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THE ARTIFICIAL PANCREAS HOW WILL IT BENEFIT PEOPLE WITH DIABETES

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Artificial pancreas is a technology developed to help people with diabetes to

automatically control their blood glucose level by providing the substitute endocrine

functionality of a healthy pancreas (Cobelli, Renard & Kovatchev, 2011).It is the most exciting

development in the field of type 1 diabetes since discovery of insulin in 1921. Currently under

development in locations across the globe, this system allows existing devices to communicate

with one another and automatically dispense insulin using real time data thereby keeping blood

sugar levels as close to normal as possible. As such, it helps to mitigate long term and short term

complications of the disease. The management of diabetes has increasingly become linked to

innovations in diabetes technology. This system is a possible treatment option for people with

type 1diabetes.

Type 1 diabetes also known as juvenile diabetes or insulin dependent diabetes is a

lifelong condition that causes one’s blood sugar level to go too high. It is characterized by

immune mediated destruction of the pancreatic beta cells resulting in insulin deficiency (Lawson

& Muirhead 2001). The pancreas produces too little or no insulin. Insulin is a very important

hormone produced in the pancreas by beta cells as it allows glucose to enter the cell to produce

energy. When the immune system destroys the cells in the pancreas called beta cells, it causes

the development of Type 1 diabetes. Without insulin, glucose builds up in the blood stream

instead of going into the blood cells. This build up is called hyperglycemia. As such, the body is

unable to use the glucose for energy leading to symptoms of type 1 diabetes.

People infected with type 1 diabetes have become experts at monitoring their own blood

glucose level. Before invention of this automated system, the full burden of diabetes self-

management fell heavily on then patient or on the parent if a patient is still young. Type 1

diabetes is a life threating condition which requires close monitoring with daily care. The
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patients have to calculate the appropriate insulin doses based on what they eat, their physical

activity and their glucose levels among other factors. To compensate for the lost pancreatic cells

they inject insulin daily. This lifelong monitoring is very tiresome and difficult; as such the

stable blood glucose can often be elusive (Cobelli, Renard & Kovatchev, 2011).An artificial

pancreas is therefore a very welcome development for them because this system can keep the

blood glucose level within an acceptable range even after consuming carbohydrate rich meals.

Artificial pancreas also called a closed loop control system is an automated closed-loop system

that is composed of a continuous blood sugar monitor, an insulin infusion pump and a glucose

meter for calibrating the monitor. The devices are designed to work together, monitoring the

body’s glucose level and automatically pumping appropriate doses of insulin as determined by a

computer algorithm (Bruttomesso et al, 2009) . The infusion pump is a small computerized

device that delivers insulin continuously through a catheter inserted beneath the skin. The

continuous glucose monitoring system measures glucose level in real time throughout the day

and night via a very tiny electrode called a glucose sensor. The glucose meter sends data to an

external monitoring and display device. It operates like a real pancreas in that the two opposing

hormones insulin and glucagon are delivered into the blood stream of a patient. The pancreas is

an organ in the body that produces several hormones including insulin and glucagon. It also

secretes digestive hormones that help break down food. Insulin helps the cells to take up glucose

from the blood for use for energy. On the other hand glucagon causes the liver to release stored

up glucose which raises the blood glucose levels.

The main goal of AP is to automatically monitor and regulate glucose levels. This

eliminates the need for patients with type 1 diabetes to check their blood sugar levels regularly

and inject insulin. The better glucose levels are controlled, the less the risk of long term diabetes
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related health complications such as hyperglycemia, hypoglycemia, diabetic nerve disease

(neuropathy), heart attack and stroke. Whilst treatment methods such as insulin injections and

insulin pump devices are effective at managing diabetes, they are still invasive and there is no

guarantee that it will be able to maintain optimum glucose levels. Artificial pancreas system

however leaves very little room for human error.

Not only does Artificial pancreas device system monitor glucose levels in the body but

also help people manage diabetes by maintaining good control as well as improving the quality

of life of the patients living with type 1 diabetes and their families by lowering the risk of

hyperglycemia. These devices may be able to significantly lower the patient’s risk of developing

complications later in life by reducing or even overcoming the burdens of hypoglycemia. The

biggest worry of parents with type 1 diabetes is that their child will have a low blood sugar

emergency in the night. However, this can be well managed by an artificial pancreas system.

Nevertheless this automated system also adjusts automatically the delivery of insulin to

reduce high blood glucose levels, hyperglycemia and reduces the occurrence of low blood

glucose hypoglycemia with little or no input of the patient (Del Favero et al, 2015).

Hypoglycemic events can have catastrophic consequences and is one of the most the most life

threatening situations for patients with type 1 diabetes especially children.

Majority of the people living with type 1 are now able to achieve their recommended

therapeutic goals with the development of the artificial pancreas. This has led to the

improvement of glycaemia and alleviation of the risk of hypoglycemia while reducing the burden

of type 1 diabetes.

While the advantages are numerous, this automated system also comes with some

disadvantages. This system is designed to measure only the glucose level in the tissue fluid
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which does not change as quickly as the glucose level in the blood. This can commence to

inappropriate dosing of insulin when blood sugar level is way too high or too low. Many users

are concerned about the reliability of this technology. It is very tiresome and difficult to wear and

carry around the different pieces of the artificial pancreas device.

In conclusion, though the biomedical creation is far from perfect, several issues need to

be solved before it is fully beneficial to the patients with Type 1 diabetes.. These issues are

constantly being worked on and just like limbs and heart before it. The challenges to using this

automated artificial pancreas include the need to wear multiple infusion devices. Regardless of

its present imperfections, there is no doubt artificial pancreas has the potential to give a new

lease of life to millions of people suffering from type 1 diabetes.

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Reference List

Bruttomesso, D., Farret, A., Costa, S., Marescotti, M.C., Vettore, M., Avogaro, A., Tiengo, A.,

Dalla Man, C., Place, J., Facchinetti, A. and Guerra, S., 2009. Closed-loop artificial

pancreas using subcutaneous glucose sensing and insulin delivery and a model predictive

control algorithm: preliminary studies in Padova and Montpellier.

Cobelli, C., Renard, E. and Kovatchev, B., 2011. Artificial pancreas: past, present,

future. Diabetes, 60(11), pp.2672-2682.

Del Favero, S., Place, J., Kropff, J., Messori, M., Keith‐Hynes, P., Visentin, R., Monaro, M.,

Galasso, S., Boscari, F., Toffanin, C. and Di Palma, F., 2015. Multicenter outpatient

dinner/overnight reduction of hypoglycemia and increased time of glucose in target with

a wearable artificial pancreas using modular model predictive control in adults with type

1 diabetes. Diabetes, Obesity and Metabolism, 17(5), pp.468-476.

Lawson, M.L. and Muirhead, S.E., 2001. What is type 1 diabetes. Evidence-based diabetes care,

pp.124-150.