Young Children Gain Glycemic Control in Artificial Pancreas Study

A small study of elementary school-age children with type 1 diabetes (T1D) has shown that an artificial pancreas system can offer better control of blood glucose levels with fewer cases of hypoglycemia.

The study from researchers at the University of Virginia—one of the world’s leading sites for research on this technology—found that a dozen children ages 5 to 8 spent more time in range when using the system, which connects an insulin pump and continuous glucose monitor (CGM) through an algorithm to automatically dispense the right amount of insulin.

Results were presented by Mark DeBoer, MD, MSc, MCR, an associate professor at the University of Virginia, at the recent meeting of the Endocrine Society in Orlando, Florida. In the study, children using the artificial pancreas technology kept their blood glucose in range 73% of the time, compared with 47% with usual home care. The target range for blood glucose was 70 to 180 mg/dL.

The children also cut the amount of time with high blood glucose levels in half—those using the technology were above 180 mg/dL only 25.8% of the time, compared with 51.5% for those with usual care.

“Up until now, parents and doctors have had to decide how much insulin to give young children throughout the day to avoid dangerously low or high blood sugars,” DeBoer said in a statement.

Earlier work has shown that artificial pancreas systems are safe and effective for adults and teenagers with T1D. The first FDA-approved system, the Medtronic’s MiniMed 670G, will start shipping to priority access customers in June 2017.

While the study was small, DeBoer said it shows promise for the technology’s use in young children. “In the future, this type of technology is likely to become the standard of care for type 1 diabetes control for children in this age range.”

Young children reaching school-age are in particular need of more reliable diabetes management technology, as many school systems create barriers to these children to participate in sports or school functions that involve food, despite laws against these practices. Many elementary schools no longer have a school nurse, and there have been several civil rights cases in recent years against districts that try to pull children from their neighborhood school to one with a nurse.

A study in Diabetes Care last year asked parents about their acceptance of an artificial pancreas system after their young children took part in a trial for a new device at summer camp. The study found that 70.5% of the parents found the technology easy to use and 67% felt it was useful in improving glucose control. Almost all (94%) intended to use the artificial pancreas technology long term.