Dr Eda Cengiz Explains Artificial Pancreas Systems' Implications for Patients and Clinicians
Hybrid closed-loop insulin delivery systems, also referred to as an artificial pancreas, can help improve the management of diabetes while researchers seek a cure, as well as provide reassurance for patients and their families, according to Eda Cengiz, MD, MHS, FAAP, associate professor of pediatrics at Yale School of Medicine.
Transcript (slightly modified) The FDA approved the MiniMed 670G closed loop system in September 2016. What are the implications of this approval for patients and physicians?
Diabetes is not an easy disease, and it keeps you busy with blood sugar checks. You have to think about carbohydrate counting, you have to check your blood sugar patterns. The whole idea about this system is we’re trying to give people a break and let the system do some of the work so they don’t have to think about diabetes as much and they can enjoy their lives. For people with diabetes, I think this is going to be an amazing opportunity to utilize technology to take away some of the burden of diabetes management.
Another major advantage is while it’s taking away some of the burden, it’s also a safe system. At night, the blood sugar control is outstanding. None of the clinicians, I’m a clinician myself, we’re not that good. We cannot adjust insulin dose every night for each patient and optimize it in a way that they will have blood sugars throughout the night. A lot of people worry about low blood sugars in the middle of the night, but if you have a system adjusting insulin and checking glucose patterns every 5 minutes, that’s amazing. That’s how you can achieve almost perfect control overnight and you don’t have to worry about it, you can sleep through the night.
I’m a pediatric endocrinologist, so for my patient group, their parents can sleep at night. Our kiddos can go to sleepovers; they don’t have to worry about what’s going to happen with blood sugars. Their parents can actually check the system, see what’s going on, and on top of that now they have a little bit of freedom to actually do whatever they want because the system will alert them if the predicted blood sugar is going to be low at a certain time point.
Those are all benefits of it for people with diabetes. As a clinician, 70% to 80% of our patients are not within target range, and despite everything we try, we cannot even reach a 50% or a 30% improvement. But with these systems, there’s a great opportunity. If you have 70% or 80% of your patients in poor glycemic control, that translates into future complications.
While we’re trying to discover the cure for diabetes, we can’t afford to wait for a cure. In the meantime, we have to keep our patients happy, healthy, and from a clinician perspective I think artificial pancreas hybrid closed-loop systems can achieve better glycemic control and also reduce complications of future diabetes if we can keep improving blood sugar control. Our patients will be healthy until we discover the cure for diabetes, so we’re hoping that those are going to be some outcomes of hybrid closed-loop once it’s implemented widely in the clinical field.