Artificial Pancreas For Managing Blood Sugar In Type 2 Diabetics
A 2016 UK study investigated the safety and efficacy of artificial pancreases for managing blood sugar in type 2 diabetics in a non-intensive care unit setting. Compared with conventional insulin therapy, artificial pancreases were found to be more effective at maintaining the target range of blood sugar and were well-received by patients. Persistent high blood sugar in patients with type 2 diabetes is associated with greater disease severity and an increased risk of death. For many type 2 diabetics, high blood sugar results from the pancreas inability to produce sufficient levels of insulin, the hormone which allows cells to absorb sugar from the bloodstream. Patients with advanced diabetes and persistent high blood sugar are typically monitored for significant changes in blood sugar and insulin is administered by health professionals alongside other blood sugar-lowering medications, according to various regimens typically used in intensive care units (ICU) .These regimens are labour-intensive and expensive to maintain, and as such, are not well-suited outside of the ICU. One proposed alternative to conventional insulin regimens is an automated system of insulin delivery an artificial pancreas which would monitor blood sugar and accordingly dispense insulin in real time. Early trials have suggested such systems are feasible in an ICU setting, though more research is necessary to determine their feasibility, safety, and efficacy outside of the ICU. 2016 UK trial published in the Lancet Diabetes & Endocrinology examined the safety and efficacy of a closed-loop, automated insulin delivery system in type 2 diabetics. Between February 20, 2015, and March 24, 2016, a total of 40 adults diagnosed with type 2 diabetes for at least 1 year receiving insulin treatment were recru Continue reading >>
Artificial Pancreas Performs Well In Type 2 Diabetic Inpatients
Artificial Pancreas Performs Well in Type 2 Diabetic Inpatients NEW ORLEANS A small pilot study showed that, during a short hospital stay mainly for foot-ulcer complications, glucose levels of patients with type 2 diabetes who were on insulin were better managed by a closed-loop insulin-delivery system (artificial pancreas) than by subcutaneous insulin injection by nurses. Compared with 20 patients who received standard care, 20 patients who received a fixed insulin dose, with no boluses, via the automated closed-loop delivery system had glucose levels that were more often within the recommended target range during their hospital stay, with no adverse effects. "This study showed that automated subcutaneous closed-loop insulin delivery without meal announcement is feasible and safe in insulin-treated type 2 diabetes in the general ward," Hood Thabit, MD, Cambridge Metabolic Unit, Cambridge University, United Kingdom, summarized, presenting the study here at the American Diabetes Association (ADA) 2016 Scientific Sessions . This insulin-delivery system "could potentially be an effective and safe tool to manage inpatient hyperglycemia in this particularly underserved population, while easing the burden of healthcare professionals in hospitals," he added. Whereas this type of insulin-delivery system has shown promise in type 1 diabetic patients, "this is the first time that anyone has done a closed-loop artificial-pancreas study in this [type 2 diabetic] population, mainly because we clinicians are unaware how suboptimally managed patients in the wards are," he told Medscape Medical News. It's not anyone's fault, he stressed; the healthcare system is simply overly burdened with an increasing number of patients with type 2 diabetes. However, these are early days, and before Continue reading >>
Artificial Pancreas: The Future Of Diabetes Treatment
Managing diabetes can be challenging. Even with careful monitoring and use of insulin, it’s not always easy to keep blood sugar levels normal. An artificial pancreas may be a way to help people with type 1 diabetes manage their condition. Researchers began studying the potential of these devices decades ago. The FDA recently approved it for treating type 1 diabetes in people age 14 and older. Artificial pancreases hit the market in 2016. The devices automate blood sugar management. They dose the correct amount of insulin when the body needs it. A smart phone or tablet can direct a computer program that controls the artificial pancreas. It links to a glucose monitor sensor and insulin pump to find out blood sugar patterns and control insulin delivery. The pancreas releases hormones and digestive enzymes in the body. Insulin is a hormone that allows glucose (sugar) uptake from the blood into the cells to use for energy. This process lowers blood glucose levels. Glucagon is another hormone in the pancreas. It causes the liver to release stored glucose. This raises blood glucose levels. In type 1 diabetes, the pancreas can’t make the insulin needed to regulate a person’s blood glucose. Glucose stays in the blood. Insulin is not available to allow for cellular uptake. This makes blood sugar levels rise. It can cause serious acute and chronic health problems. The “hybrid system” is the only type of artificial pancreas available. It’s closed-loop system includes a sensor attached to the body. It measures glucose levels every five minutes. It also automatically gives or withholds insulin via an insulin pump. The pump is attached to the body via a catheter connected to the insulin pump. It also contains a computer chip that determines insulin doses. It’s considered Continue reading >>
Artificial Pancreas Improves Blood Glucose Control In Type 2 Diabetes
Artificial pancreas improves blood glucose control in type 2 diabetes Artificial pancreas improves blood glucose control in type 2 diabetes Families eating with TV on are more likely to eat fast food, study finds 09 November 2016 People with type 2 diabetes staying in hospital had improved blood sugar levels following treatment with an artificial pancreas , a study finds. Forty adults were hooked up to the closed-loop insulin delivery system as part of a three-day study looking into its efficacy as a treatment for people with type 2 diabetes . An artificial pancreas monitors blood sugar levels and adjusts insulin delivery accordingly, eliminating the need for regular blood glucose tests and manual insulin injections . All the participants were taking insulin before the study, which was conducted at Cambridge's Addenbrooke's Hospital. Half were treated with an artificial pancreas and the others continued with their standard injections. The participants achieved optimal blood sugar levels 60 per cent of the time compared to those on conventional injections, who only managed to be within the desired target range 38 per cent of the time. There were no incidences in either group of severe hypoglycemia or diabetic ketoacidosis (DKA). The research was carried out by the University of Cambridge Metabolic Research Laboratories and published in The Lancet Diabetes and Endocrinology. Dr Roman Hovorka, lead researcher, said the artificial pancreas allowed for "more responsive insulin delivery and the expectation, so far supported by clinical studies, is that health outcomes can be improved." He said: "We presently use the closed loop system in people with type 2 diabetes staying in hospital. Glucose control in hospital is often suboptimal and our aim is to improve it while people Continue reading >>
We Finally Have An “artificial Pancreas” For Diabetes. But It's A Letdown.
Melinda Wedding The first thing Melinda Wedding thinks about when she wakes at 6:15 am is checking her daughter Carson’s blood sugar to see if she needs another dose of insulin. "Type 1 diabetes is constant," Wedding told me. "There’s no downtime." Throughout the day she might look at her watch, which gives her a reading of her daughter’s blood sugar, up to 100 times. With that data comes hundreds of decisions about when Carson should eat and how to use her insulin pump. Every night, Wedding wakes up two or three times to check on her daughter’s blood levels again. If Carson misses a dose of insulin — and she sometimes does as she learns to manage her condition — her blood sugar will rise. Over time, that could lead to all sorts of adverse effects, from brain fogs and stomachaches to a coma or kidney failure. You'd think that a new device called the "artificial pancreas" would be a godsend for someone like her. Designed to make insulin delivery less of a hassle by automating it, the MiniMed 670G by Medtronic was called "revolutionary" and a game changer after the Food and Drug Administration approved it in September. But families like the Weddings say the device, slated to hit the market in spring 2017, has been incredibly overhyped. For starters, it isn’t a true artificial pancreas — it only automates the delivery of one type of insulin — and patients who use it still have to do a lot to manage their condition. "I hate [the name]," Wedding summed up. "It gives the connotation that the problem is solved, when it’s far from solved." The device also does nothing to fix one of the most pressing problems facing the 1 million people with Type 1 diabetes in America: The cost of insulin is skyrocketing so much that some patients are being forced to cut back Continue reading >>
Closed-loop Insulin Delivery In Inpatients With Type 2 Diabetes: A Randomised, Parallel-group Trial - Sciencedirect
Volume 5, Issue 2 , February 2017, Pages 117-124 Closed-loop insulin delivery in inpatients with type 2 diabetes: a randomised, parallel-group trial We assessed whether fully closed-loop insulin delivery (the so-called artificial pancreas) is safe and effective compared with standard subcutaneous insulin therapy in patients with type 2 diabetes in the general ward. For this single-centre, open-label, parallel-group, randomised controlled trial, we enrolled patients aged 18 years or older with type 2 diabetes who were receiving insulin therapy. Patients were recruited from general wards at Addenbrookes Hospital, Cambridge, UK. Participants were randomly assigned (1:1) by a computer-generated minimisation method to receive closed-loop insulin delivery (using a model-predictive control algorithm to direct subcutaneous delivery of rapid-acting insulin analogue without meal-time insulin boluses) or conventional subcutaneous insulin delivery according to local clinical guidelines. The primary outcome was time spent in the target glucose concentration range of 56100 mmol/L during the 72 h study period. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov , number NCT01774565 . Between Feb 20, 2015, and March 24, 2016, we enrolled 40 participants, of whom 20 were randomly assigned to the closed-loop intervention group and 20 to the control group. The proportion of time spent in the target glucose range was 598% (SD 187) in the closed-loop group and 381% (167) in the control group (difference 218% [95% CI 104331]; p=00004). No episodes of severe hypoglycaemia or hyperglycaemia with ketonaemia occurred in either group. One adverse event unrelated to study devices occurred during the study (gastrointestinal bleed). Closed-loop insulin delivery wit Continue reading >>
- Hybrid closed-loop insulin delivery systems for type 1 diabetes come of age
- Can a dual-hormone closed loop delivery systems become a “technical cure” of diabetes?
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
Artificial Pancreas Safe For Hospitalized Diabetics
November 18, 2016 / 4:05 PM / a year ago Artificial pancreas safe for hospitalized diabetics (Reuters Health) - An automatic insulin delivery system that has performed well in type 1 diabetes patients also proved safe and feasible for type 2 diabetes patients on a general hospital ward, according to a U.K. study. The so-called artificial pancreas, or closed-loop insulin delivery system, monitors blood sugar levels and increases or decreases insulin delivery in response - approximating how a healthy pancreas would work, researchers write in The Lancet Diabetes and Endocrinology. The system eliminates the skin-pricks and manual insulin injections that many type 2 diabetes patients currently rely on, the authors note. The artificial pancreas allows more responsive insulin delivery and the expectation, so far supported by clinical studies, is that health outcomes can be improved, said senior author Dr. Roman Hovorka of the University of Cambridge Metabolic Research Laboratories. But it costs more than injections and requires patients to wear a device around the clock, Hovorka told Reuters Health by email. For the study, the researchers enrolled 40 adults with type 2 diabetes who were receiving insulin therapy in general wards at Addenbrookes Hospital in Cambridge. Half received closed-loop insulin delivery and half received conventional insulin injections for three days. The artificial pancreas includes a glucose sensor inserted into the skin, which took measurements every 1 to 10 minutes and used the information to determine how much insulin to deliver. Patients with the artificial pancreas spent about 60 percent of the three-day study period in their target blood sugar range, compared to an average 38 percent of the time in the comparison group. There were no incidents o Continue reading >>
What Is The Pancreas? What Is An Artificial Pancreas Device System?
What is the pancreas? The pancreas is an organ in the body that secretes several hormones, including insulin and glucagon, as well as digestive enzymes that help break down food. Insulin helps cells in the body take up glucose (sugar) from the blood to use for energy, which lowers blood glucose levels. Glucagon causes the liver to release stored glucose, which raises blood glucose levels. Type 1 diabetes occurs when the pancreas produces little or none of the insulin needed to regulate blood glucose. Type 2 diabetes occurs when the pancreas does not produce enough insulin or the body becomes resistant to the insulin that is present. Patients with type 1 diabetes and some patients with type 2 diabetes inject insulin, and occasionally glucagon, to regulate their blood glucose, which is critical to lower their risk of long-term complications such as blindness, kidney failure and cardiovascular disease. When managing diabetes, many patients must vigilantly test blood glucose with a glucose meter, calculate insulin doses, and administer necessary insulin doses with a needle or insulin infusion pump to lower blood glucose. Glucagon may be injected in an emergency to treat severe low blood glucose. Some patients benefit from additional monitoring with a continuous glucose monitoring system. For more information on what diabetes is and how it is treated and managed, refer to the following websites: National Diabetes Information Clearinghouse at the National Institute of Diabetes and Digestive and Kidney Disorders (NIDDK) What is an artificial pancreas device system? The Artificial Pancreas Device System is a system of devices that closely mimics the glucose regulating function of a healthy pancreas. Most Artificial Pancreas Device Systems consists of three types of devices alre Continue reading >>
Artificial Pancreas Improves Blood Glucose Control In Type 2 Diabetes
Artificial pancreas improves blood glucose control in type 2 diabetes Artificial pancreas , blood sugar , Diabetes , diabetes mellitus , Diabetes mellitus type 2 , Efficacy , Feedback , Injection (medicine) , insulin , pancreas Author: Jack Woodfield/Source: diabetes.co.uk People with type 2 diabetes staying in hospital had improved blood sugar levels following treatment with an artificial pancreas , a study finds. Forty adults were hooked up to the closed-loop insulin delivery system as part of a three-day study looking into its efficacy as a treatment for people with type 2 diabetes . An artificial pancreas monitors blood sugar levels and adjusts insulin delivery accordingly, eliminating the need for regular blood glucose tests and manual insulin injections . All the participants were taking insulin before the study, which was conducted at Cambridges Addenbrookes Hospital. Half were treated with an artificial pancreas and the others continued with their standard injections. The participants achieved optimal blood sugar levels 60 per cent of the time compared to those on conventional injections, who only managed to be within the desired target range 38 per cent of the time. There were no incidences in either group of severe hypoglycemia or diabetic ketoacidosis (DKA). The research was carried out by the University of Cambridge Metabolic Research Laboratories and published in The Lancet Diabetes and Endocrinology. Dr Roman Hovorka, lead researcher, said the artificial pancreas allowed for more responsive insulin delivery and the expectation, so far supported by clinical studies, is that health outcomes can be improved. He said: We presently use the closed loop system in people with type 2 diabetes staying in hospital. Glucose control in hospital is often suboptimal and Continue reading >>
Artificial Pancreas Is A Safe And Effective Treatment For Type 1 Diabetes
Artificial pancreas is a safe and effective treatment for type 1 diabetes Use of an artificial pancreas is associated with better control of blood sugar levels for people with type 1 diabetes compared with standard treatment, finds a review of the available evidence published by The BMJ today. The findings show that artificial pancreas treatment provides almost two and a half extra hours of normal blood glucose levels (normoglycaemia) a day, while reducing time in both high (hyperglycaemia) and low (hypoglycaemia) blood glucose levels. While further research is needed to verify the findings, the researchers say these results support the view that "artificial pancreas systems are a safe and effective treatment approach for people with type 1 diabetes." The artificial pancreas is a system that measures blood sugar levels using a continuous glucose monitor (CGM) and transmits this information to an insulin pump that calculates and releases the required amount of insulin into the body, just as the pancreas does in people without diabetes. Lead researcher, Eleni Bekiari at Aristotle University of Thessaloniki, Greece and the team set out to investigate the effectiveness and safety of artificial pancreas systems in people with type 1 diabetes. They reviewed the results of 41 randomised controlled trials involving over 1000 people with type 1 diabetes, that compared artificial pancreas systems with other types of insulin based treatment, including insulin pump therapy. They found that the artificial pancreas was associated with almost two and a half additional hours in normoglycaemia compared with other types of treatment when used overnight and over a 24 hour period. Use of the artificial pancreas also reduced time spent in hyperglycaemia by approximately two hours - and in Continue reading >>
Artificial Pancreas Could Improve Outcomes In Diabetes
Artificial Pancreas Could Improve Outcomes in Diabetes The first of 4 new clinical trial of artificial pancreas systems has begun, which could benefit patients with type 2 diabetes. The National Institutes of Health (NIH) recently started the first of 4 separate research efforts to evaluate and revise artificial pancreas systems. If the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) studies successfully provide new insights, patients with type 2 diabetes will be able to access this potentially life-changing device. This research is one of the last steps before seeking regulatory approval for the use of the permanent device in these patients. The artificial pancreas is a system that monitors blood glucose levels, and administers insulin or a combination of insulin and another hormone, in response to the levels, according to the NIH. The system would completely replace fingerstick testing, glucose monitoring systems, or other methods of insulin delivery. These studies aim to collect the data necessary to bring artificial pancreas technology to the people who need it, said Guillermo Arreaza-Rubn, MD, director of NIDDKs Diabetes Technology Program. Results from these studies could change and save lives. In previous studies, researchers and patients worked together to evaluate the short-term use of artificial pancreas devices in children with type 1 diabetes. The FDA approved a hybrid model of an artificial pancreas in 2016. This system senses rising glucose levels at mealtimes and throughout the day, and adjusts insulin levels accordingly, the NIH reported. In the previous trials, the artificial pancreas was observed to reduce the burden of disease management on patients and their caregivers. The device also resulted in more optimal glucose levels Continue reading >>
The First ‘artificial Pancreas’ Systems Are Coming To Market
The first so-called artificial pancreas systems – wearable devices that take charge of the crucial process of measuring glucose levels and delivering precise doses of insulin – are now beginning to come to market. That’s welcome news for the nation’s 30 million diabetics, who stand not only to get some relief from the seemingly incessant stream of lancets, test strips and syringes, but also to stay healthier. That’s because an artificial pancreas can keep the disease on a tighter leash than they can, by testing more frequently and delivering more precise insulin doses. That’s not only important for patients, but could ease strains on the nation's healthcare system. This spring, Medtronic became the first supplier out of the gate when it began outfitting a pre-selected pool of type 1 diabetes patients with its new MiniMed 670G. Once that group is trained and equipped – probably by midyear – Medtronic expects to make the device more widely available. Several efforts – including startup Bigfoot Biomedical, Insulet and a partnership between Dexcom, Tandem and TypeZero – are hot on Medtronic’s heels, with active studies now underway and plans to go to market late this year or in 2018. Though the term artificial pancreas is widely used, medical professionals tend to steer clear because some patients hear it and think they’re in for an organ transplant. They’re not. An artificial pancreas doesn’t replace the actual organ. Devices aren’t implanted or surgically attached. Moreover, they only take over one of the organ’s digestive responsibilities: that is, regulating glucose levels. Those in healthcare prefer the term “closed-loop systems,” so called because they monitor glucose levels, employ artificial intelligence to make dosing decisions a Continue reading >>
How Can An Artificial Pancreas Treat Type 2 Diabetes?
How can an artificial pancreas treat type 2 diabetes? The idea behind this is to develop a single system that will watch your blood glucose level 24/7 and give you insulin or other drugs automatically when you need them. A type called the hybrid closed loop system won approval from the FDA in 2016. It tests your glucose level every five minutes and gives you insulin when you need it. Artificial pancreas research has focused mostly on people with type 1 diabetes. It may help people with type 2 as well. National Institute of Diabetes and Digestive and Kidney Diseases: "Insulin, Medicines & Other Diabetes Treatments." American Diabetes Association: "Medicines," "What Are My Options?" "Other Injectable Medications," Insulin Routines," "Types of Insulin." Diabetes Teaching Center at the University of California, San Francisco: "Types of Insulin." Mayo Clinic: "Diseases and Conditions -- Diabetes." Group Health: "Types of Insulin and How They Work." Reviewed by Michael Dansinger on April 20, 2017 National Institute of Diabetes and Digestive and Kidney Diseases: "Insulin, Medicines & Other Diabetes Treatments." American Diabetes Association: "Medicines," "What Are My Options?" "Other Injectable Medications," Insulin Routines," "Types of Insulin." Diabetes Teaching Center at the University of California, San Francisco: "Types of Insulin." Mayo Clinic: "Diseases and Conditions -- Diabetes." Group Health: "Types of Insulin and How They Work." Reviewed by Michael Dansinger on April 20, 2017 What should you know about your medicine for diabetes? THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not Continue reading >>
The Artificial Pancreas: Now And In The Future
This story was updated on April 27, 2017. Since she was diagnosed with type 1 diabetes almost 40 years ago, Alecia Wesner has spent a lifetime managing her condition: Crunching numbers, counting carbs, and trying on a variety of wearable devices to help keep her blood glucose under control. My numbers are within a recommended target, but I work like crazy at that, she says. So when Wesner, 43, was asked to participate in trials for a hybrid artificial pancreas insulin delivery system, the New York Citybased lighting and jewelry designer jumped at the chance. The system,called the Diabetes Assistant (DiAs), is an automated blood glucose management tool, what some researchers are referring to as a closed-loop system or bionic pancreas. Over the course of a few years, Wesner has spent weeks going to study visits at Mount Sinai Hospital in New York City and sleeping in hotels while hooked up to an artificial pancreas prototype with teams of doctors watching her blood glucose levels rise and fall in real time. She has since used the systemsmade up of an insulin pump, a continuous glucose monitor (CGM), and a smartphone application running a program that lets the two communicate and administer insulinwhile training for cycling events. Designed to mimic the function of its namesake organ, the system calculates a persons insulin needs based on glucose readings, activity, carb intake, sleep, and other factors. Then it automatically adjusts and delivers basal doses of rapid-acting insulin around the clock. Thats an especially big deal at night, when people with diabetes have to wake up in order to treat highs or lows. Where the artificial pancreas most noticeably differs from the real thing is in mealtime insulin delivery. In the trial Wesner took part in, the experimental syste Continue reading >>
Discuss complications in the Diabetes Forum Country guides for people with diabetes travelling abroad Browse test strips and get online VAT relief Join 250,009 people in the Diabetes Forum An artificial pancreas uses man-made technology to match the way a pancreas works An artificial pancreas uses man-made technology to match the way a pancreas works. An artificial pancreas is a man-made device that is designed to release insulin in response to changing blood glucose levels in a similar way to a human pancreas. Artificial pancreas systems are being studied as a possible treatment option for people with type 1 diabetes and type 2 diabetes. There are three main artificial pancreas systems being worked on by researchers: The most widely tested artificial pancreas is a closed-loop insulin delivery system, also referred to as a closed loop artificial pancreas. Cambridge University has long pioneered research into the closed-loop system: their device is currently being tested on humans under controlled and home conditions. It is made up of an externally worn insulin pump which communicates wirelessly to a CGM worn as a patch on the skin. The CGM measures blood sugar levels and the result is fed into a small computer which calculates how much insulin (if any) needs to be delivered by the insulin pump. The dose is then delivered into the body, completing the cycle. In 2016, the European Commission announced it will fund a Cambridge University trial testing test whether an artificial pancreas can help young children manage type 1 diabetes. Medtronic is among the other research teams pursuing closed-loop insulin delivery. The biopharmaceutical company released data in September 2016 showing positive results from their hybrid closed-loop system ; they launched the MiniMed 640G ar Continue reading >>