If you or someone close to you has insulin-dependent diabetes, you know the endless, time consuming daily ritual of fingersticks, injections, and dealing with low blood sugar episodes that can occur at the most inconvenient times. Now imagine if there was a machine that could automatically deal with all of these tasks, smoothly regulating the blood sugar and preventing the terrible thirst that comes with a high blood sugar level or the shaky, disoriented feeling that comes with being low.

Within the next few years, such a device may be on the market. This miracle machine is the artificial pancreas. Contained within it is a sensor to monitor blood sugar levels, an insulin infusion pump, and a computer algorithm that continuously controls insulin delivery.

It's getting closer to reality every day. The Juvenile Diabetes Research Foundation (JDRF), which started an Artificial Pancreas Project in 2006, now has teams in various countries working to create automatic systems that can replicate what a non-diabetic's pancreas does, according to the JDRF.  "The development of an artificial pancreas system is an essential step towards an ultimate cure for type 1 diabetes--a bridge to a cure," said Aaron Kowalski, PhD, assistant vice president for Glucose Control at JDRF and research director of JDRF's Artificial Pancreas Program, in a press release.

So far, research is promising. A recent study of children and teenagers with type 1 diabetes at the University of Cambridge showed that the artificial pancreas could lower the risk of overnight low blood sugars. Study participants between 5 and 18 years old were monitored in the hospital for the study. 

"Basically, an artificial pancreas will do automatically what the body's own pancreas does," explains Lauren Golden, MD, endocrinologist at the Naomi Berrie Diabetes Center at NewYork-Presbyterian Medical Center in New York City. "What they are trying to do is create a closed loop system so that the sensor and the pump would calculate how much insulin is needed and then dispense it."

Currently, she explains, the insulin pump can recommend a suggested amount of insulin but that calculation is based just on the diabetic's blood sugar level. Many other factors--like a person's activity level or whether or not he has a cold--come into play as well.

Once it becomes available, an artificial pancreas could make a tremendous difference with overnight low blood sugars, says Stuart Weiss, MD, of the NYU Langone Medical Center in New York City. "A lot of patients on insulin have trouble in the middle of the night when their blood sugar drops," he says. "And repeated episodes of hypoglycemia can make patients less sensitive to the next one. If they aren't aware of their sugar dropping, they could pass out."

No machine is perfect, though, and even when an artificial pancreas becomes a reality, patients will still need to be educated about how to care for their diabetes, Golden cautions.  "We will always want patients to be able to confirm the recommendation being made by the machine," she says.

Sources

Phillips, Quinn. "Artificial Pancreas?" 27 January 2010. Diabetes Self Management.

http://www.diabetesselfmanagement.com/Blog/Flashpoints/artificial-pancreas/

Hovorka, Roman, Allen, Janet and more, "Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial" 27 February 2010, Pages 743-751.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61998-X/fulltext

Juvenile Diabetes Research Foundation, "Roche Diabetes Care Partners with UC Santa Barbara and Sansum Diabetes Research Institute to support JDRF's Artificial Pancreas Project," 11 February 2010

http://www.artificialpancreasproject.com/news/2-11-10-roche-release.html