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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.

First Artificial Pancreas Tested

In France, Renard is leading the first clinical trial of an artificial pancreas -- a fully automated system that combines Medtronic MiniMed's long-term glucose sensor and its implantable insulin pump.

In a minor surgical procedure, the implantable sensor is inserted into a neck vein leading to the heart. The sensor is connected, via an electrical-type wire under the skin, to the implantable insulin pump: As blood sugar levels fluctuate, a signal tells the pump how much insulin to deliver.

"The patient doesn't have to do anything," Renard says. "It's all automatic. Even if you're eating a high-carb meal, the sensor will give the appropriate signal to deliver more insulin."

Renard says data from the first five patients who used the device for at least six months show the sensor accurately measured glucose in 95% of cases when compared with values obtained by fingersticks.

"Our goal was to reach 90% accuracy, so this is very accurate," he says.

More importantly, blood sugar levels were maintained in the normal range more than 50% of the time in the patients using the pump connected to the sensor, compared with about 25% of the time for the patient using fingerstick values to tune insulin delivery from the implantable pump.

Also, the risk of blood sugar plummeting, known as hypoglycemia, to dangerously low levels -- a possibility whenever extra insulin is delivered -- dropped to less than 5%, Renard says.

Among the next steps, he says, is to make the sensor more durable so it only has to be changed every two or three years. While implantable insulin pumps work for an average of eight years before they have to be changed, the sensors stop working after an average of nine months, he says.

Nevertheless, Renard see this as an easy hurdle to overcome. "We will just use a different material and make it stronger," he says.

But Joseph says this may present a formidable challenge: "Many years of research [show that] sensors tend to fail within months rather than years due to the harsh environment of the body."

The mathematical programs that calculate just how much insulin should be delivered at different parts of the day also needs to be refined, Renard says. "Right now, the insulin pump allows a diabetic to spend about half of his day in normal glycemia, just like a non-diabetic. But that means that he is not in control the other 50%, which is a bit too high."

But again, he says, this is an easy problem to solve. "The major problem is to have the accurate sensor, and we have it now. Within two years we should have one that works longer and better, and after that, it will be clinically available."

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People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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