Blood sugar improves when adults with type 1 diabetes use modern insulin pumps. This is shown by a study at the University of Gothenburg. Patients are also overwhelmingly positive about the treatment.
New sophisticated insulin pumps measure blood sugar levels constantly and use specific algorithms to dose insulin and automatically keep blood sugar levels in check. The modern technology is called AHCL (Advanced Hybrid Closed Loop). The pump delivers insulin around the clock via a tube connected to a thin cannula in the subcutaneous fat. In Sweden, these pumps have been available for the treatment of type 1 diabetes in recent years.
Control of blood sugar
The study was carried out in collaboration with Sahlgrenska University Hospital Östra, and its results are published in the journal Journal of Diabetes Science and Technology. 142 randomly selected adults with type 1 diabetes who were treated with one of two different AHCL pumps at six diabetes clinics in Sweden were included in the study. The study participants were on average 42 years old, and had had their AHCL pump for just over a year and a half on average.
Patients had a clear improvement in blood sugar when using the hybrid pump. The goal of insulin treatment is to keep blood sugar level, between 3.9–10 mmol/L. On average, the patients’ time with a blood sugar within this range increased by about three and a half hours per day. Before the pump was inserted, the patients’ blood sugar was within this range an average of 57 percent of the time. With the hybrid pump, the average proportion of time with a target blood sugar increased to 71.5 percent.
Reduced risk of organ damage
ST physician Ramanjit Singh is connected to research at the University of Gothenburg and lead author of the current study:
– It is a significant improvement that patients increase their time in the target area by as much as three and a half hours on average. Guidelines consider improvements of approximately one hour within the target range to be important in reducing the risk of organ damage, says Ramanjit Singh.
The new treatment also reduced the time with excessively low blood sugar values, from 0.7 percent to 0.3 percent of the time during the day. More severe hypoglycemia did not appear to be more common in patients on hybrid pump therapy.
In the study, participants were also asked to indicate how satisfied they were with the advanced pump, compared to the diabetes treatment they had before. The results of the research survey were clear. On a scale from minus 18 (worst) to plus 18 (best), the average result was plus 14.8.
Side effects and safety
Even if the treatment thus works well, the researchers behind the study note that there is development potential. As many as one in three patients had skin reactions to the adhesive used in the dressing of infusion sets or sensors.
Marcus Lind, professor of diabetology at Sahlgrenska Academy at the University of Gothenburg, leads the work at the diabetes research unit established at Sahlgrenska University Hospital Östra, where the research was carried out:
– We believe that the blood sugar values will improve further when more patients receive the new treatment. This will lead to reduced organ damage and a better prognosis. Development of more tolerable products for the skin is important together with the treatment and further larger studies to assess the safety of the treatment are of value, says Marcus Lind.
The insulin pumps that were included in the study have the designations MiniMed™ 780 G and Tandem® t:slim X2™ with Control IQ™. The study was an academic study conducted independently of the companies that operate these pumps.
Study: Effects, safety, and treatment experience of advanced hybrid closed loop systems in clinical practice among adults living with type 1 diabetes; https://doi.org/10.1177/19322968241242386.
Expert contacts:
Ramanjit Singh, ST physician at Sahlgrenska University Hospital, connected to research at the University of Gothenburg, [email protected], tel. 0736-95 86 23
Marcus Lind, professor, Sahlgrenska Academy at the University of Gothenburg, [email protected], tel. 0700-82 42 39
Portrait pictures: Ramanjit Singh (photo: Gothenburg University) and Marcus Lind (photo: Anette Juhlin)
Press contact: Elin Lindström, [email protected], tel. 0766-18 30 37
The Sahlgrenska Academy is part of Gothenburg University’s Faculty of Medicine education and research in medicine, odontology and healthcare science, www.gu.se/sahlgrenska-akademin
