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The term “artificial pancreas” has been used loosely over the years to describe medical device systems that do some of the things a real pancreas does to regulate blood sugar. But a real pancreas is fully automatic—and previous systems weren’t. Now researchers have tested an artificial pancreas that comes closer to the real thing.
The new system even learns to anticipate what your insulin needs will be so it can keep your glucose levels in a healthy range.
How a real pancreas works
A human pancreas constantly supplies the body with a low amount of insulin, called “basal” or “background” insulin, to maintain proper glucose levels. But the work of the pancreas doesn’t stop there. Some things can temporarily raise your blood sugar, such as eating, stress, or illness. The pancreas reacts by providing more insulin whenever it’s needed to bring high levels down.
People with diabetes have an impaired ability to make or respond to insulin. To compensate, everyone with type 1 diabetes must administer insulin a number of times each day. Some people with type 2 diabetes use insulin too.
How an artificial pancreas works
Most artificial pancreas systems include three components:
• A continuous glucose monitor (CGM)
• A sensor worn under the skin to measure glucose levels
• An insulin infusion pump
Special software enables the CGM and insulin pump to communicate with one another so the appropriate amount of insulin can be released.
Ideally, all insulin needs would be automatically detected and met by the artificial pancreas without the user doing anything. That’s called a “closed-loop” system. But current commercial artificial pancreas systems can’t compensate very well for short-term surges in blood sugar caused by meals and other everyday variables. Artificial pancreas users still need to frequently administer rapid-acting insulin for immediate needs.
The new system
A team led by Harvard researchers added key improvements to a conventional artificial pancreas system, designed to eliminate the need for self-administered rapid-acting insulin. They created a closed-loop system by adding one more piece of equipment: a smartphone.
The new system prototype does more than respond to live glucose readings as other systems do. An advanced algorithm, put into the user’s smartphone, learns his or her habits and detects recurring patterns of insulin needs at different times of day. Using this information, the system can predict when insulin needs will increase. It delivers the right amount of insulin in advance so the insulin has time to start working and will be ready just when it’s needed.
Rather than trying to hit a precise target number for glucose levels and maintain it, the algorithm works to keep glucose levels within a safe range.
Does it work?
In the study, 30 people with type 1 diabetes used the artificial pancreas system for 12 weeks. There were significant improvements in reducing their HbA1c levels, a primary measure of blood sugar control.
“We took a disciplined group that had very good overall HbA1c levels before the trial, and we brought the group level even lower,” said Frank Doyle, a lead author of the trial and dean of the Harvard John A. Paulson School of Engineering and Applied Sciences, in a news release.
The system keeps learning, making adjustments every week to refine and improve blood sugar control.
Users might worry about a machine giving them too much insulin, but they can manually override the system’s recommendations if necessary. In the clinical trial, that was rarely needed—less than 10 percent of the time. Researchers also found that using the new system reduced the amount of time when test subjects had hypoglycemia—dangerously low blood sugar.
A work in progress
The advanced artificial pancreas system did well in this study, but it still needs more clinical trials to prove itself before it’s available to the public. Meanwhile, there are other new artificial pancreas systems in development. Thanks to technology, the future of blood sugar control looks simpler and more promising than ever.
Would you use this artificial pancreas system? Why or why not? Add your comment below.