Sue Marshall diabetes Professor Nick Oliver Imperial College London



In February 2014 we ran a feature on the development of the

BiAP, a Bio-Inspired Artificial Pancreas. Here we catch up with

Nick Oliver, Professor of metabolism at Imperial College, who

reports on current progress of the research. By Sue Marshall.

The artificial pump is a

simple setup, in theory.

Information from a CGM

sensor feeds into an

insulin pump. Within the

pump there is an algorithm. The algorithm

uses the CGM data to adjust the rate

of insulin being delivered in a pump

set for automated insulin delivery. The

sophistication of the algorithm is key to

accurate dosing. It seems likely that CGM

sensors are not going to get much more

accurate than they already are, although in

the future there may be more contenders

in the space (which, at present, is not

very crowded). So improvements have

to be found in the insulins used and the


Says Oliver, "Over time, these

algorithms have developed and evolved.

They can now include information on heart

rate, exercise and even stress. Likewise,

beyond just putting in a carbohydrate

value, there are other things in the body

that affect absorption other than glucose.

Beta cells in normal people would also

respond to levels of amino acids, fat

and other factors, yet at the moment

we rely on just a blood glucose reading

and a carb count to calculate a bolus.

An artificial pancreas is not conscious; it

is not able to adjust to factors it doesn't

know about. So we are now working on

algorithms to be adaptive and flexible,

using additional information about activity

and environmental factors. For example, a

child at school may be in the playground

one day and may be inside the next day

due to rain stopping play. An artificial

pancreas system needs to be able to

adapt to that so needs the information."

There is a lot of research going on

regarding a closed loop (or artificial)

pancreas with different approaches

being taken to bringing a viable solution

to people with diabetes. There are bihormonal pumps, which carry both

insulin and a preparation of glucagon in

separate chambers (arguably glucagon

is not, at present, stable enough to be

relied upon). It has been said that it's

important to get just one hormone right

first, and that should be insulin as it is

stable and proven. The subtlety of insulin

delivery is core to a reliable artificial pump.

Genomics are now being used to help

assess the best treatments and delivery

for cancer patients. Can similar insights

be used in diabetes care to improve what

treatments, when?


The BiAP pump has been in development

for about 10 years, since uber-engineer

Chris Toumazou (Europe's 'top inventor')

started looking at how to improve medical

devices. Says Oliver, "He had to start

speaking with doctors, and we found that

our terminology got in the way. When he

was talking about 'variable resistors', as

doctors we would be using the phrase

'membrane channels'. Chris wanted

to replicate a beta cell as an electronic


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