Artificial Pancreas Withstands Rigorous Exercise in Small Trial

In 2017, there were promising advancements to develop an “artificial pancreas” or closed-loop system that monitors blood sugar and automatically delivers insulin. Another recent study provides more hope that the technology will radically transform diabetes management in the near future—that is, for those who can afford it.

Researchers compared U.S. teenagers with Type 1 diabetes who used either the artificial pancreas or an open-loop system (traditional pump) while engaging in a five-day ski camp. They found that those with the closed-loop system stayed within a healthy range of blood glucose more consistently than those without the device. The first group, which consisted of 16 participants, stayed within range approximately 71% of the time, while their peers (also consisting of 16) only stayed within range 65% percent of time. This disparity may not seem significant, but, according to researchers, it suggests that the technology can withstand intense exercise, something that previous studies had not fully investigated.

Researchers also noted fewer incidence of dangerous low and high blood sugars among the teens with the device. Teens with the closed loop system reached a dangerous low 1.8% of the time, compared to teens without the device reaching low levels 3.2% percent of the time. Dangerously high blood sugars occurred 7% of the time, compared to 9.3% of the time.

One of the lead researchers told Medscape, who first reported on the study: “All type 1 diabetes patients using an insulin pump should very seriously consider using an artificial pancreas, regardless of how active they are.” Mike Breton added, “Eventually, this system may allow people with diabetes the freedom to participate safely in physical activities that they likely avoided in the past.”

Breton may be referring to the fact that many individuals with Type 1 diabetes avoid strenuous exercise out of fear of its impact on blood glucose levels. Alternatively, they may avoid intense exercise because of the frequency with which they must stop to monitor blood sugar and manually adjust insulin delivery. He is confident that automation will encourage individuals with diabetes to pursue any of the sports and activities that they enjoy.

Researchers acknowledged the relatively small size of the study, as well as the insular focus on one sport (skiing). Future studies might examine other types, intensities, and durations of exercise, as well as other age groups and populations.

Still, the results are promising, especially since there have been other recent findings of activity’s long-term benefits for individuals with Type 1 diabetes. A Reuters study, for instance, found that active individuals with T1D are less likely than their inactive peers to die prematurely even with comparable complications present (such as kidney disease).

Medtronic released its version of the artificial pancreas system in limited cities earlier this year. Other medical device makers are expected to roll out their own products for clinical testing in early 2018. But as with most diabetes gear, the artificial pancreas will probably not be within financial reach for all living with the disease. The cost of the system, including disposable sensors, will exceed $10,000 annually, according to some estimates. Even for those with both a provider and insurer approving use of the device, out-of-pocket costs may be prohibitive.

Furthermore, many individuals may opt out of the system. One tech expert recently predicted that “smart” insulin pens will be more popular than the artificial pancreas, since more individuals worldwide use manual injections than insulin pumps.

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Audrey Farley is a former editor of Insulin Nation.

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