Type 1 diabetes is one of the most common chronic diseases in children; around one in 4,000 children under 14 years of age is diagnosed with the disease each year in the UK. The disease causes the pancreas to stop producing sufficient insulin to regulate blood sugar (glucose) levels, and poor glucose control can lead to complications including eye, heart and kidney disease. Episodes of very low glucose levels can cause serious complications and may be life threatening.
People affected by the condition have to manage their condition through long term treatment. This usually involves regular insulin injections – in some cases, several times a day. However, a team at the University of Cambridge and Cambridge University Hospitals hopes to replace these treatments with an artificial pancreas, a small, portable medical device designed to carry out the function of a healthy pancreas in controlling blood glucose levels, using digital technology to automate insulin delivery. The system is worn externally on the body, and is made up of three functional components: continuous glucose monitoring, a computer algorithm to calculate the insulin dose, and an insulin pump.
The artificial pancreas promises to transform management of type 1 diabetes. Several trials have already shown that it is effective for use both school children and adults in the home environment, and last year saw the first natural birth to a mother fitted with an artificial pancreas. However, there has as yet been no research into its use by young children at home.
Now, KidsAP, a collaboration led the University of Cambridge and involving institutes across Europe and in the US, has received a €4.6millon under the European Commission’s Horizon 2020 programme to carry out a trial of the artificial pancreas among children aged one to seven years with type 1 diabetes. Cambridge has received a €1.6m share of the grant to act as coordinator of the project.
“We’ve already seen that the artificial pancreas can have a very positive effect on people’s lives and now, thanks to funding from the European Commission, we can see whether young children will also see these same benefits,” said Dr Roman Hovorka from the Department of Paediatrics at the University of Cambridge and Addenbrooke’s Hospital, who is leading the project. “At the moment, children have to have frequent insulin injections that are at best inconvenient, but at worst painful. We hope this new technology will eliminate this need.”
An initial pilot of 24 children, the main study will split 94 children into two groups: one will be treated over a year by the artificial pancreas and the other half by state-of-the-art insulin pump therapy, already used by some adults and teenagers. The researchers will measure quality of life and investigate the impact of the two approaches on the children’s daily life, as well as looking at which is the more effective, and cost-effective, approach.
“If the artificial pancreas is shown to be more beneficial than insulin pump therapy, then we expect that it will change how type 1 diabetes is managed both nationally and internationally, with a much improved quality of life for young children,” added Professor David Dunger, collaborator on the project.
An international trial to test whether an artificial pancreas can help young children manage their type 1 diabetes will begin next year, thanks to a major grant awarded by the European Commission.
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