691-P: Closed-Loop Glycemic Control with the Insulin-Only Bionic Pancreas for the Management of Type 2 Diabetes

Abstract

Closed-loop insulin delivery has been shown to improve glycemia in patients with type 1 diabetes (T1D) but fewer studies have applied these technologies to the management of type 2 diabetes (T2D). We conducted a random-order crossover feasibility study in 5 adults with T2D who used basal and prandial insulin, comparing automated glycemic control with the insulin-only bionic pancreas (BP) to usual care (UC) in the home-use setting. Each study period was one week long. Non-insulin diabetes medications besides metformin were held during the BP arm only. The BP utilized the same control algorithms previously tested in T1D. The system was initialized with participants’ body mass only; no information on insulin requirement or regimen was provided to the BP. Participants were encouraged to enter qualitative meal announcements (“typical”, “small”, or “ large” amounts of carbohydrate) for main meals but not for snacks. The BP used a target glucose of 100 mg/dl (110 mg/dl is the minimum target previously used by the insulin-only configuration in T1D studies). There was a nominal improvement in mean continuous glucose monitor (CGM) glucose in the BP compared to UC arms (137±8 vs. 153±21 mg/dl) with similar % time Disclosure J. Sherwood: None. C. A. Balliro: Consultant; Self; Beta Bionics, Inc., Novo Nordisk. M. Hillard: None. R. Selagamsetty: Employee; Self; Beta Bionics, Inc. F. El-khatib: Employee; Self; Beta Bionics, Inc., Stock/Shareholder; Self; Beta Bionics, Inc. E. Damiano: Other Relationship; Self; Beta Bionics, Inc., Stock/Shareholder; Spouse/Partner; Beta Bionics, Inc. S. J. Russell: Advisory Panel; Self; Companion Medical, ConvaTec Inc., Consultant; Self; Beta Bionics, Inc., Novo Nordisk, Other Relationship; Self; Beta Bionics, Inc., Research Support; Self; Beta Bionics, Inc., Novo Nordisk, Zealand Pharma A/S. Funding The Leona M. and Harry B. Helmsley Charitable Trust