Artificial Pancreas Helps Manage Blood Sugar in Children with Diabetes

Control-IQ — an artificial pancreas system originally developed by the University of Virginia Center for Diabetes Technology — helps young children with type 1 diabetes maintain their blood sugar levels longer than children not using the system.

Type 1 diabetes occurs when the pancreas doesn’t produce insulin or only produces it in small amounts. The condition usually develops in children and requires daily management with insulin injections to maintain healthy blood sugar levels.

For children with diabetes, controlling blood sugar levels throughout the day can be challenging. The process involves keeping track of foods eaten, monitoring blood sugar frequently, and taking the appropriate insulin dosage to ensure blood sugar remains stable. Most often, parents shoulder the responsibility of these management tasks.

Moreover, if diabetes is not properly managed, it can lead to hypoglycemia or low blood sugar. In addition, poorly controlled diabetes can cause ketoacidosis — a life threatening complication that happens when blood sugar levels rise too high.

However, in a study published on March 16 in The New England Journal of Medicine, scientists found that the FDA-approved Control-IQ artificial pancreas system improved blood sugar control in children ages two to six. Specifically, study participants who used the device remained within their targeted blood sugar range more often than those not using the system.

Control-IQ is a device developed at the University of Virginia Center for Diabetes Technology and manufactured by Tandem Diabetes Care that monitors blood sugar levels and uses algorithms to adjust insulin delivered through an insulin pump.

To conduct the research, scientists recruited 102 children aged two to six with type 1 diabetes. Sixty-eight participants received the Control-IQ system for 13 weeks, and 34 children maintained their usual diabetes management routines.

The team found that the children with the artificial pancreas spent three more hours a day in their target blood sugar range than those that did not use the system. Most notably, the artificial pancreas helped stabilize blood sugar levels during the overnight hours.

Although the participants and their families could use the device safely overall, adverse events included two cases of severe hypoglycemia in the participants using the artificial pancreas and one case in those not using the system. In addition, the failure of a small plastic tube that delivers insulin into the body caused one Control-IQ participant to experience diabetic ketoacidosis.

However, most study-related training sessions and visits were completed virtually, which means the Control-IQ system could be a potential diabetes management tool for people without access to endocrinologists.

In a UVA Health news release, lead investigator Marc D. Breton, Ph.D., a UVA School of Medicine researcher, says, "at the end of the day, this technology significantly improved glycemia and ensured safety of our youngest patients, but perhaps just as importantly it lessened these families’ constant anxiety about glucose levels, especially during the night."

Breton also notes, "it is incredibly rewarding for us to hear about these families’ experiences and how they manage to integrate these new tools in their life, offering some reprieve to the challenges they face."