Living with diabetes blog
I recently had the privilege of meeting Dr. Francine Kaufman — a distinguished professor emerita of pediatrics and communications at the Keck School of Medicine and past president of the American Diabetes Association — at a Mayo Clinic endocrine lecture program. The focus of Dr. Kaufman's talk was on current and future technology in diabetes. As part of her presentation, Dr. Kaufman discussed artificial pancreas research and what must happen before the artificial pancreas can become a reality.
As you may know, the pancreas is an amazing, complex organ. The three components of the artificial pancreas — or closed loop system — are the insulin pump, the continuous glucose sensor and mathematical equations called algorithms. Algorithms determine how much insulin should be given minute-by-minute to keep the blood glucose in a healthy target range.
Many artificial pancreas research questions still need to be answered. These include:
- What's the best algorithm? The race is on. Many researchers are working on this question. Mayo Clinic is currently conducting a study to learn if sugar metabolism after meals changes with the time of day or from day to day.
- Is delivering only insulin sufficient? Does an artificial pancreas truly have to mimic pancreas function by giving glucagon to prevent low blood glucose and also release gastrointestinal hormones related to meal blood glucose excursions? This could mean two separate pumps may be needed.
- Is the insulin now used good enough? The current rapid insulins act slower than actual human insulin released from a pancreas. Ultra-rapid insulins are presently in development.
- Is one sensor good enough? What about lag time?
The development of the artificial pancreas will more than likely be implemented in steps. One existing insulin pump and sensor alerts the wearer of an oncoming event, automatically stopping the insulin pump if the person doesn’t act on the warning. The system is available in much of the world, but the manufacturer is still awaiting Food and Drug Administration (FDA) approval in the United States. Two other major companies are also awaiting FDA approval for integration of their insulin pump and glucose monitor products.
The future looks good for the artificial pancreas, or closed loop system. We just have to let researchers sort through the remaining questions — I'm hoping that will be sooner than later.
Sept. 21, 2012