Artificial Pancreas Beats Insulin Pump in Test
An artificial pancreas could potentially solve those problems by taking over the decision-making process and applying sophisticated computer algorithms to decide how much insulin is needed at any given moment.
But developing such a device isn't easy. It has to be able to continuously detect patients' blood sugar levels and know whether the levels are trending up or down. There also has to be a piece of the device that holds and delivers insulin. Right now, most artificial pancreas devices, including the one tested in this study, use already-available insulin pumps and continuous glucose monitors. Such monitors measure blood sugar levels every few minutes with a sensor that's inserted under the skin, and send the results to a transmitter.
An artificial pancreas also needs a place to house its computer program or algorithm. Right now, that's generally housed in a laptop that sits on the bedside overnight, as it was in the current study. The hope is that the algorithm could exist within one of the other devices, or maybe even as an application on a cell phone.
In the new study, 56 children from three different diabetes camps in Israel, Slovenia and Germany were randomly assigned to an overnight session on the artificial pancreas, or with standard treatment using an insulin pump and continuous glucose monitor. The following night, they switched.
All of the children had type 1 diabetes, and were between the ages of 10 and 18.
Diabetes camps offer a great place to test the artificial pancreas, because the children are often far more active than usual. All that extra activity leaves them prone to low blood sugar levels throughout the night. Also, staff members are already assigned to check blood sugar levels at certain times in the night.
The artificial pancreas system tested in this study shuts off insulin delivery when it senses that blood sugar levels are going too low. It can also deliver additional insulin when blood sugar levels are rising.
A low blood sugar level is below 70 milligrams per deciliter (mg/dL). On nights that children were on standard treatment, 36 episodes of low blood sugar occurred. On nights that youngsters were on the artificial pancreas, only 12 low blood sugar episodes occurred. Phillip said adjustments could be made to the artificial pancreas to reduce the number of episodes on the artificial pancreas even further.