Bionic pancreas
Type 1 diabetes requires constant administration of insulin to maintain blood glucose levels within normal limits and reduce the risk of neuropathy, kidney failure, heart disease and other complications. Thus, patients are forced to repeatedly pierce their skin every day – to measure blood sugar levels and to inject insulin.
Portable devices that make life easier for patients with diabetes have already been approved. A pump implanted under the skin delivers insulin throughout the day, and an alternative to a standard glucose meter is a continuous glucose monitor – a device that monitors blood sugar levels using a sensor placed under the skin. There are also hybrid closed-loop systems that combine an insulin pump, a continuous glucose monitor and a computer algorithm that analyzes glucose readings and automatically adjusts insulin doses in the pump. Studies show that hybrid systems control blood sugar levels better than other methods.
But the systems currently available require significant patient involvement. For example, in order to get the right dose of insulin before a meal, users must specify in advance how many grams of carbohydrates they plan to eat.
A research team from Harvard Medical School and the Massachusetts General Hospital Diabetes Research Center in Boston has developed a system that eliminates such "math." The bionic pancreas (iLet Bionic Pancreas), as the developers called it, includes an insulin pump and a glucose monitor. Counting carbohydrates is not required, users simply enter body weight, what meal they plan (breakfast, lunch or dinner), and then whether they plan to eat the "usual" amount, more or less. Based on this data, the system makes all dosage decisions and delivers insulin autonomously.
To test the device for compliance with standard methods of maintaining normal glucose levels, the researchers invited more than 300 volunteers aged 6 to 79 years, then randomly assigned them to groups using a bionic pancreas (219 people) or standard treatment – either a closed-loop hybrid system, or an insulin pump, or injections (107 people). At the beginning of the study and after 13 weeks of follow–up, the participants were determined the level of glycated hemoglobin A1c - an indicator of the average blood glucose level over the past three months (the target value for people with diabetes is 7% or less).
In general, patients using a bionic pancreas had a decrease in A1c from an average of 7.9% to 7.3%, while there were no changes in the standard treatment group, and A1c was 7.7% before and after follow-up.
In addition, the blood sugar level of patients using a bionic pancreas remained within the target range for longer, on average 2.5 hours per day.
The iLet Bionic Pancreas device is under review by the U.S. Food and Drug Administration (FDA). If approved, it will be the most automated and cost-effective system for the treatment of type 1 diabetes for tracking blood sugar levels and delivering insulin with minimal involvement of the patient himself.
The article Bionic Pancreas Research Group Multicenter, Randomized Trial of a Bionic Pancreas in Type 1 Diabetes is published in the New England Journal of Medicine.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru .