The Loop Study | Results + Analysis

Living With Diabetes, News & Media, Patient Care + Research + Clinical Trials, Technology

Author: Tristan Elliott

At long last, we’ve put together the BC Diabetes Loop (Artificial Pancreas) Study and we’re pleased to share the results and analysis.

Over the last 2 years, BC Diabetes has been leading the pack when it comes to using technology in the treatment of diabetes.  Our Medical Director, Dr. Tom Elliott, is an early adopter, pioneer and champion of innovative and novel ways to help our patients.

Approximately five years ago, when CGM became mainstream, we made it a mission to get as many of our patients as possible using it.  We did the same thing with insulin pumps.  When, as a result of the hard work and dedication of a small number of people with Type 1 Diabetes and our allies, it became clear that the two could be combined to create an Artificial Pancreas, BC Diabetes embraced Looping.

On 2020-Aug-01, BC Diabetes began doing in-house installations of the tubeless Omnipod Eros-Dexcom G6-Riley link-iPhone master branch “Loop” system.  Although not Health Canada approved, this version of Loop is our defaults entry-level recommendation for the Artificial Pancreas.  It uses a conservative algorithm that has been installed, by our estimates, on more than 20,000 individuals worldwide, and is especially affordable in BC because both the Omnipod and Dexcom systems are covered by Pharmacare.

Since we started, more advanced systems have become available.  We have advanced systems for both Android and iPhone users.  For Android users, we utilize the AndroidAPS (AAPS) system.  For iPhone users, we utilize the FreeAPSX (FAX) system.

We provide installation, servicing and support for patients across Canada, free of charge.  The only thing that someone who is insulin-dependent needs to be helped by us is a referral from a doctor, nurse practitioner or a community health organization.  Becoming a patient is simple and can be accomplished by visiting our Become Our Patient page.

To date, BC Diabetes has installed Loop in its various flavours on 200+ clients.  We are currently supporting 162 individuals on the Artificial Pancreas, as some of the 200+ have done multiple installations, having moved from Loop to a more advanced setup.  The results, as you will see, are amazing.  Our youngest patient was 18 months old at the time of installation.  We’ve done 15 installs on children under the age of 10 and 13 for patients over the age of 70.

Below you will see the improvements in both Time in Range (TIR), which we’ve set as a blood sugar between 4 and 10, and A1c.  The average TIR for users of all 3 systems was 83%, which is well above the Diabetes Canada target of 70%.  Artificial Pancreas users have also averaged a significant drop in A1c, with the average being -0.7.

When we do a new installation, we have the individual do a quality of life survey.  This way, we’re able to measure scores on various questions both before they start using an Artificial Pancreas, and after.  All of our clients signed informed consents and individual data are never shared without permission.

Below you will see the improvements in both Diabetes Distress (the distress associated with living with diabetes) and Fear of Hypoglycemia.  There were no episodes of severe lows or DKAs (life-threatening/severe high blood sugars).  The group as a whole showed a more than 40% reduction in Diabetes Distress, which is significant.  The Fear of Hypoglycemia also decreased precipitously, by more than 30%.

The Artificial Pancreas is a game-changer for people with Type 1 Diabetes or Type 2 Diabetes that requires intensive insulin therapy.  BC Diabetes will be writing a scientific paper on our findings and publishing the results.

Every week, we start more and more people on these systems.  We’ve had many parents tell us that they finally feel comfortable letting their kids go to a sleepover, or that they no longer worry when their kids are at school.  We have adults who used to spend every waking hour thinking about their diabetes who now have far less stress.  BC Diabetes runs a Telegram support group, where our clients help each other troubleshoot and optimize their settings.

The Artificial Pancreas is changing lives for the better.

For more on this topic, see our Handout.

If you have questions, email us at questions@bcdiabetes.ca.