Diabetes Treatment Advances with Trial of Artificial Pancreas

A group of Massachusetts researchers has successfully completed the first run of human trials of the latest artificial pancreas design—a development that will free type 1 diabetics from relying on daily insulin injections.

In the design, a blood glucose monitor signals a subcutaneous device to release insulin and glucagon, which are deficient pancreatic hormones in type 1 diabetics.

The technology depends on an automated software that uses a glucose-control algorithm to determine the appropriate amounts of insulin and glucagon a patient needs, according to Edward Damiano, an associate professor of biomedical engineering at Boston University.

The artificial pancreas differs from typical glucose-control methods for type 1 diabetics by including minute injections of glucagon, Damiano added.

“Most people realize that type 1 diabetics have trouble producing insulin, but what is less commonly known is that they often don’t produce enough glucagon,” said Steven J. Russell, an instructor in medicine at Harvard Medical School who also worked on the project.

Constant glucose-monitoring systems face the problem of a delay between the release of insulin and its absorption in the body. If the body responds too slowly, too much insulin can accumulate and result in hypoglycemia—a worst-case scenario, according to Firas El-Khatib, a researcher at Boston University.

The latest artificial pancreas uses glucagon as extra protection by increasing dangerously low glucose levels when a patient is nearing hypoglycemia.

The researchers discovered in that variability in the rate of insulin-absorption is very high—not only across the general population, but also for specific individuals. The versatility of the algorithm in the artificial pancreas allows the device to treat patients with widely differing insulin absorption rates.

Russell said that the researchers are preparing for the second phase of human trials next month, which will give patients—some as young as 12—a more portable system and require them to eat six meals a day over the course of 51 hours.

In a little more than a year, the researchers say they hope to begin trials with completely wearable devices—and not long after that, trials at home.

“If all goes well, we could have a working system in five years” said Damiano, who hopes to have the system ready before his son—who was diagnosed with type 1 diabetes as an infant—goes to college.

“We would love to be put out of business by someone who finds a cure for type 1 diabetes,” Russell said. “But until that happens, we’re going to continue to work to help people who are suffering.”