Alternative Treatment for Patients with Type 1 Diabetes Mellitus
- Insulin injection primary treatment for T1DM;
- Continuous glucose monitoring improves conditions for patient;
- Artificial pancreas breakthrough development enhancing glucose control;
- Approved by the FDA but not widely known to the public.
Type 1 diabetes mellitus (T1DM) is a significant healthcare concern in modern medicine. It is a chronic disorder with beta cells of the pancreas destroyed by autoimmune antibodies. Usually, T1DM is developed in childhood but can arise as late as mid-late adulthood. Modern approaches to treatment focus on continuous glucose monitoring which then provides optimal times for insulin injections. However, the development of artificial pancreas technology provides an opportunity for more effective and safe treatment that is ongoing 24/7. The study by Dai et al. (2018) seeks to compare the artificial pancreas treatment in comparison to traditional insulin administration in T1DM patients. It is a meta-analysis of studies, including patients only with T1DM and comparison with a control group. It is necessary to do so to evaluate the effectiveness between the new technology and traditional methods of treatment.
Study Results
- Artificial pancreas maintains better mean concentration of glucose;
- Patients with artificial pancreas saw less time in hypoglycemic phase;
- Daily insulin required (24-h period) better with artificial pancreas, indicating effective continuous glucose control;
- Number of hypoglycemic events was not significantly different (Dai et al., 2018).
Studies were included that directly compared artificial pancreas with the control group for T1DM. A total of 8 studies were analyzed for a combined sum of 354 patients. In a range of comparisons vital to the wellbeing and treatment of T1DM patients, the artificial pancreas demonstrated better results and margins than that of control which utilized standard glucose monitoring and insulin injections. Better concentration of glucose and daily insulin requirement favored the artificial pancreas. Meanwhile, time spent in the hypoglycemic phase was lower, while time spent outside the hypoglycemic and euglycemic phases was higher, once again benefiting the artificial pancreas. The number of hypoglycemic events did not differ, but these may have been a result of unpredicted glucose spikes due to the physiology or behavior of the patient that no system can predict.
Implementation and Discussion
- Artificial pancreas effective alternative 24h treatment;
- Safer due to significantly lower time period in hyperglycemia phase;
- Improves overnight glucose control – major issue currently for diabetics;
- Closed loop (artificial) system is more efficient in long-term.
There are significant benefits to the artificial pancreas which introduces a closed loop system that is fully automated in comparison to the semi-automated hybrid control systems currently in place. While this is complex technology, it seems to have matured and is demonstrating highly promising results across various centers and types of patients (Dai et al., 2018). These findings are supported by the National Institute of Health which has hosted its own multicenter randomized clinical trial, with the new system greatly more effective in regulating blood glucose levels in T1DM patients than existing treatments. The nighttime aspect is once again emphasized since blood sugar can drop dangerously low when an individual is asleep. The artificial pancreas has a safety module which prevents hypoglycemia as well as intensifies control overnight, allowing to achieve normal glucose levels in the morning. With an artificial pancreas system, the amount of time that blood glucose levels are in target ranges increases by as much as 2.6 hours per day compared to control groups (NIH, 2019).
References
Dai, X., Luo, Z., Zhai, L., Zhao, W., & Huang, F. (2018). Artificial pancreas is an effective and safe alternative in patients with type 1 diabetes mellitus: A systematic review and meta-analysis. Diabetes Therapy, 9(3), 1269–1277. Web.
NIH. (2019). Artificial pancreas system better controls blood glucose levels than current technology. U.S. Department of Health and Human Services. Web.