Project 466655

Type 1 diabetes is an auto-immune disease characterized by the loss of insulin due to the destruction of pancreatic beta cells. Dysregulated production of insulin results in elevated blood glucose levels. Consequently, individuals with type 1 diabetes require insulin replacement therapy like multiple daily injections and insulin pump therapy. Closed-loop systems, or artificial pancreas systems, are emerging therapy choices for individuals with type 1 diabetes that increase the time spent in target glucose range. These systems are made up of three components: a glucose sensor to measure blood glucose levels, an insulin infusion pump, and a dosing algorithm to adjust insulin delivery based on sensor readings. Current systems require that users input the carbohydrate content of their meals for insulin bolusing. However, accurate carbohydrate counting is a challenging and burdensome task for most patients, with an estimation error of around 20%. Pramlintide, a synthetic analog of amylin, is used as an adjunct therapy for treatment of type 1 diabetes as it can normalize post-prandial glucose levels. We will conduct a pilot study to assess the performance of a fully automated, insulin-and-pramlintide, artificial pancreas with no carbohydrate counting in adult participants compared to an insulin-alone artificial pancreas with carbohydrate-matched boluses. It will comprise of three to five 14-hour interventions in a supervised outpatient setting where participants follow their regular dietary and exercise patterns. We will recruit 10 participants currently on insulin pump therapy. This feasibility study is the first step towards achieving our goal of extending our fully automated artificial pancreas research to outpatient settings and the first of its kind in the field.