The artificial pancreas has long been the dream of researchers and people with diabetes. While it has not yet been perfected, recent technological advances are inching that dream closer to reality.
For people with diabetes, particularly those with type 1 diabetes, disease management is continual. That’s because the pancreas is unable to produce insulin, a hormone necessary to life. Coping with diabetes means being involved with your own treatment every hour of every day of every year.
If you have diabetes, you must be vigilant about monitoring blood sugar levels, calculating how much insulin to use and when to use it. That may require injections two to four times a day. Frequent injections can be painful. Over time, it may also cause an accumulation of fat under the skin called lipohypertrophy. This condition makes it harder for your body to use insulin.
Many people with type 1 diabetes choose to use an insulin pump instead of injecting themselves multiple times a day. The pump releases insulin throughout the day. With a pump, insulin is delivered through a catheter placed beneath the skin of the abdomen. People can also press a button to release insulin after eating. But a person using the pump has to take great care with it, and it has to be disconnected to shower or bathe.
With either pump or injections, the stress of disease management can take a toll. An artificial pancreas system could help keep your diabetes under control and lower the chance of complications. It could also relieve the stress associated with insulin treatment and enhance your quality of life.
How the Pancreas Works
The pancreas produces hormones, including a very important hormone called insulin. After you eat, the pancreas releases insulin into your bloodstream. Insulin helps your body turn sugar (glucose) into energy. Insulin also tells your liver, muscles, and fat cells to take excess glucose and store it until you need it.
Without insulin, glucose builds up in your blood (hyperglycemia). Untreated, high blood sugar can lead to diabetic coma (diabetic ketoacidosis) and become life threatening. The long-term risks of hyperglycemia include heart disease, nerve damage, and kidney damage. When blood sugar gets too low (hypoglycemia), you may have visual problems, feel shaky, and have unclear thinking. It can cause fainting, seizures, or coma.
It’s the job of the pancreas to release insulin at just the right times and in just the right doses to prevent these complications from occurring.
How the Artificial Pancreas Will Work
An artificial pancreas won’t be quite like a natural pancreas. It won’t need to be an internal organ. Rather, the device can be an external system that marries the work of a continuous glucose monitoring system with an insulin pump.
Two components of the artificial pancreas are already in use. First, continuous glucose monitoring systems (CGM) check glucose levels via a sensor under the skin. The CGM then sends results to a wireless monitor. People using a CGM must check the monitor to find out if their levels are too high or too low. They can also program the monitor to sound an alarm or track trends. Second, insulin pumps worn on the body can dispense insulin throughout the day.
A third component is most crucial to the artificial pancreas. This is the technology that will allow the CGM and insulin pump to communicate with each other. It may sound simple on the surface, but communicating properly is a complicated process.
In an artificial pancreas system, the glucose monitor will send information to an external controller embedded with an algorithm. Using the algorithm, the device will calculate the dosage needed and command the pump to deliver the proper insulin dose. The transfer of information between devices will, in effect, perform the insulin-regulating job of a healthy pancreas. The margin for error will be decreased, and the patient will be freed of the decision-making burden.
Clinical trials with artificial pancreases are being conducted around the world. However, an effective system is still not available. The U.S. Food and Drug Administration hasn’t yet approved a device for use in the United States.
What the Future May Hold
Even when it comes to fruition, the artificial pancreas won’t represent a cure for diabetes. It won’t eliminate the need for monitoring or lessen the importance of diet and exercise in keeping the disease under control.
However, the system could significantly lower the risk of hyperglycemia and hypoglycemia. It has the potential to transform diabetes management and treatment, along with and the lives of those who must live with it.