Even more works by Professor David O’Neal and the D.T.R.G featured in
the limbic, the premier medical news site.
Written by Mardi Chapman, this piece discusses multiple projects our amazing team has collaborated on, including the REGENT-1 Study, the Sensor Line Combo Study, and our Renal HCL Study among others.
Mardi Chapman’s latest piece can be found below
The latest diabetes technologies focus on user acceptance
By Mardi Chapman
Novel devices and procedures are promising further improvement in the management of diabetes, according to early research presented at the 2023 ADA Scientific Sessions.
Endocrinologist Professor David O’Neal, Director of the Diabetes Technology Research Group at the University of Melbourne, spoke to the limbic about some of the presentations from his team.
Combined glucose sensing and insulin delivery
Professor O’Neal said while there was still room for improvement with glucose control in type 1 diabetes, the fundamental issues had been addressed and there was now more focus on the interface between the person with diabetes and their devices.
“We’re now seeing a situation where we are improving glucose control with tight targets … HbA1c less than 7%. Basically most of the closed loop systems now are consistently hitting targets of more than 70% time-in-range and minimising hypoglycemia at the same time.”
“The bigger room for improvement is ensuring that the people using these devices are happy with them and it suits their needs … rather than us telling them what their needs are,” he said.
Data presented at ADA involved a prototype subcutaneous cannula combining glucose sensing and insulin infusion tested in 24 adults on insulin pump therapy.
Professor O’Neal said previous barriers to this technology had included the preservatives in insulin causing glucose spikes as well as the glucose sensor and the insulin delivery cannula requiring replacement after different lengths of time.
“What Pacific Diabetes Technologies [link here] have now developed is a new approach to glucose sensing where it’s a single needle going in with the sensor in the wall of the cannula.”
“What we’ve shown with this feasibility study is that the cannula delivers insulin reliably and there’s no drop off in insulin delivery over four days. The results obtained from the sensor in the investigational device were just as good as those results obtained from a current commercially available sensor,” he said.
And combining a glucose sensor and insulin delivery together in one needle would significantly reduce the burden of care in people living with type one diabetes, Professor O’Neal added.
Tubeless insulin ‘patch’ pump
Data was also presented at ADA on the Omnipod DASH Insulin Management System [link here], a tubeless insulin pump controlled by a handheld device.
Professor O’Neal said it was significantly less intrusive than having a tethered insulin pump with tubes.
The Victorian study compared patients, either on MDI or tube pumps, randomised to remain on their usual care or crossover to the patch pump.
“And essentially what it showed very nicely across a number of metrics of user satisfaction, whether it be the Diabetes Technology Questionnaire or the System Usability Scale, was a marked preference for the patch pump,” he said.
People on multiple daily injections found they could more finely titrate their insulin, while the people on tube devices had a device that was easier to use and less intrusive.
There was also a minor improvement in glucose control, but Professor O’Neal stressed that was not the primary endpoint of the study.
Investigational procedure for type 2 diabetes
The ADA meeting also heard about early research on endoscopic re-cellularisation via electroporation therapy [link here to Endogenex] to restore impaired duodenal signalling that adversely impacts glucose control in type 2 diabetes.
Professor O’Neal stressed the research was proof-of-concept only, yet the early results were promising.
The study comprised 30 adults, with HbA1c 7.5-11.0% while on one to four non-insulin glucose-lowering medications, who received a single or double application of pulsed energy.
The study reported ‘clinically meaningful changes in metabolic control’.
“The results we’ve seen are promising in times of time in glucose rage and HbA1c, but bear in mind this is not definitive proof. What we’ve shown is that the procedure is feasible and it’s safe… but we can’t make any claim that this is going to help people with type two diabetes at this stage until the randomised controlled studies are performed,” Professor O’Neal said.
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