The pancreas is a deeper abdominal organ that most people don’t know much about. But it plays an important role in controlling blood sugar levels.
For people with type 1 diabetes, an artificial pancreas can make a big difference.
The new FDA-approved device has most of the functions of a real pancreas, closely monitoring blood sugar levels and automatically releasing insulin when needed.
How does the pancreas work?
After a meal, blood glucose rises and the pancreas releases insulin, which transports glucose from the blood to the cells, where it is supplied or stored for subsequent use.
When blood sugar levels are low, the pancreas releases a hormone called glucagon. This signal causes the liver to release stored glucose into the bloodstream.
Type 1 diabetes is when there is damage to the cells of the pancreas that produce insulin. Because the pancreas cannot produce hormones, people with this disease need insulin when their blood sugar gets too high. The only way to know when insulin is needed is to check your blood sugar several times during the day.
How does an artificial pancreas work?
An artificial pancreas works much like a real pancreas, constantly monitoring blood sugar levels and releasing insulin when blood sugar gets too high. There is also a continuous release of tiny amounts of insulin.
The sensor monitors blood glucose levels in real time through electrodes attached to the body’s skin. The CGM and insulin pump can be worn underneath the underwear, and together they monitor blood glucose levels.
Every 5 minutes, the CGM checks the blood glucose through the sensor and sends the blood glucose reading to the insulin infusion pump.
When blood glucose levels are too high, the insulin pump automatically delivers a precisely measured dose of insulin through a patch and a thin tube called a catheter.
Insulin infusion can be stopped when blood glucose returns to target levels.
A smartphone app allows patients and doctors to track blood glucose levels and the dose of insulin being infused.
What are the problems with an artificial pancreas?
There have been no serious adverse reactions associated with the artificial pancreas. However, some minor adverse reactions may occur in users:
- Low blood sugar (hypoglycemia);
- Hyperglycemia (high blood sugar);
- Redness and itching of the skin around the infused patch.
Progressing toward an automated model
In September 2016, the FDA gave the first approval to market an artificial pancreas for the treatment of type 1 diabetes in people 14 years of age and older. It is called the MiniMed 670G.
This is a “hybrid” system that is not yet fully automated. You still have to manually enter the amount of carbohydrates you eat so the system can adjust the insulin dose.
But a fully automated device may be on the horizon. Currently, many models are in clinical trials.
These systems will automatically adjust the dose of insulin needed without any action on the part of the patient. If you want to try such a system in advance, you need to participate in the appropriate research program. Consult your doctor to find out if such clinical trials exist in your area.