Grant: Operating Grant

In healthy individuals, blood sugar levels are tightly controlled by 2 hormones: insulin and glucagon. Secretion of insulin, a vital hormone to reduce blood sugar, is lost in type 1 diabetes (T1D). Thus, T1D patients are currently treated by intensive insulin therapy. Hypoglycemia (low blood sugar) is frequent in T1D individuals. Hypoglycemia causes physical and psychological morbidity and sometimes leads to death. In case of hypoglycemia, patients might need glucagon, a key hormone to raise blood glucose. Poor glycemic control in T1D leads to long-term complications such as heart disease, blindness, kidney failure and amputation. We have developed a wearable artificial pancreas (WAP) that regulates sugar levels for adults with T1D. Two configurations of the WAP have been developed, one that infuses insulin and another that infuses insulin and glucagon. The systems are composed of 3 components: continuous glucose sensor (to read blood sugar changes), insulin infusion pumps (to provide insulin with or without glucagon) and an intelligent dosing method that links the sensor with the pump (to suggest dose changes to the pump based on the information provided). In a controlled environment, we have shown that the WAP improved glucose time in target by 17% while reducing hypoglycemic risk by 8-fold over 15 hours. In order to show the effectiveness of the 2 systems, we aim to compare it in 20 adults with T1D for a 60-hour in a far less controlled environment. The study will be conducted under close to free-living conditions. The participants will have the freedom in their day schedule, food intake and physical exercise. This study is an essential step leading to out-patient studies to be conducted under completely free-living conditions. The WAP has a great potential to improve patients quality of life, improve health outcomes, promote physical activities and alleviate the burden of diabetes management from the patients and their health care providers.