(Reuters Health) - An artificial pancreatic system using smartphone applications along with glucose sensors and insulin pumps has shown hope in preliminary trials in people with type 1 diabetes, researchers report.
At present, patients with type 1 diabetes must control their blood sugar levels throughout the day. Many use an insulin pump that sends certain amounts of hormones to the body through a catheter 24 hours a day. But eating, exercising, and other factors can increase blood sugar levels or cause them to decline, and then patients need to adjust the amount of insulin pumped into the body.
The new application, which was tested in accordance with the Food and Drug Administration protocol of six adults with type 1 diabetes, worked with two brands of pumps and two types of glucose sensors, the researchers reported in Diabetes, Technology & Therapeutics.
"This is a small step to enable technology to be part of a portable device so people can control their diabetes without having to issue an insulin pump or sensor in public," said lead author Eyal Dassau of the John School of Engineering. A. Paulson from Harvard. and Applied Sciences in Cambridge, Massachusetts. "You can only see the screen and no one will know you have diabetes."
Current pumps can maintain a constant flow of insulin that can be modulated by the user by turning the knob if glucose levels fluctuate. But this is not a "smart" device, said Dassau. "They can be programmed to calculate food," he said. "But what is missing is the brain that can read glucose every five minutes from the sensor."
And while hackers have developed similar alternative solutions, they have not been tested in clinical trials, said Dassau. "All our studies are regulated by the FDA," he added.
During the 48-hour study, patients traveled far without warning of application and consuming significant amounts of carbohydrates. In fact, every meal is eaten in the restaurant and dinner includes ice cream.
Although there are challenges to the new system, the researchers see a trend toward better time in the target glucose range 70 to 180 mg / dL and a significant reduction in time when blood sugar is very low. None of the six patients had high blood sugar levels, even with high carbohydrate foods, and the incidence of low blood sugar levels decreased.
In type 1 diabetes, the pancreas produces little or no insulin, a hormone that functions "as if the traffic police told you where to go and when," Dr. Jason Ng, endocrinologist at University Medical University. from Pittsburgh. "So what happens when you lose the ability to modulate insulin is that you lose the ability to direct sugar to where to go or when to stay in the blood, and because of that, you have to give insulin."
While there has been great progress in the development of pumps and sensors, connecting them with a kind of algorithm has become a "holy cup," said Ng, who was not involved in the new study.
Hackers have been trying for years to get glucose sensors and pumps to communicate with each other.
"It's kind of wild, wild west there," Ng said.
The problem with this research is that it is very small. "You can't draw too many conclusions based on so many patients," Ng said.
Larger studies are needed to ensure the safety and efficacy of new artificial pancreatic applications. But a big advantage will be used on the person's own cellphone, said Dr. Samuel Sultan, an abdominal transplant surgeon at New York-Presbyterian / Weill Cornell Medical Center.
"As advances occur with the artificial pancreas, ultimately patients with diabetes will have a healthier life and a better quality of life," Sultan said. "And from my perspective as a transplant surgeon, fewer patients can undergo pancreatic transplantation, which requires major surgery and immunosuppressive drugs to prevent rejection."