Emerging Technologies

The artificial pancreas helping manage diabetes

Holly Hickman
Writer, GE Look Ahead
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Future of Global Health and Healthcare

When a child is diagnosed with Type 1 diabetes, “the first thing parents stop doing is sleeping”, says a Colorado mother of an adolescent son with the condition. A Type 1 diabetic’s pancreas produces little or none of one of the hormones critical to safe blood-sugar regulation.Nighttime tends to be the most dangerous time for a Type 1 diabetic, especially for young children who might not recognise a catastrophic hypoglycemic attack during sleep or even for adult diabetics whose sensitivity to the warning signs  (such as “the shakes”, sweating, dizziness or sudden, extreme hunger) has waned over decades. With hypoglycemia carrying risks of coma or worse, parents or spouses of Type 1 diabetics often wake up multiple times per night to test the diabetic’s blood-glucose levels.

That up-all-night scenario and constant finger-pricking could change, however, thanks to variations on a so-called bionic pancreas that automatically and near-continuously tests blood-glucose levels and then adjusts hormone delivery. Various versions are currently being tested in Australia and the United States.

One model, received in recent weeks by a four-year-old Australian boy, is attached to the body via tubing inserted under the skin. In contrast to an insulin pump, which delivers minute amounts of blood-sugar-lowering hormone throughout the day and must be manually set to stop delivery in the event of hypoglycemia, the $8,000 device closely monitors blood-sugar levels and automatically ceases insulin delivery if hypoglycemia is imminent.

A different kind of the artificial pancreas, one that utilises both insulin and glucagon—a hormone that increases glucose in the bloodstream—is taking shape in the United States.

Biochemical engineer Edward R. Damiano, the father of a teenaged Type 1 diabetic, has spent years developing an artificial pancreas. His version uses a sensor and an iPhone to help regulate blood-sugar levels. Trials last summer in two separate groups (32 diabetic adolescents and 20 adults) showed improvements over conventional insulin pumps. The average number of hypoglycemic incidents among the youths, for example, was cut by half—from 1.6 per day to 0.8.

Mr Damiano’s system mimics the pancreas in that it doesn’t just automatically stop insulin delivery—it can also inject glucagon to raise blood-sugar levels. Its continuous glucose monitor uses an embedded sensor to measure interstitial fluid among cells, which indicates glucose trends. The sensor pings the attached iPhone 4S, which uses software to calculate insulin and glucagon doses every five minutes. The diabetic also can enter carbohydrate intake estimates to aid in the calculations.

It’s not a cure, surmises a Type 1 diabetic named Eric who has not tried either device, but “the idea of not having to prick my finger constantly or continuously monitor my monitor is appealing”.

When he was diagnosed at 17, his doctor told him “a cure was within reach … 12 years, max.”

That was 25 years ago.

“I’d prefer not to rely on so much technology, but barring a new pancreas altogether, it would indeed be nice to use this and sleep through the night without worry.”

This post first appeared on GE LookAhead. Publication does not imply endorsement of views by the World Economic Forum.

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Author: Holly Hickman is a writer for GE LookAhead.

Image: Ed Damiano holds up the prototype for the portable monitor for a bionic pancreas at the family’s home in Acton, Massachusetts. REUTERS/Brian Snyder
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