Bionic pancreas Edward Damiano, Steven Russell, Firas El-Khatib, Boston University

KITLIVING

The bionic pancreas system has been

developed by Boston University. The report

of a clinical trial led by a Massachusetts

General Hospital (MGH) physician is

being published in The Lancet. Steven

Russell (MD, PhD, of the MGH Diabetes

Unit and assistant professor of Medicine

at Harvard Medical School) says, "For

study participants living at home without

limitations on their activity and diet, the

bionic pancreas successfully reduced

average blood glucose, while at the same

time decreasing the risk of hypos."

Developed by Edward Damiano (PhD),

and Firas El-Khatib (PhD), both of the BU

Department of Biomedical Engineering,

the bionic pancreas controls blood sugar

using both insulin and glucagon. Insulin

is used to bring blood sugars down, the

glucagon to increase glucose levels.

Russell explains, "This system requires

no information other than the patient's

body weight to start, so it won't take a lot

of time and effort by health care providers

to initiate treatment. Since no carbohydrate

counting is required, it should reduce the

burden on people living with diabetes."

After a 2010 clinical trial confirmed

that the original version of the device

could maintain near-normal blood sugar

levels for more than 24 hours in adult

patients, two follow-up trials (reported in

a 2014 New England Journal of Medicine

paper) showed that an updated version of

the system successfully controlled blood

sugar levels in adults and adolescents for

five days. Another follow-up trial published

in The Lancet Diabetes and Endocrinology

in 2016 showed it could do the same for

children as young as six.

Smart system

The bionic pancreas system consisted of

a smartphone (iPhone 4S) that wirelessly

communicated with two pumps delivering

either insulin or glucagon. Every five

minutes the smartphone received a

reading from the CGM, then that reading

was used to calculate and administer a

dose of either insulin or glucagon. The

algorithms controlling the system were

updated for the current trial to better

respond to blood sugar variations.

Although the device allows participants to

enter information about upcoming meals

into a smartphone app, allowing the

system to deliver an anticipatory insulin

dose (entries optional in the latest trial).

If participants' blood sugar dropped

to dangerous levels or if the monitor or

one of the pumps was disconnected for

more than 15 minutes, the system alerted

study staff, so they could check with the

participant or their contact person.

Each of 39 participants that finished

the study completed two 11-day study

periods, one using the bionic pancreas

and one using their usual insulin pump

and any continous glucose monitor

they had been using. On days when

participants were on the bionic pancreas,

their average blood glucose levels were

significantly lower than when on their

standard treatment. Blood sugar levels

were at levels indicating hypoglycemia

for 0.6% of the time when participants

were on the bionic pancreas, versus

1.9% of the time on standard treatment.

Participants reported fewer episodes

of symptomatic hypoglycemia while on

the bionic pancreas, and no episodes of

severe hypoglycemia were associated

with the system. It performed even better

during the night period, when the risk of

a hypo is usually a particular worry. "Type

1 diabetics tend to let their blood sugar

run high at night to reduce that risk,"

explains Russell, "Our study showed

that the bionic pancreas reduced the

risk of overnight hypos to almost nothing

without raising the average glucose

level. In fact the improvement in average

overnight glucose was greater than the

improvement in average glucose over the

full 24-hour period."

Damiano, whose work on this project

is inspired by his son's Type 1 diabetes,

adds, "The availability of the bionic

pancreas would dramatically change the

life of people with diabetes by reducing

average glucose levels - thereby reducing

the risk of diabetes complications -

reducing the risk of hypos, which is a

constant fear of patients and their families,

and reducing the emotional burden of

managing Type 1 diabetes."

The bionic pancreas

Index

  1. Page 0001
  2. Abbott Freestyle Libre, Flash Glucose Monitoring, blood testing without lancets
  3. Sue Marshall, The Grumpy Pumper, Desang Diabetes Magazine, hypos, DRWF, Diabetes UK, CGM, the full s
  4. DRWF, diabetes news, Adocia insulin, Type 2 diabetes
  5. Sanofi diabetes care, diabetes highs and lows
  6. Page 0006
  7. Diabetes Risk Score, Professor Khunti, Leicester Diabetes Centre
  8. diabetes kit
  9. Medtronic diabetes insulin pump, Medtronic Minimed 640G, and Medtronic Enlite CGM,
  10. Desang diabetes magazine diabetes diet
  11. diabetic diet, carbs and cals, Chris Cheyette and Yello Baliola
  12. Page 0012
  13. National Institute of Medical Herbalists
  14. my diabetes kit, the grumpy pumper
  15. my diabetes kit, the grumpy pumper
  16. my diabetes kit, the grumpy pumper, insulin pump, Animas Vibe, Dexcom
  17. Ascensia Contour Diabetes blood test meters
  18. my diabetes kit, the grumpy pumper, insulin pump, Animas Vibe, Dexcom
  19. Page 0019
  20. Page 0020
  21. Page 0021
  22. Sue Marshall, closed loop insulin pump, artificial pancreas, CGM
  23. artificial insulin pump, bionic bi-hormonal pump
  24. artificial insulin pump, Medtronic 640g insulin pump
  25. Bionic pancreas Edward Damiano, Steven Russell, Firas El-Khatib, Boston University
  26. Agamatrix Wavesense Jazz Wireless, blood test meter and app
  27. artificial insulin pump, bionic pancreas, CGM, type 1 diabetes, Type 2 diabetes
  28. Page 0028
  29. Medtronic diabetes insulin pump, Medtronic Minimed 640G, and Medtronic Enlite CGM,
  30. Chris Chapman GlucoRx, type 2 diabetes, blood test meters
  31. Chris Chapman GlucoRx,
  32. Making Carbs Count pseudograins
  33. Making Carbs Count pseudograins
  34. Accu-Chek Insight insulin pump
  35. Page 0035
  36. Page 0036

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