England trials hybrid closed loop 'artificial pancreas’

England is spearheading the world’s first nationwide test of an ‘artificial pancreas’ that is potentially life-altering for people living with type 1 diabetes.

Around 35 NHS diabetes centres across the country are piloting the artificial pancreas - a so-called hybrid closed loop system - with 875 adults and children benefiting for a year so far.

The hybrid closed loop technology continually monitors blood glucose and automatically adjusts the amount of insulin given through a pump.

It can eliminate finger prick tests and prevent hypoglycaemic and hyperglycaemia attacks, which can lead to seizures, coma or even death for people with type 1 diabetes.

NHS experts want to discover whether the tech can help people with diabetes safely and effectively control their condition in real-world settings.

Type 1 diabetes is a serious condition where a person’s blood glucose (sugar) level is too high because the body cannot make insulin. This happens because the body attacks the cells in the pancreas that make the insulin. The NHS in England currently spends around £10bn a year on diabetes, which is around 10 per cent of its budget.


Professor Partha Kar, NHS national speciality advisor for diabetes, said: “Having machines monitor and deliver medication for diabetes patients sounds quite sci-fi like, but when you think of it, technology and machines are part and parcel of how we live our lives every day.

“A device picks up your glucose levels, sends the reading across to the delivery system…and then the system kicks in to assess how much insulin is needed.

“It is not very far away from the holy grail of a fully automated system, where people with type 1 diabetes can get on with their lives without worrying about glucose levels or medication.”

hybrid closed loop
Using a lancet on a finger to check blood sugar level (Image: Montri Thipsorn, Adobe Stock)

According to Diabetes UK, hybrid closed loop systems comprise a continuous glucose monitor, algorithm, and insulin pump.

The continuous glucose monitor is placed under the skin to send blood sugar readings to a device such as mobile phone or to the insulin pump.

The algorithm – which can be part of an app on a separate device, or the insulin pump itself - reads the blood sugar information and calculates how much insulin is needed.

The insulin pump automatically releases insulin into the body based on blood sugar readings. The exception to this is at mealtimes when the pump requires information about carbohydrates being consumed.

Under the NHS’s pilot, all of the closed loop systems that are licenced for use within the UK are available to participants.

The data collected from the pilot, along with other evidence, will be considered by the National Institute for Health and Care Excellence (NICE) as part of a technology assessment. NICE will make a recommendation about wider adoption within the NHS following a review of the evidence.