CamDiab app puts people living with diabetes back in control of their condition

Cambridge-based CamDiab is receiving long-overdue recognition after appearing on the BBC’s The One Show, which reported on how its CamAPS FX app helps patients manage diabetes.

Over a decade of research has established that the app, which runs on a patient’s smartphone, is safe and effective in treating anyone aged one year or older with type 1 diabetes, including pregnant women.

Type 1 diabetes is a life-threatening condition affecting an estimated 400,000 people in the UK, 29,000 of which are children. It is a chronic condition that requires ongoing monitoring through life and has a life-long impact on both those diagnosed with it and their families.

It occurs when the pancreas no longer produces insulin which helps the body to keep blood sugar levels from getting too high or too low. This means that people must constantly navigate the balancing act of monitoring their sugar levels via finger prick tests and dietary management such as counting carbohydrates and addressing any imbalances with injections of insulin throughout the day.

Professor Roman Hovorka from the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge developed CamAPS FX which, combined with a real-time glucose monitor and insulin pump, acts as an artificial pancreas, mimicking the key functions of a healthy pancreas.

The app operates a ‘hybrid closed-loop system’, so mealtime insulin needs to be given via the app by the person using the system, but at all other times the algorithm works by itself.

Prof Hovorka explained: “CamAPS FX makes predictions about what it thinks is likely to happen next based on previous experience. It learns how much insulin the child needs per day and how this changes at different times of the day. It then uses this to adjust insulin levels to help achieve ideal blood sugar levels. Other than at mealtimes, it is fully automated, so parents do not need to continually monitor their child’s blood sugar levels.”

Self-management of the condition is particularly difficult overnight, where individuals often go to sleep anxious about their glucose levels dropping below a safe range (hypoglycaemia), or having to take finger-prick tests to assess blood glucose levels during the night, leading to interrupted sleep which has been linked to poor educational attainment for children with the condition.

This level of self-management and calculating glucose levels can be challenging for people with diabetes, especially children, and fewer than one in five are meeting the recommended targets for blood pressure, blood glucose control and cholesterol – the three recommended treatment targets from the National Institute for Health and Care Excellence (NICE).

CamAPS FX was developed by researchers at the University of Cambridge to help patients more easily manage their condition by mimicking the key functions of a healthy pancreas. The app communicates autonomously with a patient’s continuous glucose monitor and insulin pump and uses a complex adaptive algorithm to automatically calculate and administer the optimal dose of insulin every eight to 12 minutes.

Over a decade of research has proven the app, which runs on a patient’s Android smartphone, to be safe and effective in treating people with type 1 diabetes, aged one year or older, including pregnant women.

In particular, the app’s algorithm has been shown to increase the time an individual is in the desired blood glucose range and also reduces the risk of a low blood sugar incident (hypoglycaemia), compared to an individual self-calculating insulin dose.

Furthermore, research has identified that those using the app felt less burdened by their diabetes and more able to lead flexible and spontaneous lives.

The One Show on November 15 featured a young child who lives in Oxford who was filmed managing her diabetes before and after using the app. Here in Cambridge, the CamAPS FX app has also been adopted by Sofia-Stevie Wright, aged five.

Sofia-Stevie’s mother, Sam, said of the experience: “The diagnosis changed everything forever, I can remember the first few weeks like it was yesterday.

“Almost overnight I felt like I needed to be an expert in diabetes to best care for my little girl. She is my absolute priority, so I just did it, and I feel really proud of myself and my mum for doing it – she’s been on this journey with us from the beginning.”

Like most parents with a newly diagnosed child with type 1 diabetes, Sam quickly became an expert at finger prick tests, basal and bolus insulin dosing and what to do when her daughter was hypoglycaemic.

Injecting your child would be a challenge for any parent, but particularly for Sam as she also had to overcome a fear of needles.

“The clinical team at Addenbrooke’s Hospital were amazing at helping me overcome some big challenges in those early days, especially Adam Dawes, clinical nurse specialist at the hospital. I don’t think we’d be where we are today without the support of Adam and the clinical team.”

Eventually Sofia-Stevie received a continuous glucose monitor (CGM) to support her care. A CGM is a small device with a sensor worn just under the skin to measure glucose levels continuously.

Sam saw the CGM as a step in the right direction, particularly as the device meant she no longer had to set alarms at night – the device would alert her if Sofia-Stevie’s glucose levels were out of range automatically. The CGM also syncs with Sam’s phone so she can check Sofia-Stevie’s blood glucose levels at school and it also helps teachers with care through the day.

Then, in January 2020, Sam was introduced to the CamAPS FX app – and hasn’t looked back since.

Professor Hovorka concluded: “Our aim is to alleviate the ever-present burden of type 1 diabetes and improve health outcomes.

“To have Maebh’s story using the CamAPS FX hybrid closed-loop system shared on the BBC’s The One Show was great to see. Having stories like Maebh’s and Sofia-Stevie’s shared with the public helps us on our journey to provide widely available, clinically proven and user-friendly artificial pancreas technology to people with type 1 diabetes.

“CamAPS FX is already having an impact on the lives of children and their families. It is available through a number of NHS trusts across the UK, including Cambridge University Hospitals NHS Foundation Trust, and the team hope it will soon be available even more widely.”

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