Automated glycemic control with a bionic pancreas for type 1 diabetes mellitus: A systematic review and meta-analysis

Puguh Oktavian; David Setyo Budi; Idznika Nurannisa Wibowo; Reyna Cesariyani Rahmadianti Rusuldi; Avianita Dewi Kusumawardhani; Ifan Ali Wafa; Hamzah Rafly Rahman; Nando Reza Pratama; Sony Wibisono Mudjanarko

doi:10.1016/j.dsx.2023.102847

Automated glycemic control with a bionic pancreas for type 1 diabetes mellitus: A systematic review and meta-analysis

Diabetes Metab Syndr. 2023 Sep;17(9):102847. doi: 10.1016/j.dsx.2023.102847. Epub 2023 Aug 23.

Authors

Puguh Oktavian¹, David Setyo Budi¹, Idznika Nurannisa Wibowo¹, Reyna Cesariyani Rahmadianti Rusuldi¹, Avianita Dewi Kusumawardhani¹, Ifan Ali Wafa¹, Hamzah Rafly Rahman¹, Nando Reza Pratama², Sony Wibisono Mudjanarko³

Affiliations

¹ Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia.
² Nuffield Department of Medicine, University of Oxford, United Kingdom.
³ Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Soetomo General Academic Hospital, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia. Electronic address: sony.wibisono@fk.unair.ac.id.

PMID: 37639999
DOI: 10.1016/j.dsx.2023.102847

Abstract

Background and aims: The use of a bionic pancreas with automated insulin delivery systems to prevent complications of diabetes mellitus shows conflicting results. We aimed to comprehensively discuss the potential use of a bionic pancreas in patients with type 1 diabetes (T1D).

Methods: A systematic database search was conducted on October 24, 2022, for articles investigating the use of a bionic pancreas in patients with T1D. The hemoglobin A1c (HbA1c) level, mean glucose level, glucose coefficient of variability, time-in-range (TIR), and adverse events were investigated.

Results: Nine studies were included in this review. The data from these studies suggested that the use of a bionic pancreas could reduce the HbA1c (mean difference [MD] = -0.40% [95% confidence interval {CI} = -0.59 to -0.21], I² = 0%, p < 0.0001) and mean glucose levels (MD = -21.06 [95% CI = -24.66 to -17.46], I² = 45%, p < 0.00001) and improve the TIR (MD = 14.41% [95% CI = 10.99 to 17.83], I² = 60%, p < 0.00001). The most common adverse events reported were nausea and vomiting.

Conclusions: The use of a bionic pancreas shows potential in preventing complications of T1D by improving the TIR and decreasing the HbA1c and mean glucose levels. Furthermore, serious adverse events with the use of a bionic pancreas and standard of care show insignificant results, suggesting a good safety profile.

Keywords: Automatic glycemic control; Bionic pancreas; Continuous glucose monitoring; Diabetes mellitus; Time-in-range.

Publication types

Review