Presentations at ADA’s 71st Scientific Sessions Demonstrate Strong Progress on the Artificial Pancreas
We had the great privilege of attending the American Diabetes Association’s 71st Scientific Sessions in sunny San Diego, CA from June 24-28. All the best researchers from around the traveled to Southern California and presented their newest and most exciting data. Out of over 3,000 abstracts presented at the meeting, we were most enthusiastic about the significant and groundbreaking progress on the artificial pancreas (AP; also known as the “closed-loop”). Tremendous excitement has surrounded JDRF’s Control-to-Range Trial since it was first announced in 2010. The trial will focus on keeping glucose values within a targeted range (as opposed to a specific number like 100 mg/dl) following meals and exercise. At ADA, data from a pilot version of the trial was presented. Eight subjects using the control-to-range system spent an impressive 93% of a 24-hour period between 70-180 mg/dl, compared to just 77% for those on standard pump therapy. There’s no doubt that everyone in the field is looking forward to more results in the coming year.
We also heard from Dr. Edward Damiano, who discussed an innovative future (2011-2012) study featuring five-day long closed-loop experiments using an iPod touch connected to an Insulet OmniPod PDM; to the surprise of everyone in the audience, Dr. Damiano actually brought the prototype with him. Both insulin-only and insulin-glucagon versions of the closed-loop system will be tested in the study. Most notably, patients accompanied by a chaperone will be allowed to roam freely around the hospital campus, with unrestricted eating and exercise. Considering most trials of the artificial pancreas take place in very carefully monitored clinical research or hospital settings, this proposed study would certainly push the boundaries of closed-loop research.
On that note, Dr. Roman Hovorka and his team at Cambridge University announced at ADA that they have proposed a three-week home-use study of the artificial pancreas. An ethics committee has approved the study, with a decision expected by the United Kingdom Regulatory Authority sometime this summer. For everyone tirelessly working towards an AP, a home-use study would represent a major, major milestone in the history of closed-loop research.
Finally, studies are beginning to look at the therapeutic benefits of short-term closed-loop control in people at the onset of diagnosis. The ultimate hope is that such treatment can preserve beta cell function and improve future glycemic control. In an exciting presentation at ADA, Dr. Stuart Weinzimer shared early results from a TrialNet and DirecNet study that puts patients on three to four day inpatient hybrid closed-loop control within one week of diagnosis. Patients will be followed for the next two years, but preliminary results show that those receiving closed-loop control within one week of diagnosis spent 85% of time within the target blood glucose range (71-180 mg/dl) and achieved mean glucose levels of 138 mg/dl by day three of the study. Case studies of patients also demonstrate that glycemic control is still excellent even months after hybrid closed-loop therapy. If the study indeed turns out to preserve beta cell function, it may fundamentally change the early treatment of new-onset type 1 diabetes. --AB
