system. That means users still need to manually program mealtime insulin bolus doses, but the system automatically adjusts insulin delivery the rest of the time. Several recent studies have demonstrated the potential benefits of using a hybrid closed-loop insulin delivery system, with most of these studies focused on type 1 diabetes. These systems have been shown to help improve blood glucose control and quality of life, and they’ve been shown to be safe in young children with type 1 diabetes.
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For the latest study, though, researchers were interested in the potential benefits of a fully automated closed-loop system — one that doesn’t require any mealtime input from users — in adults with type 2 diabetes. Since many people with type 2 diabetes don’t require mealtime insulin, this type of system was considered potentially a good fit for studying in this population — but it wasn’t clear whether automated insulin delivery would be beneficial at all in the first place, since many people with type 2 produce a significant amount of insulin on their own.
The study participants were 26 adults (19 men and seven women) who completed two different eight-week study periods. During one period they received their standard insulin therapy while wearing a glucose sensor that recorded, but did not display, their glucose readings. During the other period, they used the CamAPS HX fully closed-loop system. There was a “washout” period lasting two to four weeks between the two eight-week study periods, and the order in which each participant completed the two periods was randomly decided.
Overall, the proportion of time that participants spent within a target glucose range of 70 to 130 mg/dl was 66.3% during the period with closed-loop insulin delivery, compared with just 32.3% during the period with standard insulin delivery. The proportion of time that participants spent with a glucose level above 130 mg/dl was 33.2% during the period with closed-loop insulin delivery, and 67.0% during the period with standard insulin delivery. Participants’ average glucose level during the period with closed-loop insulin delivery was 166 mg/dl, compared with 227 mg/dl during the period with standard insulin delivery. No severe episodes of hypoglycemia (low blood glucose) occurred during either study period.
“Fully closed-loop insulin delivery improved glucose control without increasing hypoglycemia compared with standard insulin therapy,” the researchers wrote, noting that this delivery method “may represent a safe and efficacious method to improve outcomes in adults with type 2 diabetes.”
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Source URL: https://www.diabetesselfmanagement.com/news-research/2023/01/23/closed-loop-insulin-delivery-beneficial-for-type-2-diabetes/
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