Digital health breakthrough with automated insulin delivery in hospital trials
Recent research indicates that the combination of automated insulin delivery and continuous glucose monitoring could be an effective method for regulating blood sugar levels in hospitalised adults suffering from diabetes.
A collaborative study from Emory University, Stanford University, and the University of Virginia recently published in Diabetes Technology & Therapeutics, involved the utilisation of the Omnipod 5 insulin delivery system in conjunction with the Dexcom G6 continuous glucose monitor (CGM). Over a period of 10 days, 18 hospitalised adult patients with diabetes were observed. On average, during their hospital stay, the participants’ glucose levels remained within the desired range 68% of the time. Notably, these participants utilised the automated insulin delivery system for about 95% of the trial duration.
Dr. Francisco Pasquel, from Emory University School of Medicine, highlighted the study’s implications. He stated, “The combination of an automated insulin delivery system with features suitable for hospital settings, together with real-time remote continuous glucose monitoring, offers a promising approach to optimise glucose management in hospitals. This could substantially reduce the risk of hypoglycemia.”
For this study, participants were adults, 18 years or older, with either type 1 or type 2 diabetes. They were already on insulin therapy upon being admitted to the hospital. Trained medical staff and the research team utilised the automated system and the CGM to regulate each participant’s glucose levels for up to 10 days or until their discharge. The trial also included comparing the CGM’s accuracy with conventional blood glucose tests. Various data points, including medication consumption, blood components, CGM data, and insulin delivery specifics, were meticulously gathered.
By the study’s conclusion on August 8, 2022, 18 adults had participated fully. Out of these, 16 had over 48 hours of active CGM data, which was used for further glycemic analysis. The average blood sugar level recorded was 167 mg/dL. Interestingly, the daily average insulin delivery was 0.21 U/kg, while the total daily insulin dosage averaged at 0.41 U/kg. Participants also suspended insulin for approximately 20% of the time, and there were no occurrences of severe hypoglycemia or diabetic ketoacidosis.
A survey filled out by 16 participants at the end of the study revealed their experiences. All respondents were in favour of using the automated system for managing their glucose levels during their hospital stay. An impressive 94% even expressed a desire to use the system at home. However, 38% found the necessity of using finger sticks for verifying CGM data cumbersome, with 19% showing a preference for solely relying on the CGM.
The research team acknowledged certain limitations to their study, such as the limited participant number and the study’s design. They pointed out that the hands-on approach by the study’s investigators and nurses might not be easily replicated in typical hospital settings. The team advocated for more comprehensive research with randomised controlled trials to validate these preliminary findings and to better understand the broader applicability and effectiveness of automated insulin systems in varied settings.
