Automated glycemic control with the bionic pancreas in cystic fibrosis-related diabetes: A pilot study

Abstract

Cystic fibrosis-related diabetes (CFRD) is the most common extrapulmonary manifestation of cystic fibrosis. The current standard of care for CFRD involves treatment with insulin, typically via multiple daily injections. We conducted a small pilot study comparing usual care with automated glycemic control using the bihormonal (insulin and glucagon) and insulin-only configurations of the bionic pancreas. Both configurations of the bionic pancreas achieved good glycemic control, with mean glucose levels <150 mg/dl and minimal hypoglycemia. Subjects reported improved treatment satisfaction and reduced burden of diabetes management with the bionic pancreas. Further investigation of automated glycemic control in the treatment of CFRD is warranted.

Keywords: Automated glycemic control; Bionic pancreas; Closed loop; Continuous glucose monitor; Cystic fibrosis; Cystic fibrosis-related diabetes; Glucagon; Insulin.