Towards an artificial pancreas — does it really make life easier?
Do you know that a person suffering from type 1 diabetes has to inject insulin approximately 120 000 times in their lives? Many patients have their first diabetes onset in childhood and since it is a chronic autoimmune disease, they have to live with this burden lifelong.
The first patient was treated with insulin in 1922, which was an isolated ox-pancreas extract. Before this turning point, no cure for type 1 diabetes patients was available and the patients, who were mostly children, died within two years after the onset. They suffered a dreadful death by diabetic ketoacidosis caused by a permanent high level of blood glucose.
Luckily, the therapies for type 1 diabetes patients improved considerably since then. However, two things are still obligatory for every diabetic person:
1. Measurement: Monitoring the blood sugar levels either by pricking the finger or by modern needle-free alternatives.
2. Reaction: Providing the body with insulin by injecting the hormone regularly in combination with a meal and additionally in times of crisis by using either injections, pens or insulin pumps.
Wouldn’t it be great for every patient if the two tasks were combined in one automated system? A system that monitors the blood glucose level and reacts accordingly?
In the article I read this week, Clara Rodríguez Fernández from Labiotech describes the development of a fully automated insulin-delivery system, a so-called artificial pancreas. This system would not need any further input from the patient and could already be commercially available within the next decade.
However, to develop a fully automated, ‘closed loop’ system, three main challenges remain to be tackled:
1. Since insulin acts slower than food, a faster, better and smarter insulin needs to be developed.
2. In diabetic persons not only the insulin, but also multiple hormones like amylin and glucagon homeostasis are impaired. For a fully automated system, a development of a multi-hormone system is necessary.
3. The improvement of intelligent algorithms that can adapt to the patients’ needs and lifestyle is required.
“This would not only take a big burden away. It could also improve glucose control, as the algorithm can be more precise than the person.” — Clara Rodríguez Fernández.
Personally, I agree that the artificial pancreas would indeed take a big burden away from diabetic persons. Neither would they fear the consequences of severe long-term complications due to insufficient insulin levels, nor would their life be in immediate danger after injecting too much insulin. A fully automated, closed loop system would definitely relieve the patients from all the decisions they are constantly confronted with.
However, I am convinced that the patients can only enjoy the advantages of the artificial pancreas if the system proves absolutely reliable. The blood glucose level does not only depend on the meals, but also on a plethora of external factors: stress, physical activity, the female cycle, suffering from a cold or other illnesses, etc. Every factor has to be considered by the system and taken into account.
If the systems prove unreliable, the diabetic patients might suffer stress and sudden obstacles in their daily routine. This constant fear of unforeseen complications will impair the well-being of a diabetic.
Knowing people with type 1 diabetes in my close environment, I am delighted to read about the development of an artificial pancreas and am looking forward to seeing it on the market. I am convinced that it will make life easier for everybody suffering from type 1 diabetes, if it proves to be reliable.
Have a read through the original article yourself and discover the obstacles and possibilities in the development of an artificial pancreas: The Three Steps Needed to Fully Automate the Artificial Pancreas.
