Alternative methods of maintaining glycemia in patients with diabetes

Diabetes mellitus of the 1st type of endocrine autoimmune disorder involving destruction of pancreatic cells. This is manifested by decreased production of insulin, and as a result, a chronic increase of glucose level in the blood. Unlike diabetes of the 2nd type, this type of diabetes often affects young patients.

Treatment of diabetes of the 1st type is aimed at compensation of metabolic disorders, prevention of hyperglycemia and prevention of complications of diabetes. Since the middle of last century for control of the disease are used an insulin pump. During this time, they have undergone significant changes and today are high-tech devices approaching the size of a smartphone.

Major breakthrough of recent years in diabetology is the creation of systems of “closed loop”. They consist of an insulin pump, the device of continuous control of glycemia and computer or app to your smartphone based on the intelligent algorithm of insulin. It is now believed that such systems can significantly improve glycemic control and quality of life in patients with diabetes.

A meta-analysis, published in the latest issue of the journal The BMJ, (https://www.bmj.com/content/361/bmj.k1310) is devoted to a review of studies examining the efficacy and safety of systems “closed loop” in patients with diabetes of the 1st type. Although the first system is “closed loop” was approved by the FDA only in 2016, to work managed to pick up 41 study, involving more than 1,000 participants.

It turned out that patients using the system “closed loop”, which is 9,6% more likely to have normal values of blood glucose than the comparison group. This is equivalent which is equivalent to an additional 140 minutes normal glycemia during the day. The most significant differences appeared at night, when the risk of change of glucose level is the greatest. The frequency of episodes of hyperglycemia were also lower in the “closed loop”.

The obtained results confirm the effectiveness of the systems “closed loop” in patients with diabetes mellitus of the 1st type. At the same time, it is too early to talk about the impact of the use of such systems on outcomes of the disease. It is expected that assessment of the outcomes will be a focus of further research. In addition, no research has evaluated the effectiveness of such systems in patients younger than 5 who are most in need of simplification of the control of glycemia.

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