Researchers speaking at an annual conference suggested that research into making an artificial pancreas so patients with type 1 diabetes can better control glucose levels, is progressing rapidly and that the technology could be commercially available in just a few years.
On Sunday, as part of the 70th Scientific Sessions of the American Diabetes Association (ADA) that is running from June 25 to 29 in Orlando, Florida, scientists from the ADA and the international charity Juvenile Diabetes Research Foundation (JDRF) spoke in a joint session about how quickly research into treatments for type 1 diabetes and its complications is progressing, with particular emphasis on the Artificial Pancreas Project.
Dr Roman Hovorka, from the University of Cambridge in the UK, said early results from a new clinical study funded by Diabetes UK showed that adults with type 1 diabetes were able to use the new “artificial pancreas” technology to significantly improve control of glucose levels overnight without increasing their risk of hypoglycaemia (low blood sugar), even after a large meal with a glass of wine.
Hovorka’s team at Cambridge, which specializes in developing computer programs that mimic how the body works, is one of eight core research groups in the JDRF Artificial Pancreas Consortium.
The new Artificial Pancreas technology comprises three elements: an insulin pump, a continuous glucose monitor and a sophisticated computer program. The aim is to fine tune the system to do the job of a healthy pancreas: provide precisely the right amount of insulin to the body exactly when it needs it.
Currently, many patients around the world are successfully using two elements of the technology in an “open loop” fashion, where they take a reading and decide for themselves how much insulin the pump should release.
The insulin pump is housed in a small device about the size of a pager and delivers insulin via a long thin tube connected to a catheter that is inserted under the skin. Currently available technology allows the patient to control the dose.
The continuous glucose monitor or CGM comprises an insulin sensor that is inserted just under the skin and connected to a wireless transmitter that sends glucose readings to a display device that the patient can read.
The aim of the Artificial Pancreas Project is to move the technology to a “closed loop” system, and that’s where the computer program comes in.
The computer program uses the CGM readings to work out if the glucose levels in the body are too high, too low, or just right, and then tells the insulin pump how much to dispense, if any. It’s a closed loop system because it does not require the intervention of the patient.
In an earlier study Hovorka and colleagues had demonstrated the feasibility and efficacy of overnight closed loop insulin delivery in adults with type 1 diabetes, compared with conventional continuous subcutaneous insulin infusion (CSII).
In their latest study, they showed that closed loop insulin delivery performed better than CSII even when the subjects had wine with their meal the night before. (Alcohol is a particular challenge because it increases the risk of nocturnal or next morning hypoglycemia).
In a second presentation at the same session, Professor Marilyn Ritholz, Senior Psychologist at the Joslin Diabetes Center in Boston, Massachusetts, reported on the progress of another study in the Artificial Pancreas Project where she and her colleagues are trying to identify characteristics of people with type 1 diabetes who are most likely to be successful users of continuous glucose monitors.
Sources: JDRF, ADA.
Written by: Catharine Paddock, PhD