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JDRF Artificial Pancreas

I have been hearing a lot about the development of an artificial pancreas, and it does get me excited. However I do know from other people that during the last 30 years there have been many promises of artificial pancreas. So I wanted to know the history of how the artificial pancreas has developed – I found this from JDRF who are researching at the moment:

This Month’s Question is Answered by Aaron J. Kowalski, Ph.D.

Q: My young son and I both have type 1 diabetes. I’ve been hearing about the artificial pancreas for so many years now. When are we really likely to see one that we can use and how will the JDRF Artificial Pancreas Project make it happen faster?

A: Thank you for your question. We talk a lot in research about ‘translating’ the discoveries we make in academia to ‘real-world’ solutions. You are correct — people have been talking about an artificial pancreas for a long time. It seems like it would be straightforward to develop a closed-loop system. Interestingly, one such system does exist since the 1970s! It’s called the Biostator and did an excellent job of regulating glucose levels automatically by delivering insulin and glucose intravenously. But, this is where the translation is important. The Biostator is large — the size of a small refrigerator — and delivering insulin IV risks infection over long periods of time. However information from the Biostator is valuable in understanding what is required for an artificial pancreas to be truly successful. It will need to have some key characteristics in order to be useful for the majority of people with diabetes:

  1. It will need to work, meaning it will need to control one’s diabetes better than people with diabetes self-manage.
  2. It will need to be safe, which is critical. As you appreciate, too much insulin at the wrong time is dangerous and an artificial pancreas will need to have safety mechanisms built in that will eliminate technical failure.
  3. It will need to be easy enough to use in everyday life for the majority of people with diabetes. I don’t plan to carry a refrigerator around with me and I’m sure you don’t want to either!

The JDRF Artificial Pancreas Project has been focused over the last two years on each of these issues and I believe the artificial pancreas will evolve from some near-term solutions — such as systems that minimize hypo- and hyperglycemia (low and high blood sugar) — to more sophisticated closed-loop systems that come closer to replicating what a pancreas does when there is no diabetes (perhaps by including glucagon or other hormones). Some of these solutions are going to happen quickly. Already Medtronic has developed a system, called Veo, which uses CGM data to turn off their pump when someone is hypoglycemic and not responding to their alarms. JDRF-funded artificial pancreas researchers are testing other approaches this year that could take today’s pumps and sensors and combine them to help people with diabetes in the very near term. For example, researchers at Stanford and the University of Colorado are studying software that could minimize hypoglycemia exposure. Another group of JDRF-funded investigators are studying what is called a ‘treat-to-range’ approach in which the pump would automatically reduce high and low blood sugar events while the person with diabetes retains much of the control. These solutions would take advantage of technologies that are already FDA approved and the JDRF is working with the academic researchers, the continuous glucose monitor (CGM) and insulin pump companies and the FDA to determine the pathway to seeing this potential new technology realized.

To build a fully automated artificial pancreas is a bigger challenge and will take time investment. The CGM technology will likely need to evolve over time if we want to target truly ‘euglycemic’ or non-diabetes like glucose levels. We also have the challenge of today’s insulins, which do not work fast enough to prevent post-meal high blood sugar in an automated system. Finally, if we want systems that pump more than just insulin, we will need new pump technology to dispense more than one hormone at a time.

The JDRF Artificial Pancreas Project team is focused on all of these options — the near term potential of adding automation to insulin pumps and significantly reducing high and low blood sugar levels and the longer-term potential of a fully-automated system. I believe each step of the way will help people with diabetes live healthier and easier lives.