Leacsaidh Macdonald Marlow
Following recent and ongoing trials into a new potential treatment for diabetes; the artificial pancreas, many type I and II patients may find their lives made significantly easier with regards to managing and treating their condition daily. Leacsaidh Macdonald Marlow discusses.
Type I diabetes is a condition in which a person’s body is unable to produce its own insulin, a hormone which breaks down glucose (sugar) in the body, causing them to have significantly raised blood sugar levels, especially following a meal high in carbohydrates. Type II diabetes is an acquired condition in which somebody’s somatic cells stop responding to the insulin being produced by their pancreas, which similarly results in a build-up of glucose in the blood stream which isn’t being broken down. Both conditions require patients to monitor their blood sugar very closely and they often must inject multiple doses of insulin daily in order to maintain their blood glucose level (BGL) in a safe range. Having a blood glucose level too far on either side of this optimum range can lead to hypo- or hyperglycaemia (too low and too high, respectively), which can lead to confusion, passing out and even seizures if not treated quickly and accurately. Thus, it is incredibly important that diabetes patients monitor their BGL and respond quickly to any changes, a task which is exhausting for many because it requires constant attentiveness, often causing patients to get up multiple times every night.
The artificial pancreas would be extremely integral in reducing the strain on type I patients at night
A recent development in diabetes research, a treatment being referred to as an artificial pancreas, may transform the lives of people living with diabetes, reducing the need for constant independent monitoring and frequent insulin injections. The intention of the artificial pancreas is to copy the control of BGL by a healthy functioning pancreas. It uses a continuous glucose monitor (CGM) to detect when a patient’s BGL is outside of the optimum range, wirelessly signalling to a pump which will deliver a calculated dose of insulin into the patient’s body to reduce their blood sugar to a safe concentration. The CGM would check the patient’s blood sugar significantly more frequently than people would if they were to manually monitor their own, up to every couple of minutes, and deliver frequent smaller doses of insulin throughout the day as needed. The artificial pancreas would be extremely integral in reducing the strain on type I patients at night, when naturally blood sugar levels fall due to a decreased intake of carbohydrates, as there is less of a necessity to manually monitor and inject insulin which would usually require someone waking up multiple times in the night.
As of April 2022, patients across many NHS centres in the UK have been able to trial the artificial pancreas.
Furthermore, researchers are currently interested in developing a ‘dual hormone’ system which would deliver glucagon, a hormone which hydrolyses glycogen stores in the body in order to increase the concentration of sugar in the blood, as well as insulin, to further increase the period of time which patients spend in the ideal BGL range. The introduction of a glucagon delivery system alongside the insulin pump would largely decrease the chances of a patient entering hypoglycaemia, reducing the further risks that can come along with extended periods spent in a hypoglycaemic state.
Following Cambridge University’s January 2023 review of a clinical trial, the benefits of the new artificial pancreas are unequivocally obvious, with patients experiencing twice as much time within the ideal BGL range as compared to those in the control group, as well as consistently having lower average blood sugar levels.
While further development is required before the artificial pancreas can replace current diabetes treatments for most patients, the results of all clinical trials that have been undertaken point to it being a highly effective treatment option for both type I and II, and it is hoped that in the next year onwards large numbers of patients will be invited to trial it.
Leacsaidh Macdonald Marlow
Featured image courtesy of Towfiqu barbhuiya via Unsplash. Image license found here. No changes were made to this image.
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