Progress on Development of Artificial Pancreas Brings Hope to Diabetics
At a symposium on advances in diabetes technology as part of the American Diabetes Association’s annual meeting, Dr. Richard A. Insel, executive vice president for research at the Juvenile Diabetes Research Foundation (JDRF), presented the progress made so far on an artificial pancreas which will help diabetes gain greater blood sugar control.
“We have pioneered the development of a closed-loop artificial pancreas because we believe it will significantly impact the lives of individuals with both type 1 and type 2 diabetes, by providing exquisite control of blood sugar,” said Dr. Insel during a teleconference.
"The promise in the near term of these technologies is not only to help us reduce significantly the risk of long-term diabetic complications, but also to reduce the risk of having a catastrophic hypoglycemic event, and further help people with diabetes live easier," said Aaron Kowalski, research director of the JDRF's Artificial Pancreas Project, during the teleconference.
Artificial pancreas technology has three components. First, a continuous glucose monitoring (CGM) device, which is attached by a wire to the body, that measures and trends blood glucose levels. Second, an insulin pump, also attached to the body, doses insulin at a continuously low level, but can also be adjusted. The system also delivers glucagon, a naturally occurring hormone that prevents blood sugars from dropping too low. Third, a sophisticated computer program controls when and how much insulin to deliver.
Research trials performed so far within the JDRF Artificial Pancreas Project have tested various levels of automation, multiple computer programs, and a range of in-clinic situations, including large and small meals, nighttime control, and exercise.
Dr. Roman Hovorka, a principal research associate in the department of pediatrics at the University of Cambridge, reported that the development of an artificial pancreas can significantly improve overnight blood sugar control in adults without the fear of hypoglycemia (low blood sugar).
During one study published in The Lancet, 12 adult patients with type 1 diabetes consumed a high-carbohydrate dinner (100 grams) with a glass of white wine close to bed time. Drinking alcohol in the evening raises the risk of nocturnal hypoglycemia. Patients maintained their blood sugar levels within the target range 70% of the time, compared to 47% without the technology. When hypoglycemia did occur, the time spent with low blood sugar was reduced.
Children tested with the artificial pancreas have also shown a reduction in hypoglycemic incidents by half, extending the time they spent at target blood sugar levels. Preliminary research is being explored on using the system for pregnant women with type 1 diabetes.
Dr. Kowalski believes the technology could be available within the next few years. "Our plan is to move into home studies, which hopefully will happen later on this year," said Dr. Hovorka.
More information about the JDRF Artificial Pancreas Project can be found online at www.jdrf.org/artificialpancreasproject. The site includes information for people with type 1 diabetes about research leading to the development of an artificial pancreas, as well as interactive tools, project timelines, chats with researchers and access to information about clinical trials.
Kumareswaran K, et al "Overnight closed loop (CL) glucose control following consumption of alcohol in adults with type 1 diabetes (T1D)" ADA 2010; Abstract 0358-OR.