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Artificial Pancreas on the Horizon

An artificial pancreas could revolutionize the treatment of diabetes, and it may only be a few years away.

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For millions of people with diabetes worldwide, life is a series of fingersticks, injections, and surges and dips in blood sugar levels. But with its promise of automatically regulating a person's blood sugar, the artificial pancreas could change all that.

"The artificial pancreas will revolutionize the treatment of diabetes," says Eric Renard, MD, PhD, professor of endocrinology, diabetes and metabolism at Montpellier Medical School in Montpellier, France. "It will prevent diabetes complications, [which include blindness, kidney failure, amputations, heart disease, and death]. And quality of life will be tremendously improved as people won't have to be constantly pricking and monitoring themselves," says Renard, who is leading the first clinical trial of the device.

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The artificial pancreas is designed to help patients with type 1 diabetes maintain blood sugar levels within the normal range -- critical for preventing diabetes complications, he explains.

The man-made organ has three parts, all of which have to work perfectly in synch: a sensor that continually monitors blood or tissue sugar levels, an insulin infusion pump, and a computer algorithm that controls the delivery of insulin minute by minute based on measured blood sugar, says Jeffrey I. Joseph, DO, director of the Artificial Pancreas Center at Thomas Jefferson University in Philadelphia. The sensor relays information to the pump, which then dispenses just the right amount of insulin.

A fully automated and integrated device probably won't be ready for prime time for at least four years -- maybe more. But "we're getting there one step at a time," Joseph says, with researchers worldwide testing various components of the system alone or in combination.

Insulin Pump a Step Forward

Furthest along in development is the insulin pump, which is worn on a belt or totally implanted in the body. The external pump is already used by thousands of people with diabetes worldwide, and the implantable pump is approved in Europe and is in clinical trials in the U.S. Either can be used in an artificial pancreas.

The development of the implantable pump was a major step forward, Renard says, with studies showing significant advantages over multiple daily injections of insulin in controlling blood sugar levels and improving quality of life.

Made by Medtronic MiniMed of Northridge, Calif., the hockey puck-sized device is implanted under the skin of the abdomen, from where it delivers insulin to the body, "just like the real pancreas," he says.

Lori Hahn, a 41-year-old Californian who has had diabetes for more than a decade, says the implantable pump has changed her life. "Before the pump, my life was a roller coaster, both blood sugar-wise and emotionally," says Hahn, who is participating in a U.S. clinical trial. "I felt out of control and had to focus a lot of my time on controlling my blood sugar.

"With the implantable pump, I can forget I am a diabetic," says Hahn, a working wife and mother of three active youngsters.

The pump, which uses specially formulated insulin, is refilled every two to three months. It delivers insulin in short bursts throughout the day, similar to a pancreas. It is also programmed to deliver higher amounts of insulin for mealtimes. Before a meal or snack, a push of a button on a pager-sized personal pump communicator tells the pump to dispense a dose of insulin.

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