Department of Mechanical Engineering, Centre for Bioengineering, University of Canterbury, 20 Kirkwood Avenue, Christchurch, 8041, New Zealand.
Department of Paediatrics, University of Otago, Christchurch, New Zealand.
BMC Endocr Disord. 2024 Aug 1;24(1):134. doi: 10.1186/s12902-024-01652-y.
Use of Continuous Subcutaneous Insulin Infusion (CSII) has been shown to improve glycemic outcomes in Type 1 Diabetes (T1D), but high costs limit accessibility. To address this issue, an inter-operable, open-source Ultra-Low-Cost Insulin Pump (ULCIP) was developed and previously shown to demonstrate comparable delivery accuracy to commercial models in standardised laboratory tests. This study aims to evaluate the updated ULCIP in-vivo, assessing its viability as an affordable alternative for those who cannot afford commercially available devices.
This first-in-human feasibility study recruited six participants with T1D. During a nine-hour inpatient stay, participants used the ULCIP under clinical supervision. Venous glucose, insulin, and β-Hydroxybutyrate were monitored to assess device performance.
Participants displayed expected blood glucose and blood insulin levels in response to programmed basal and bolus insulin dosing. One participant developed mild ketosis, which was treated and did not recur when a new pump reservoir was placed. All other participants maintained β-Hydroxybutyrate < 0.6 mmol/L throughout.
The ULCIP safely delivered insulin therapy to users in a supervised inpatient environment. Future work should focus on correcting a pump hardware issue identified in this trial and extending device capabilities for use in closed loop control. Longer-term outpatient studies are warranted.
The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623001288617) on the 11 December 2023.
持续皮下胰岛素输注(CSII)已被证明可改善 1 型糖尿病(T1D)的血糖控制效果,但高昂的成本限制了其可及性。为了解决这个问题,我们开发了一种可互操作的开源超低成本胰岛素输注系统(ULCIP),并在之前的标准实验室测试中已证明其输送精度可与商业模型相媲美。本研究旨在评估该更新后的 ULCIP 的体内性能,评估其作为无法负担商业设备的患者的经济实惠替代方案的可行性。
这是一项首次人体可行性研究,招募了六名 T1D 患者。在为期 9 小时的住院期间,参与者在临床监督下使用 ULCIP。监测静脉血糖、胰岛素和β-羟丁酸,以评估设备性能。
参与者对程控基础和推注胰岛素剂量表现出预期的血糖和胰岛素水平。一名参与者出现轻度酮症,经治疗后放置新的泵储液器后未再复发。所有其他参与者的β-羟丁酸均保持在<0.6 mmol/L。
ULCIP 在监督下的住院环境中安全地为使用者提供胰岛素治疗。未来的工作应集中于纠正本试验中发现的泵硬件问题,并扩展设备功能以用于闭环控制。需要进行更长期的门诊研究。
该试验于 2023 年 12 月 11 日在澳大利亚新西兰临床试验注册中心(ACTRN12623001288617)前瞻性注册。