Breakthrough in Creating Artificial Pancreas
System Allows for Continuous Monitoring of Blood Sugar at Night
WebMD News Archive
Feb. 4, 2010 - It has been called the Holy Grail of treatment for insulin-dependent diabetes, and it may be close to
For decades, researchers have searched unsuccessfully for ways to
automatically coordinate insulin delivery with real-time changes in blood sugar
to essentially create an artificial pancreas that maintains target
blood sugar levels with minimal effort.
Now new technology is making this possible, and new research shows that an
experimental system can improve nighttime blood sugar control.
Using sophisticated computer software, researchers were able to coordinate
the actions of a commercially available continuous glucose monitoring device
and insulin pump to allow
automatic insulin delivery in response to real-time glucose readings.
The system proved better than a conventional insulin pump for maintaining
optimal blood sugar levels during the
night in a study from the U.K.'s University of Cambridge.
Aaron J. Kowalski, PhD, of the Juvenile Diabetes Research Foundation,
which was involved in funding the research, says the study represents
an important step forward in the search for a clinically feasible artificial
pancreas to improve outcomes and quality of life among insulin-dependent
"This is hugely promising and very significant research," he tells WebMD.
"Nighttime is the time of day that strikes fear into patients and parents of
children with diabetes."
Nighttime Risk: Low Blood Sugar
That’s because blood sugar levels can fall to dangerously low levels during
sleep, especially in people who
maintain very tight control of their blood sugar with insulin during the
Low blood sugar, or hypoglycemia, can result in
seizures and even sudden death.
Kowalski speaks about the issue from personal experience. Growing up,
he shared a bedroom with a brother with type 1 diabetes.
“[My brother’s] blood sugar would tend to get very low at night, especially
when he exercised, Kowalski says. “He would have seizures and he ended up
having to go to the hospital more than a few times.”
The newly published study included 19 children and teens with type 1 diabetes who
used the artificial pancreas system for 33 nights and a conventional insulin
pump for 21 nights in a hospital setting.
During certain nights, the delivery systems were challenged by having the
children eat a large meal or exercise before bedtime. Both of
these activities increase the risk for nighttime hypoglycemia.
While using the artificial pancreas system, the children maintained blood
sugar levels in the normal range 60% of the time, compared with 40% of the time
while using a conventional insulin pump.
No significant hypoglycemic events were reported with the experimental
system, compared with nine events with the conventional pump. And the children
and teens experienced mild hypoglycemia half as often with the experimental
The study appears today online in The Lancet.
"We showed that this first-generation artificial pancreas can improve
nighttime blood sugar control," study researcher Roman Hovorka, PhD, of the
University of Cambridge, tells WebMD. "This is critically important
because between 50% and 70% of hypoglycemic emergencies happen at night."