Wednesday, 22 October 2014
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'Artificial pancreas' aids blood-glucose control in diabetics

An ’artificial pancreas’ has allowed diabetic patients to better control their blood-glucose levels in a recent clinical trial.

The system uses a small subcutaneous patch to continuously monitor glucose levels, sending the results via radio frequency to a small computer that calculates the appropriate insulin dose, which is then delivered by a insulin pump.

‘The system has the potential to improve the safety and effectiveness of insulin delivery and may allow more flexible lifestyles in the future,’ said Dr Roman Hovorka of Cambridge University, who led the study.

He added that it could be particularly useful when worn at night, since this is the time when most patients experience potentially dangerous blood-sugar drops — or hypoglycemic events — which are also exacerbated by alcohol consumption.

The conventional approach to diabetes monitoring and treatment is based around finger-prick testing combined with daily insulin injections that are adjusted accordingly by the patient with help from health workers. 

In recent years, several technologies have started to come through to help patients better manage their condition around their daily activities.

Indeed, several non-invasive patches that can be worn discreetly to continuously monitor blood sugar are now available. Meanwhile, insulin pumps, which are the size of a mobile phone and can be worn on a belt, have been developed to deliver a more steady dose over the course of the day. However, these still require input and co-ordination from patients or clinicians, with the potential for errors or simple forgetfulness.

What the team did was to connect these technologies in a closed-loop system that it likens to an ‘artificial pancreas’. By designing algorithms to interpret blood-glucose signals and deliver the appropriate dose, it hoped to achieve completely autonomous monitoring and dose delivery.

’The point of this was to test the devices in different real-world situations,’ Hovorka said of the subsequent clinical trial.

It was worn by 12 diabetics overnight after they had consumed a large meal with 100g of carbohydrate accompanied by alcohol at 8.30pm. There was a 22 per cent improvement in the time participants kept their blood-glucose levels in a safe range and a halving of the number of incidents of low blood-glucose levels.

‘Closed-loop systems may serve as a bridge until diabetes is cured by, for example, stem-cell therapy or islet transplantation,’ Hovorka said.

Artificial pancreas: 1. Glucose levels monitored continuously 2. Required insulin dose calculated 3. Insulin does delivered automatically Diabetes UK

Artificial pancreas: 1. Glucose levels monitored continuously 2. Required insulin dose calculated
3. Insulin dose delivered automatically (Diabetes UK)


Readers' comments (5)

  • I hope this becomes available to all diabetics very soon, and is widely publlicised among those who are sufferers. So many of the previous attempts at 'closed loop' control are not generally available years after reading about them in The Engineer, and many of the contacts I have on the medical side do not seem to be aware of the devices.

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  • Fantastic an actual attempt at closed loop diabetes control. However wearing a 'box of tricks' on the outside could make one feel a little like a cyborg

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  • We self fund a pump for my daughter. CGM systems are available but the cost is prohibitive as they have to be replaced several times a week. This is going to be the key area to address as health service funding is going to dry up for this type of treatment. Great idea just has to be affordable

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  • 1) True closed-loop systems are plagued by the fears of incorrect control. Blood glucose monitoring through the same cannula as the insulin delivery has been available for a while, but I suspect the manufacturers fear over the consequences of a failure, or even slightly-less-than-perfect loop control would lead to unfortunate legal persecution (in the USA, I guess).
    2) If you've been sticking-yourself variously for the last 35 years, then honestly, a small box is REALLY of no consequence at all. Frightening for those who've no experience of it, but, well, it's just "one of those things". (and it certainly beats dying!).
    3) Type 1 diabetes cure has been "available in 10 years or so" for the last 30 years in my experience.
    4) If only there was a knowledgeable group out there (and no, "support groups", well meaning as they are, rarely have the background and understanding that engineers have. Especially in something so like a conventional control system that we deal with most of our careers!

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  • Echoing the previous comment about affordability, whilst this is exciting news for any long-term (Type 1) diabetic, it is the issue of public funding that will keep this technology from most. It's hard enough as it is to get funding for an insulin pump; CGM systems, although available for some time now, are still prohibitively expensive for the majority.
    Balanced against potential savings from treatment costs of long term complications, the argument for NHS funding for this type of technology is compelling, albeit overlooked.

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