We are interested in using diabetes technology to improve life in people with diabetes and related conditions. Specifically we are developing and clinically testing the artificial pancreas in various populations. The artificial pancreas consists of a subcutaneous glucose monitor, a control algorithm, and an insulin pump. Our work includes the development of computer-based simulations for pre-clinical evaluation and optimisation of the artificial pancreas.
Plain English Summary of Research
Type 1 diabetes is one of the most common chronic diseases in children. Paediatric surveys report a rapid increase in number of cases. Type 1 diabetes is associated with life-long dependency on insulin administration. Poor glucose control during adolescence and young adulthood leads to an increased risk of diabetes Complications, e.g. eye, heart, kidney disease. Episodes of very low glucose levels are a major complications preventing near-normal glucose control. For many adults, youth and parents/carers, the fear of low glucose levels is often greater than the fear of long-term complications leading to elevated glucose levels.
Our research builds on recent technological advances. Use of insulin pumps is increasing. In adults, insulin pumps have been shown to improve overall glucose control and reduce the occurrence of severe hypoglycaemia, as compared to multiple daily injection therapy. Adults, young people and their families are becoming increasingly familiar with insulin pumps and many have integrated pumps into their daily practice. A more recent technology, real-time continuous glucose monitoring, enables greater understanding of glucose excursions, provides low and high glucose alarms, and facilitates more responsive insulin dose adjustments.
We develop and test the artificial pancreas which is an emerging technology promising to transform management of type 1 diabetes. The artificial pancreas delivers automatically insulin according to real-time sensor glucose levels, combining glucose sensor, insulin pump and a control algorithm, to achieve as much as possible functionality of a heathy pancreas. We also apply the artificial pancreas in type 2 diabetes when patients are hospitalised for diabetes-related or other reasons on the general ward.
Bally L, Thabit H, Kojzar H, Mader JK, Qerimi-Hyseni J, Hartnell S, Tauschmann M, Allen JM, Wilinska ME, Pieber TR, Evans ML, Hovorka R. (2017). Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study. Lancet Diabetes Endocrinol. 2017 Apr;5(4):261-270. doi: 10.1016/S2213-8587(17)30001-3. Epub 2017 Jan 14. PMID:28094136.
Thabit H, Hartnell S, Allen JM, Lake A, Wilinska ME, Ruan Y, Evans ML, Coll AP, Hovorka R. (2017). Closed-loop insulin delivery in inpatients with type 2 diabetes: a randomised, parallel-group trial. Lancet Diabetes Endocrinol. 2017 Feb;5(2):117-124. doi: 10.1016/S2213-8587(16)30280-7. Epub 2016 Nov 9. PMID:27836235.
Tauschmann M, Allen JM, Wilinska ME, Thabit H, Acerini CL, Dunger DB, Hovorka R. (2016). Home Use of Day-and-Night Hybrid Closed-Loop Insulin Delivery in Suboptimally Controlled Adolescents With Type 1 Diabetes: A 3-Week, Free-Living, Randomized Crossover Trial. Diabetes Care. 2016 Sep 9. pii: dc161094. [Epub ahead of print]. PMID:27612500.
Stewart ZA, Wilinska ME, Hartnell S, Temple RC, Rayman G, Stanley KP, Simmons D, Law GR, Scott EM, Hovorka R, Murphy HR. (2016). Closed-Loop Insulin Delivery during Pregnancy in Women with Type 1 Diabetes. N Eng J Med. 2016 Aug 18;375(7):644-54, doi: 10.1056/NEJMoa1602494. PMID:27532830.
Thabit H, Tauschmann M, Allen JM, Leelarathna L, Hartnell S, Wilinska ME, Acerini CL, Dellweg S, Benesch C, Heinemann L, Mader JK, Holzer M, Kojzar H, Exall J, Yong J, Pichierri J, Barnard KD, Kollman C, Cheng P, Hindmarsh PC, Campbell FM, Arnolds S, Pieber TR, Evans ML, Dunger DB, Hovorka R; APCam Consortium; AP@home Consortium. (2015). Home Use of an Artificial Beta Cell in Type 1 Diabetes. N Engl J Med. 2015 Nov 26;373(22):2129-40. doi: 10.1056/NEJMoa1509351. Epub 2015 Sep 17. PMID:26379095. PMCID:PMC4697362.
Artificial Pancreas, Type 1 Diabetes, Type 2 Diabetes, Insulin Therapy, Modelling, Simulations
JDRF, Diabetes UK, Helmsley Trust, H2020, NIDDK, NIHR, NIH, FP7