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href="/endocrinology/specialty.aspx?id=1015">Endocrinology</a> </li> <li class="tag__item"> <a class="tag__link" href="/pulmonary/specialty.aspx?id=1012">Pulmonary and Critical Care</a> </li> </ul> </div> <h1 class="content-header__heading" itemprop="name">Bionic Pancreas Improves Glycemic Control in Patients With Cystic Fibrosis-related Diabetes</h1> <div class="content-header__metadata"> <p class="content-metadata"> <span class="content-metadata__media -article">Article</span> <time class="date" datetime="2024-08-14" itemprop="datePublished">Published on August 14, 2024 </time> </p> <p data-module="share-links"> </p> <p class="citation"> Originally published in <cite itemprop="citation"><a href="https://diabetesjournals.org/care/article-abstract/47/1/101/153790/Randomized-Trial-of-the-Insulin-Only-iLet-Bionic?redirectedFrom=fulltext">Diabetes Care</a></cite> </p> </div> </div> </header> <div class="-padding--vertical -padding--horizontal"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__main"> <div class="layout-columns__main__content"> <div class="content-summary"> <h3 class="content-summary__heading">Key Findings</h3> <ul> <li>Cystic fibrosis-related diabetes (CFRD) creates unique challenges for patients and can make achieving good glycemic control difficult</li> <li>A study led by Massachusetts General Hospital researchers investigated the safety and efficacy of automated insulin delivery with the iLet bionic pancreas in adults with CFRD</li> <li>They report that, compared to usual care, the bionic pancreas improved glucose control over two weeks without an increase in continuous glucose monitoring-measured hypoglycemia</li> <li>These results suggest the bionic pancreas may be an effective therapeutic option for adults with CFRD</li> </ul> </div> <p>Up to 50% of adults with cystic fibrosis (CF) are also affected by cystic fibrosis-related diabetes (CFRD), which adds significant morbidity and treatment burden. Patients with CFRD face unique challenges with glycemic control, including pancreatic exocrine insufficiency, high caloric dietary requirements, frequent pulmonary exacerbations, and systemic glucocorticoid treatment.</p><div class="article__signup-container"> <div class="email-signup-inline__container -background--white"> <style> #email-signup-inline { /* 540px */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } @media only screen and (-webkit-min-device-pixel-ratio: 2), only screen and (min--moz-device-pixel-ratio: 2), only screen and (-moz-min-device-pixel-ratio: 2), only screen and (-o-min-device-pixel-ratio: 2/1), only screen and (min-device-pixel-ratio: 2), only screen and (min-resolution: 192dpi), only screen and (min-resolution: 2dppx) { #email-signup-inline { /* 1080 width */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } } </style> <div class="content-container -width--wide -centered email-signup-inline__wrapper" id="email-signup-inline"> <div class="email-signup-inline__logo"> <img alt="Massachusetts General Hospital building" src="/assets/logos/logo-white.svg"> </div> </div> <div class="email-signup-inline"> <h3 class="email-signup-inline__heading">Subscribe to the latest updates from Endocrinology Advances in Motion</h3> <p class="email-signup-inline__subheading"></p>  <meta http-equiv="Content-Type" content="text/html; 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They report that BP improved glucose control compared to usual care, without increased continuous glucose monitoring (CGM)-measured hypoglycemia.</p> <p><a href="https://advances.massgeneral.org/contributors/contributor.aspx?id=2026">Melissa S. Putman, MD</a>, an endocrinologist in the<span> </span><a href="https://www.massgeneral.org/endocrinology/diabetes/research/research-center">Diabetes Clinical Research Center</a><span> </span>at Massachusetts General Hospital,<span> </span><a href="https://advances.massgeneral.org/contributors/contributor.aspx?id=2249">Jordan S. Sherwood, MD</a>, a pediatric endocrinologist in the Center, and colleagues share the results in<span> </span><a href="https://diabetesjournals.org/care/article-abstract/47/1/101/153790/Randomized-Trial-of-the-Insulin-Only-iLet-Bionic?redirectedFrom=fulltext" target="_blank" rel="noopener noreferrer"><em>Diabetes Care</em></a><em>.</em></p> <h2>About the Study</h2> <p>In a single-center, open-label, random-order crossover trial, the researchers compared the insulin-only configuration BP to usual diabetes care among 20 adults with CFRD. Participants were all ≥18 years old (50% female), had been diagnosed with cystic fibrosis and diabetes, managed their glucose with insulin (total daily dose of >0.1 units/kg/day), and were required to have a baseline hemoglobin A1c (HbA1c) ≥6% or a mean CGM glucose ≥125 mg/dL.</p> <p>The study duration was two weeks and visits took place at the Mass General Diabetes Research Center. Participants were randomly assigned to either BP or usual care for 14 days each.</p> <ul> <li><strong>Primary Outcome</strong>: the percent time sensor-measured glucose was in the target range 70–180mg/dL (time in range [TIR]) on days 3–14 of each arm</li> <li><strong>Key Secondary Outcomes</strong>: mean CGM glucose and the percent time sensor-measured glucose was in the hypoglycemic range <54mg/dL</li> </ul> <h2>Study Results</h2> <p>The primary outcome, TIR, was higher in the BP group than the usual care group (75 ± 11% vs. 62 ± 22%, P=0.001) with an estimated 12% treatment difference. Mean CGM glucose was lower in the BP group than in the usual care group (150 ± 19 vs. 171 ± 45 mg/dL, P=0.007).</p> <p>No significant difference in percent time with sensor-measured glucose <54 mg/dL was reported. However, self-reported symptomatic hypoglycemia episodes were higher during the BP group than in the usual care group. There were no episodes of diabetic ketoacidosis or severe hypoglycemia in either group.</p> <p>These results support the potential of automated insulin delivery technology as a therapeutic option for adults with CFRD. The researchers note that larger and longer clinical trials are needed to further investigate the safety and efficacy of the BP device in adults with CFRD and other diabetes populations.</p><p class="fat-link__wrapper u-text-right"> <a class="fat-link -caret -large" href="https://diabetesjournals.org/care/article-abstract/47/1/101/153790/Randomized-Trial-of-the-Insulin-Only-iLet-Bionic?redirectedFrom=fulltext">Read More on Diabetes Care</a> </p> <p class="cta"> <a href="https://www.massgeneral.org/endocrinology/diabetes/research/research-center">Learn more about the Diabetes Clinical Research Center</a></p> <p class="cta"> <a href="https://www.massgeneral.org/endocrinology/diabetes/about/appointments-and-referrals">Refer a patient to the Diabetes Unit</a></p> </div> </div> <aside class="layout-columns__sidebar -article__contributors"> <div class="layout-columns__sidebar__content"> <div class="profile-compact__wrapper"> <p class="u-no-margin"> <strong>Contributors</strong> </p> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=2249" itemprop="url">Jordan S. Sherwood, MD ›</a></h3><p class="profile__title" itemprop="jobTitle">Pediatric Endocrinologist, Diabetes Clinical Research Center, Massachusetts General Hospital, Instructor, Harvard Medical School</p> </div> </div> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=2026" itemprop="url">Melissa S. Putman, MD ›</a></h3><p class="profile__title" itemprop="jobTitle">Endocrinologist, Massachusetts General Hospital, Assistant Professor of Pediatrics, Harvard Medical School</p> </div> </div> </div> </div> </aside> <section class="topics-layout -article__related"> <div class="topics-layout__inner"> <div class="topics-layout__sidebar"> <h2 class="section-heading">Related topics</h2> </div> <div class="topics-layout__main"> <ul class="topics-list" data-module="topics-list"> <li><a href="/endocrinology/topic.aspx?id=1105">Diabetes</a></li> </ul> </div> </div> </section> <section class="-padding--horizontal -padding--vertical -article__related"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/endocrinology/journal.aspx?id=2275" itemprop="url">Continuous Glucose Monitoring Shows Promise for Diagnosis of Cystic Fibrosis–Related Diabetes</a> </h3> <p itemprop="description"> <p><span>Melissa S. Putman, MD, and colleagues found measures of hyperglycemia and glycemic variability provided by continuous glucose monitors were superior to hemoglobin A1c in distinguishing between patients with cystic fibrosis (CF) who did and did not have CF-related diabetes.</span></p></p> <p class="content-tease__related"> <a href="/endocrinology/topic.aspx?id=1105" itemprop="relatedLink">Diabetes</a>, <a href="/endocrinology/specialty.aspx?id=1015" itemprop="relatedLink">Endocrinology</a>, <a href="/pulmonary/specialty.aspx?id=1012" itemprop="relatedLink">Pulmonary and Critical Care</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2022-07-25" itemprop="datePublished">July 25, 2022</time> </p> </div> </div> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/endocrinology/journal.aspx?id=2620" itemprop="url">Continuous Glucose Monitoring Predicts Long-term Nutritional Outcomes in Adults With Cystic Fibrosis</a> </h3> <p itemprop="description"> <p><span>Melissa S. Putman, MD, and colleagues correlated findings on continuous glucose monitoring with a decline in body weight and a decline in body mass index over one year in adults with cystic fibrosis. Their data also suggest advanced glycation end products may represent a useful marker in this population.</span></p></p> <p class="content-tease__related"> <a href="/endocrinology/topic.aspx?id=1105" itemprop="relatedLink">Diabetes</a>, <a href="/endocrinology/specialty.aspx?id=1015" itemprop="relatedLink">Endocrinology</a>, <a href="/pulmonary/specialty.aspx?id=1012" itemprop="relatedLink">Pulmonary and Critical Care</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2024-05-13" itemprop="datePublished">May 13, 2024</time> </p> </div> </div> </div> </section> </div> </div> </article> </div> </main>  <footer class="site-footer"> <div class="-padding--horizontal"> <nav aria-label="Footer links" class="content-container -width--wide -centered -padding--bottom"> <ul class="footer__nav" role="presentation"> <li> <a href="https://www.massgeneral.org/about">About Mass General</a> </li> <li> <a 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