MMPAD Munich Meeting Report

MEETING REPORT 18 European Roadshow - Friday 25 th May, 2018 Munich, Germany Artificial pancreas – closed-loop systems Since adolescents obtain information mainly via the internet, diabetologists are more frequently confronted with questions concerning an artificial pancreas. At night, they demonstrated fewer hypoglycaemic episodes and better glucose management than sensor-guided pumps. But are the so-called closed-loop systems available in Germany? Patients still have to rely on self-made devices with algorithms that parents create along with programmers, Danne said. If physicians treat patients with self-made devices in their office, it is considered a criminal offense because these medicinal products have not been approved in Germany. "In the very moment you assess these devices, you have become the operator of the medicinal device," Danne said, adding: "and you will have the trade supervisory board on your heels." However, diabetes camps in Israel, Slovenia and Hannover in Germany showed as early as 2011 that the artificial pancreas does function well. "We have sent children into adventure pools throughout the day and even then it was functioning", Danne said. The first closed-loop study, including patients outside a clinical setting, was published in 2013 . 23 The patients had fewer hypoglycaemic events during the night and better glucose control than patients with sensor-based pumps. At night, lots of small bolus injections occurred and dosing differed each day and every night. In the USA, the system has already been approved. In addition, there are models with more complex algorithms which not only have an insulin pump but also a glucagon pump. Control units which can be operated without cables via mobile phones even exist. In the development of the artificial pancreas, the sensor is most important, yet also the weakest link in the chain, the speaker emphasised. The EMA has taken too much time here, said Danne. Nonetheless, he suggested that high expectations should be lowered as "it is not an all-round carefree package!" Even though nights are no longer a problem, these devices do not yet function very well during the daytime.