Künstliche Bauchspeicheldrüse: Spielleiter für die Diabetesbehandlung?

Medical innovation in the treatment of type 1 diabetes is taking a big step forward with the invention and testing of an artificial pancreas. Could this algorithmic smartphone device change the lives of diabetics for the better?

[Artificial pancreas device]

The treatment of type 1 diabetes could be changed forever by the artificial pancreas.
Picture credits: UVA Health

According to the Centers for Disease Control and Prevention (CDC), nearly one in ten Americans has diabetes. Of these, about 5% are Type 1 diabetics, equivalent to 1.5 million Americans.

The treatment of type 1 diabetes is highly effective, but is a relatively annoying ordeal. Patients have to regularly take blood, control blood sugar levels, and inject the appropriate amount of insulin.

Current interventions leave unwanted possibilities for human error open. They are also quite uncomfortable and unpleasant; the hunt for better treatments continues.

One of these promising improvements is the so-called artificial pancreas. The idea of ​​an artificial pancreas has been debated for decades, but only recently has it become a potentially viable option.

Designed by Boris Kovatchev and his team at the University of Virginia School of Medicine, this medical innovation has the potential to change millions of lives for the better.

Kovatchev has been working on such a device since 2006. First, this type of circulatory system, which could monitor blood sugar levels and administer insulin appropriately, was considered impossible.

The idea of ​​an artificial pancreas was greeted with skepticism by the scientific community, but fortunately Kovatchev remained unabated:

„We show that it is not only possible, but can also run on a smartphone.“

What is Type 1 Diabetes?
Insulin normally facilitates the absorption of glucose from the blood into the body where it is used. Type 1 diabetes occurs when the pancreas no longer produces enough insulin.

Type 2 diabetes is most commonly caused by lifestyle choices such as poor diet and physical inactivity; However, type 1 diabetes has no relation to lifestyle. The pancreatic beta cells that produce the insulin are attacked by an inappropriate immune response so that they are insufficient for the needs of the body.

To compensate for this deficit in biochemistry, patients often have to prick their fingers, take a blood sample, measure glucose levels, and inject with insulin to keep their balance. This regular rigmarole is necessary to keep blood sugar levels in a healthy range.

Aside from the inconvenience and inconvenience, as with anything that relies on human interaction, there is the possibility of mistakes. An elevated blood sugar level can damage the kidneys, nerves, eyes and blood vessels over time. At the other end of the spectrum, low glucose or „hypos“ in extreme circumstances can lead to coma or death.

Anything that eliminates the possibility of operating errors is of obvious benefit.

How the artificial pancreas works
Kovatchev’s artificial pancreas, also known as closed-loop blood sugar control in diabetes, takes much of the human interaction that is currently needed in self-medication.

The system’s central hub uses a platform called InControl, which runs on a newly configured smartphone. This portable device is wirelessly connected to a blood glucose meter, insulin pump and remote monitoring. The blood glucose meter records the blood sugar level every 5 minutes and delivers the measured values ​​to the InControl device.

The device is controlled by algorithms and delivers the right amount of insulin through a fine needle, without the patient having to shed even a drop of blood.

The algorithms are the place where the real innovation comes into play. They are designed to guess how much insulin is likely to be needed. It’s not enough for the technology to simply respond to blood sugar levels at a specific time, predicting glucose spikes, preventing changes, and adapting to a person’s insulin sensitivity. That’s not an easy task.

The human pancreas is able to perform these calculations with ease, but developing something as powerful as the pancreas is indeed a difficult task.

When asked about the algorithms, Kovatchev told Medical News today:

„The algorithms are based on a model of human metabolism that uses data from continuous blood glucose monitoring, past insulin administration, and possibly other available signals to detect patterns of blood sugar fluctuations and to predict where the patient’s blood glucose is.

Then the algorithm provides insulin based on predicted glucose levels. Special attention is paid to the prediction and reduction of hypoglycemia – a separate algorithm (we call it a safety monitoring system) is specially tuned to it, and it is very well suited for this task. „