Artificial pancreas system is effective at controlling blood glucose
MedWire News: A novel artificial pancreas system that delivers both insulin and glucagon as needed is effective for controlling blood glucose in Type 1 diabetics, report researchers.
“This is the first study to test an artificial pancreas using both insulin and glucagon in people with Type 1 diabetes,” said study author Steven Russell from Harvard Medical School in Boston, Massachusetts, USA.
“It showed that, by delivering both hormones in response to frequent blood sugar tests, it is possible to control blood sugar levels without hypoglycemia, even after high-carbohydrate meals.”
The researchers recruited 11 individuals with Type 1 diabetes to test the system, which combines blood glucose monitoring and insulin pump technology with software that directs real-time administration of fast-acting insulin analog lispro and glucagon.
The participants were monitored for 27 hours, during which time they consumed three carbohydrate-rich meals and slept at the hospital.
Six individuals achieved a mean blood glucose level of 140 mg/dl, which is below the maximum concentration of 154 mg/dl set by the American Diabetes Association. None of these patients developed hypoglycemia requiring treatment.
The other five individuals experienced hypoglycemia, but they were found to absorb insulin more slowly. This was corrected in a follow-up experiment during which the time-to-peak plasma lispro concentration was reduced to 65 minutes.
All insulin treatment systems, including insulin pumps, are associated with an increased risk for hypoglycemia, the researchers remark. To try to reduce the risk, ready-to-be-administered glucagon was included in the system.
“Large doses of glucagon are used as a rescue drug for people with severely low blood sugar,” explained co-author Edward Damiano from Boston University. “Our system is designed to counteract moderate drops in blood sugar with minute doses of glucagon spread throughout the day, just as the body does in people without diabetes.”
Commenting on future development of the system, Russell said: "The device we ultimately envision will be wearable and incorporate a glucose sensor inserted under the skin that communicates wirelessly with a pump about the size of a cell phone.”
He added: “The pump would administer insulin and probably glucagon, and would contain a microchip that runs the control software.”
The results of this research are published in the journal Science Translational Medicine.
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By Helen Albert