http://www.medpagetoday.com/MeetingCoverage/ADA/40027
CHICAGO -- An insulin pump that takes a break when the looped-in, continuous glucose monitor detects low glucose levels reduced nighttime hypoglycemia and prevented serious events, according to results of the ASPIRE trial in type 1 diabetes.
Action Points
An insulin pump that shuts off when the looped-in, continuous glucose monitor detects low glucose levels reduced nighttime hypoglycemia and prevented serious events.
Note that the insulin pump was not associated with increasing glycated hemoglobin values.
The mean severity and duration of nocturnal hypoglycemia fell by 38% as measured by area-under-the-curve compared with the same device without the software (P<0.001), Richard Bergenstal, MD, of the International Diabetes Center at Park Nicollet in St. Louis Park, Minn., and colleagues found. Overall glucose control didn't suffer, they reported here at the American Diabetes Association meeting and simultaneously online in the New England Journal of Medicine.
No severe hypoglycemia occurred with devices set to suspend insulin dosing for 2 hours after hitting the 70 mg/dL glucose threshold compared with four events among patients whose pumps did not have the extra programming.
"That's probably one of the first studies ever to show no severe hypoglycemia," Bergenstal told reporters at a press conference.
"This idea of automating insulin, putting some 'brains' in the pump, is really something worth continuing to explore," he added. "This is the beginning."
These findings with the new feature, part of the MiniMed 530 G system now under FDA review, might actually make patients more willing to try more aggressive therapy, suggested press conference moderator Anne Peters, MD, of the University of Southern California in Los Angeles.
"Hypoglycemia is their limiting step, it's what makes them afraid of tight glycemic control," she commented in an interview with MedPage Today. "Reducing it, and even the perception that you have less, will make people potentially feel more confident, and I really think that matters."