June 22-26, 2018 marked the American Diabetes Association’s 78th Scientific Sessions, taking place in Orlando Florida. Each year, the ADA conference brings together scientists, researchers, endos, clinicians, the diabetes industry and advocates to share in learning from the best of the best. Through 3000 original research presentations over 5 days, there’s a lot to absorb. We were there to learn all we could about the latest in Type 1 diabetes.
We wanted to take some time to share the things that we think you, the Type 1 community, should keep your eyes on, things we found interesting, and things that created buzz. Watch for updates in the coming days outlining the latest in drugs, devices, and education in this 4-part series.
OMNIPOD HORIZON HYBRID CLOSED-LOOP SYSTEM
WHAT’S NEW
Here, researchers saw adults with Type 1 wear Omnipod’s Horizon system in real-world(ish) conditions (note: they lived in a hotel for a week. I don’t know we can call that real-world, but okay…). Adults wore the system for 5 days, ate whatever they wanted, and exercised for 30 minutes each day. This was compared to a 1-week period of each person’s diabetes management while on their usual systems (injections or pump, plus CGM.) The Horizon system consisted of an Omnipod system, but utilized new closed-loop algorithms to allow for automated dosing adjustments through the day. The study showed more time spent in range and fewer hypos than on traditional therapy.
LET’S MAKE THAT SIMPLE
If you haven’t seen the Omnipod system, check it out so you have some context. Basically, we’re talking about a tubeless pump that is controlled by a remote (called a PDM), as well as a Continuous Glucose Monitor (CGM). The new Horizon system uses formulas that smart scientists out there have made that tell the Pod to give you insulin when a sensor predicts a high and reduce your basal when you’re trending low. This study found that you’re low less often and in range more often when using the system, in comparison to using your regular day-to-day diabetes devices.
SHOW US THE SCIENCE
A total of 11 adults with Type 1 diabetes participated in this trial. They ate as they wished, bolused as they normally would, and excised moderately for at least 30 minutes per day. Participants monitored their BGs for the study for 7-days prior to wearing the Horizon system and participated using closed-loop for 5-days. Time in range (between 3.9 and 10.0 mmol/L) was 11% higher during the closed-loop conditions (73% vs 62%.)
SO WHAT?
This is another study to show the benefits of closed-loop systems, and the direction of diabetes devices, in general. It’s a neat chance to see where OmniPod may be heading and to see some of their future products in use.
CLOSED-LOOP VERSUS OPEN-LOOP DEVICES
WHAT’S NEW
This study looked at whether a closed-loop system (think pump, sensor, and phone-like device that can make automatic adjustments to insulin dosing based on BG trends) would be more effective for diabetes management than an open-loop system (think, pump and sensor with manual bolusing and corrections). The study showed increased time in range on a closed-loop system versus an open-loop system with no increase in low BGs.
LET’S MAKE THAT SIMPLE
If you’re currently using a sensor and an insulin pump, think of that as an open-loop system. You still have to keep on an eye on BGs, listen for CGM alarms, and set temporary basal rates depending on more factors than we could list here. A closed-loop system can make many decisions for you. For example, it can know that you’re going high based on predictive algorithms (read: formulas) and make small adjustments in your dosing in response. These researchers found that on a totally automated system (Diabeloop) people spent more time (69%) in range (between 3.9 and 10.0 mmol/L).
SHOW US THE SCIENCE:
- 68 adults with Type 1 participated in the trial.
- They were split between 2 groups: open- or closed-loop.
- Groups used the system for 12 weeks.
- Each group got to participate in both conditions.
SO WHAT?
It looks like we’ll stay on the path of moving towards closed-loop systems. We have heard from the community that trusting devices to make these kinds of decisions for us is scary. This is one step in helping us to better understand how these systems work. More time in range and fewer lows? We think we’re on the right track!
DUAL HORMONE ARTIFICIAL PANCREAS
WHAT’S NEW
One Canadian-based study showed a significant increase in time in range for individuals using a dual-hormone Artificial Pancreas (AP) system when compared to a regular, insulin-only AP system.
LET’S MAKE THAT SIMPLE
This study puts individuals on a pump system that not only injects insulin, but also the drug Pramlintide, which is an amylin analog (a manufactured version of a hormone). Amylin is a hormone produced by our bodies after we eat to help control blood glucose (BG) levels. Except, not in our bodies – If you have Type 1, your body doesn’t make amylin, either.
SHOW US THE SCIENCE:
A total of 12 people participated in this trial. They were split between 3 groups:
- 1 group used an insulin-only AP
- 1 group used a dual-hormone AP
- 1 group used an AP with Regular (like actually Humulin R-style) insulin.
The dual-hormone group spent 85% of their time in range (between 3.9 and 10.0 mmol/L). The insulin-only group spent 71% of time in range. The third group isn’t worth mentioning (read: we won’t be using Regular insulin in our pumps any time soon!) There was no increased risk of hypoglycaemia on the system.
SO WHAT?
We’ll keep our eye on the development of dual-hormone pumps, similar to Beta Bionic’s iLet. There may be room in the future for us to begin to replace more than just insulin while striving for increased time in range!
UP NEXT…
In Part 2 and 3 of this series, we’ll share highlights from the latest in diabetes devices. Next post will include updates on the Tandem BasalIQ, Medtronic’s Guardian Connect system, and will provide a product highlight on the research around the new Omnipod DASH. Stay tuned!
Disclaimer: Please check out CIM’s Partners Page to learn more about the companies we work with. This post was not paid for and does not represent sponsored content, but it’s important to recognize that we may be biased based on the fact that some companies highlighted below support CIM in different ways. We still thought this info was important for you to know about.
