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How Can Bionic Pancreas Benefit Type-1 Diabetics? Diabetes is a condition in which the body is having a high blood glucose level either because the body does not make insulin (Type-1) or the body does not make or use insulin well. Of all diabetes, nearly 95 percent are Type-2 diabetes while only about 5 percent belong to Type-1. Type-1 diabetes, also known as juvenile diabetes because it often affects children and young adults, occurs when the body mistakenly destroys pancreatic cells that produce hormones like insulin and glucagon that regulate blood sugar level. Insulin allows cells to absorb blood glucose while glucagon prompts the live to release glucose. With insufficient amount of insulin, glucose remains in the bloodstream elevating blood sugar level. A high level of blood glucose could simply damage tiny blood vessels and lead to complications such as blindness, heart disease, stroke and kidney failure. Diabetics could lose their toes, feet or legs to amputation. Proper administration of insulin is paramount for many Type-1 diabetics, who have to repeatedly prick their fingers to check their glucose levels and determine the right amount of insulin to be injected. Some patients also use insulin pump that is more convenient since it does not require injection and can be programmed to dispense small doses of insulin regularly. But there is a problem with using a pump: it does not automatically adjust the amount of insulin to cater for a particular patient’s need and it does not dispense glucagon, too.
In a paper published June 15, 2014 in the ‘New England Journal of Medicine’, researchers from Boston University and Massachusetts General Hospital revealed they have developed an artificial pancreas that can monitor blood sugar and automatically dispenses the required amount of insulin or glucagon. The artificial pancreas, which they called ‘bionic pancreas’, consists of a smartphone (iPhone 4) hardwired to a continuous glucose monitor and 2 pumps that deliver doses of insulin or glucagon every 5 minutes. With the help of a low-energy Bluetooth signal, it is possible to make various components of the device communicate. The device not only helped more than dozens of Type-1 diabetics live free of finger pricks and other troublesome reminders of diabetes but also controlled the blood sugar levels far better than the patients could have done on their own. One important thing to note is that the device also delivers glucagon that brings blood sugar level back up when it is too low. When blood sugar levels fall too low, patients can pass out and even die. Bionic pancreas was tested in 2 separate experiments on 20 ‘free-range’ adults and 32 teenagers. A bionic pancreas was connected to each of the patients with 3 small needles for 5 days. The patients were asked to remain still and rest so their blood sugar levels did not fluctuate too much. And at that point, the patients stayed close to a laptop computer that uses complicated software to calculate how much insulin someone needs from moment to moment. Study participants used a smartphone app to indicate the meal they are about to consume and if it contains a typical amount of carbohydrates. However, the device is still a bit clunky. The insulin pump itself attaches to a quarter-sized glucose monitor implanted under the skin of the abdomen. A phone-sized external pump is stuck to the abdomen with an adhesive, and a second pump delivers the glucagon, and they are all controlled by the iPhone. The system was able to bring everybody into the range that reduces complications. With funding from the National Institutes of Health and private donations, the research team is currently working with an unnamed device maker to get the two pumps combined into one. Obviously, they still have a couple of years of work ahead and they are trying to make the price affordable for everybody as the prevailing cost for glucagon alone is extremely high: $160 a day.
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