Artificial pancreas shows promise for type 1 diabetes patients undergoing kidney dialysis

For the first time, an automated insulin delivery system has been tested in people with type 1 diabetes and end-stage renal disease, finding that the system is safe and effective in improving patients' blood sugar control.

Automated Insulin The delivery system (also called an artificial pancreas) Insulin pumps Continuous glucose monitoring (CGM) systems and Control Algorithm These work together to automatically administer the right amount of insulin based on blood sugar levels.

This technology has been proven to improve blood sugar levels and quality of life for people with diabetes, but for some people, such as those with end-stage kidney disease (ESKD) who require hemodialysis, it can be difficult to use.

This is due to the disease and the effects of renal replacement therapy, which causes problems with removing insulin and also affects blood sugar levels.

Despite these associated risks, little is known about whether automated insulin delivery is safe and effective for people with type 1 diabetes and ESKD. A new study led by Dr Janaka Karalliedde and colleagues from Guy's and St Thomas' Hospital tested this for the first time in four people with type 1 diabetes undergoing haemodialysis for ESKD.

Follow-up of the patients four and a half months later showed significant improvements in key indicators of glycemic control, demonstrating the safety of the technology.

Published in Diabetes Research and Clinical PracticeResults showed that patients spent significantly more time within the target range. Blood glucose levels My blood levels went down and I spent less time within my target range. I also saw my average blood sugar levels, my daily insulin dose, and my overall blood sugar levels drop. glucose Control index scores were not considered statistically significant.

Current research on people with diabetes and ESKD focuses almost exclusively on type 2 diabetes, leaving significant gaps in our understanding of how effective and safe the use of automated insulin delivery devices is for type 1 diabetes.

Among people with type 1 diabetes, those with end-stage renal disease have the highest rates of hospitalization and emergency department visits due to glycemic emergencies. Due to these factors, previous research and algorithm development for automated insulin dosing has not considered the experiences of these individuals and other high-risk groups with diabetes.

“These early results are promising and highlight the urgent need for further research into diabetes technologies for people with diabetes. Renal failure This is an area of ​​research that is often underrepresented. We hope this study is a first step towards conducting studies using larger, real-world data that can help better identify how automated insulin can be used. delivery a system to support people with both type 1 diabetes and ESKD,” said Dr Karaliedo, clinical lead in diabetes and cardiovascular disease.