The artificial pancreas is closer to being a reality

  
fer
09/17/2012 10:11 a.m.

Technological advances advance successfully in the creation of a computer or software program capable of interpreting the results of a continuous glycemia monitoring system and transmitting them to an insulin pump on a small device, called artificial pancreas, which will maintain the levelsof blood glucose within the normal range.

Several studies financed by the JDRF (Youth Diabetes Research Foundation) are being carried out to ensure that these prototypes that have already shown to function very well, are approved as soon as possible by the administration of food and food of the United States (FDA).

Currently people with type 1 diabetes require injecting insulin several times a day and frequently monitoring their blood glucose levels in order to adjust their insulin doses, carbohydrate intake and physical activity so that they can maintain their glycemia values ​​the mostclose to or normal as possible, as well as a level of hemoglobin A1C below 7%, and thus prevent or delay the appearance of the fearsome chronic complications associated with the poor control of diabetes.On the other hand, people with diabetes must take all necessary measures to prevent hypoglycemia episodes or low blood glucose levels and keep alert in case this occurs, in which case they will need to counteract it by ingesting food or drinks containing carbohydrates ofrapid absorption (simple carbohydrates) or ultimately requiring that someone injects them glucagon.Glucagon is an injected medicine that is used to raise blood glucose levels when the patient has lost knowledge because of hypoglycemia.

The artificial pancreas will represent an extraordinary control tool that will revolutionize the treatment of diabetes, since it will allow people with type 1 diabetes to maintain their blood glucose levels within the normal range (70 mg/dl at 110 mg/dl)No need to inject insulin or monitor your blood glucose levels.

Developing a device with these features is not an easy task

First, the device needs to have the ability to continually detect the levels of glycemia of patients, and know if the trend is for these levels to rise or to lower too much and thus be able to keep them within the normal range (70mg/dl a110 mg/dl) at all times.

For that, the artificial pancreas is required to automatically provide the exact dose of insulin that the organism requires when glycemia levels are raised above normal (hyperglycemia) and that on the other hand also has the ability to automatically supply the precise doseof glucagon when glycemia levels are descending below normal (hypoglycemia).

The artificial pancreas is a device that consists of a closed circuit that does not require user intervention in the decision -making process and is responsible for maintaining well -controlled glycemia levels by sophisticated computerized algorithms that manage the necessary insulin through a pumpof insulin and prevents hypoglycemia through a glucagon reservoir, according to the results transmitted by the Integrated System of Continuous Glucose Monitoring in the Blood.

The story of one of the participants in this study

Elle Shaheen is a young teenager with type 1 diabetes who participated in a study that was conducted at the Massachusets General Boston Hospital, where they placed an artificial pancreas connected to a laptop.In the future this device will be the size of a cell phone.

Dr. Steven Russel, an instructor from the University Medicine SchoolHarvard and head of this team of researchers said “for three days the device did the work that Elle's pancreas could never do” and added “the control of their glycemia levels was very, very good and we were very very, very, very,very pleased of what we had observed with her "

Edward Diamano, Associate Professor of Biomedical Engineering at Boston University and one of those who make up the team of researchers said the device learned the blood glucose patterns of Elle and made the appropriately necessary adjustments “The device towards adjustments every 5 minutes"He concluded by saying.

During that weekend, Elle did not have to use his insulin pump or monitor his glycemia levels and he could also eat meals that he had not been able to eat, in large quantities, for more than 4 years."She ate spaghetti with baked cheese and fried potatoes," said Stefany Shaheen, Mother of Elle and added "she ate between 67 and 100 grams of carbohydrates at each meal, when she can only eat 40 to 50 grams of carbohydrates."

At the end of this test Elle had to leave the artificial pancreas and return to its usual treatment with the insulin pump, counting carbohydrates and monitoring its glucose levels every 2 hours.

"We are too impatient to have access to this wonderful device," said Elle's mother and concluded saying "this will definitely revolutionize the way she lives."

The artificial pancreas prototype is already in the hands of the FDA

The Russel and Damian doctors have already given the artificial pancreas prototype of the Federal Pancreas to the federal agency, so small that it can be carried in a pocket or hooked to a belt.The device has two lowercase pieces that are inserted to the skin, one to continuously monitor glycemia levels and the other to supply insulin or glucagon according to what they indicate the blood glucose levels.

The FDA requires that until the artificial pancreas is not approved, doctors should keep their patients inside the hospital while using this device.

Dr. Charles Zimliki, who presides over the artificial pancreas of the FDA, testified last year to a committee of the United States Senate where he said “the potential benefits of the artificial pancreas are huge but if they are not designed properly, the use of the useFrom this device in outpatients could place these patients at significant risk. ”

Dr. Russell said that for December of this year the FDA of permission to use it in adults with type 1 diabetes that can leave the hospital and walk around accompanied by a nurse.Russell also expects children and young people to participate in a holiday camp of children and young people with diabetes that will take place during next year they can also use it.

What do the representatives of the artificial pancreas project of the JDRF think?

"I feel a lot of optimism but I stay cautiously," said Dr. Aaron Kowalski, vice president of the JDRFY treatment therapies continued to say "FDA has really changed and moves much faster .. My hope is that in oneor two years, we will see approvals of these devices that can properly control blood glucose levels, and that is only the tip of the iceberg. "

Kowalski concluded by saying that he believes that the artificial pancreas is probably approved in stages."I don't think it will be a product, but rather an evolution."

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DiabetesForo
09/17/2012 12:48 p.m.

What do I say ... Do you plan to do something about the theme of hypos?
Something more than a strident beep, I mean.

I don't know, a water reservoir with sugar or glucagon ... Something that only the hypos.
Why lower the hypers then more or less imagine that it will be simple, but and the hypos ????:?

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DiabetesForo
09/18/2012 9:35 a.m.

The 25 was going to a symposium at the University Hospital on that subject.In the end, my husband's computer engineer has asked me to go because he is interested in the subject so much that he is being seriously thinking of such a project professionally.Let's see what it counts.

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olmo
04/01/2013 5:30 p.m.

Reflot the thread ...

Source:

A pioneer clinical trial has been carried out by comparing the results of the conventional treatment for type 1 diabetes (using an insulin pump), with the results of using an artificial pancreas provided with a dual hormonal system.

The comparison between the results indicates that the artificial pancreas provides an improvement in glucose levels and a lower risk of hypoglycemia.

This promising achievement of a team of specialists from the Institute of Clinical Research of Montreal (IRCM), led by the endocrinologist Dr. Rémi Rabasa-Lhoret, can have important repercussions on the treatment of type 1 diabetes, accelerating the development of an artificial pancreasexternal that is safe and practical to use.

Artificial pancreas is an automated system that reproduces, to some extent, the work of a natural pancreas in good condition, continuously adapting insulin release to changes in glucose levels.The artificial pancreas with dual hormonal system tested in the IRCM by Rabasa-Lhoret, Ahmad Haidar and its collaborators, controls glucose levels by automatic liberation of insulin and glucagon, if necessary, on the basis of the readings of a system of a system of a system of a system ofconstant glucose surveillance (CGM) and guided by an advanced algorithm.

The team found that the artificial pancreas improved glucose control by 15 percent, compared to conventional therapy by insulin pump.The artificial pancreas also reduced the total risk of hypoglycemia in 8 times, and in 20 times the risk of night hypoglycemia.


External artificial pancreas: left, constant glucose surveillance device.The pump, holds in the belt, injects insulin under the patient's skin, to the right.The control system is in this case a smartphone or smartphone.(Photo: IRCM)

People with type 1 diabetes should carefully control their blood glucose levels so that they remain within normal values.Blood glucose control is the key to avoiding long -term complications related to high glucose levels (such as blindness or renal failure) and reduce the risk of hypoglycemia (dangerously low blood glucose levels, which can cause confusion, disorientation, disorientation, and even loss of consciousness in severe cases).

"With conventional treatments, approximately two thirds of patients fail to maintain their glucose level within normal values," says Dr. Rabasa-Lhoret."The artificial pancreas could help them achieve this goal, and reduce the risk of hypoglycemia, the great fear of most patients, and that remains the most common adverse effect of insulin treatment. In fact, nocturnal hypoglycemia ismain obstacle to achieving glycemic objectives. "

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samozeus
04/01/2013 8:02 p.m.

If I do not confuse and I see well, the Medtronic Insulin pump is placed, it is a real minilink time system or continuous glucose monitor that is connected to the pump and in case of hypo, in addition to whistling if you have it you have it you can stop the pump and amobile phone in hand.So the foot of the photo must be wrong or I don't understand and is this new?

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