‘Bionic pancreas’ for type 1 diabetics

Wireless, automated device improves glycemic control sans hypoglycemia

FINALLY, this could be the device Type 1 diabetics have been waiting for.

Russell SJ et al. reported in a recent issue of the New England Journal of Medicine a 5-day study wherein what they called as a “bionic pancreas” improved glycemic control without increasing risk for hypoglycemia in patients with Type 1 diabetes. This was compared with 5 days of treatment with a standard insulin pump—as the control intervention.

The device somehow mimics normal pancreatic function, maintaining a continuous feedback mechanism that administered insulin depending on blood glucose levels. This study was done using this wearable, automated “bionic pancreas” in 20 adults and 32 adolescents with type 1 diabetes.

The device has a subcutaneous sensor that monitored glucose continuously. It also has a subcutaneous infusion pump that administered both insulin and glucagon, designed with automatically adjusting algorithms based on glucose levels and hormone infusion rates via wireless communication.

For each participant, treatment with the bionic pancreas for fice days was compared with treatment using a standard insulin pump as the control intervention. Based on the study, the researchers reported that the mean glucose levels were significantly lower during the bionic-pancreas phase than during the control phase in both adults (133 vs. 159 mg/dL) and adolescents (142 vs. 158 mg/dL).

Furthermore, episodes of hypoglycemia; i. e., blood glucose levels <60 mg/dL, were significantly less common during treatment with the bionic pancreas than during control treatment in adults; while among adolescent subjects, the frequency of hypoglycemia was similar in the two groups.

“The bionic pancreas described in this report brings us one step closer to an ideal artificial pancreas,” wrote Allan S. Brett, MD in his commentary in Journal Watch General Medicine. However, he also noted the limitation of this technology (e.g., intermittent problems with wireless connectivity), plus the fact that it is not yet FDA-approved.

More data are still needed before this device could be recommended, but the potential of this bionic apparatus appears to be very promising. With NEJM and JW reports

VitalSigns Issue 65 Vol. 3, July 1-31, 2014

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