Thursday, January 14, 2010

Is the "Artificial Pancreas" finally coming for Type 1 Diabetics?

Families of children with Type 1 Diabetes know all about two devices that have revolutionized treatment of the disease: the insulin pump and the continuous glucose monitoring system (CGMS).

Patients with Type 1 Diabetes suffer from an autoimmune condition in which immune cells (that normally fight off infections) attack the body's own pancreas for reasons that are not entirely clear. This results in destruction of the pancreatic beta cells, normally the site of insulin production and release into the blood stream. Insulin is the hormone responsible for keeping blood glucose (also known as blood sugar) at normal levels throughout the day. Without sufficient amounts of insulin, blood sugar rises uncontrollably, causing both short- and long-term adverse effects on the body.

In the past, the only way to keep blood sugars in check was to give multiple injections of insulin throughout the day. Now it looks like there may be a new piece of technology on the horizon that comes as close as we've seen to mimicing the actions of the pancreas itself.

Developing this technology would not have been possible without the advances of the past decade.

First came the development of the insulin pump. This is a device that stays attached to the body for up to three days at a time has significantly changed the treatment of diabetes. With this device, patients can program into the pump how much insulin to give without having to stick themselves with a needle multiple times each day.

Second, and more recently, engineers created the CGMS device: a system that, like the insulin pump, is attached to the patient's skin. The CGMS is able to read blood sugars in near real time, an improvement compared to the conventional method of using a needle to draw small amounts of blood from the skin (usually the fingertips) multiple times a day to check blood sugars.

The question has always been: is it possible to perfect a system that is able to check blood sugar levels and then simultaneously supply the proper amount of insulin without the patient having to stick their fingers or program the how much insulin should be pumped multiple times a day?

The answer lies in the creation of a new technology which researchers have call the "artificial pancreas" or "closed loop system." After years of tweaking, the system finally appears ready to test. The premise is: the CGMS device will gather blood sugar data and "tell" the insulin pump what the numbers look like. Based on the trends of the blood sugars, the pump will decide how much insulin to give the patient at any given moment. This is similar to how the pancreas normally senses the body's blood sugar levels and secretes insulin in response.

Animas, a subsidiary of Johnson and Johnson, is partnering with the Juvenile Diabetes Research Foundation to pilot the first closed loop device, with hopes of forever changing the way Type 1 Diabetes is managed.

This is an idea I have discussed at length with many of my families with Type 1 Diabetes, but to be honest I don't think any of us thought it was this close to happening. In truth, there are many hurdles to jump before the final product is unveiled and deemed safe for public use. But the wheels are turning, and this is one of the best developments in the treatment of the disease in a long time.

Please see the link below for details:

http://bit.ly/4VBB3W

Be Well,
AM

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