Introduction
The artificial pancreas emerges as a transformative technology, promising to transform the lives of patients living with diabetes. Diabetes, a serious metabolic disease affecting millions worldwide, demands constant alertness to maintain optimal blood glucose levels. Traditional methodologies of insulin administration have their limitations, leading experimenters and medical experts to explore innovative results. This article delves into the details of the artificial pancreas, its development, functionality, FDA approval, and the possible impact it may have on diabetes patients.
Some artificial pancreas systems require you to count and enter the quantity of carbohydrates you consume at mealtime. These are called “ hybrid ” artificial pancreas systems, because some of the insulin is given automatically and some is given predicated on the information you enter. These systems help control blood glucose levels throughout the day , making it easier for people with type 1 diabetes to keep their blood glucose level in check. Keeping blood glucose levels in check will prevent other health problems from developing and may enhance daily life for people with type 1 diabetes.
The Development Journey of Artificial Pancreas
The development of the artificial pancreas has been a complex and cooperative effort involving researchers, engineers, clinicians, and patients with diabetes. widespread research, technological advancements, and iterative testing have led to the progress of closed- loop insulin delivery systems. The journey began with the integration of CGM systems with insulin pumps, paving the way for more advanced hybrid closed- loop systems.
How do artificial pancreas systems work?
Continuous Glucose Monitor( CGM). A CGM provides a steady stream of information that reflects the patient’s blood glucose levels. A detector placed under the patient’s skin( subcutaneously) measures the glucose in the fluid around the cells( interstitial fluid) which is associated with blood glucose levels. A small transmitter sends information to a receiver. A CGM continuously displays both an estimate of blood glucose levels and their direction and rate of change of these estimates.
Blood Glucose Device( BGD). Presently, to get the most accurate estimates of blood glucose possible from a CGM, the patient needs to periodically calibrate the CGM using a blood glucose measurement from a BGD; thus, the BGD still plays a critical part in the proper administration of patients with an APDS. still, over time, we anticipate that enhanced CGM performance may do away with the need for periodic blood glucose checks with a BGD.
Control algorithm. A control algorithm is software embedded in an external processor( controller) that receives information from the CGM and performs a series of mathematical calculations. Based on these calculations, the regulator sends dosing instructions to the infusion pump. The control algorithm can be run on any number of devices including an insulin pump, computer or cellular phone. The FDA doesn’t require the control algorithm to reside on the insulin pump.
Insulin pump. Based on the instructions sent by the controller, an infusion pump adjusts the insulin delivery to the tissue under the skin.
Possible Impact on Diabetes Management
The artificial pancreas has emerged as a paradigm shift in diabetes management. By reducing the threat of hypoglycemia and reducing hyperglycemic excursions, these systems will aid patients with diabetes to manage their disease more effectively, reducing hospital rates and associated healthcare costs.
What are the Various types of artificial pancreas systems?
There are several types of artificial pancreas systems. They include
- threshold suspend and predictive suspend systems
- insulin-only systems
- dual hormone systems
Threshold Suspend Systems
Threshold suspend systems, also known as Low Glucose Suspend systems, are an early form of artificial pancreas technology. These systems consist of an insulin pump and a continuous glucose monitoring( CGM) device. When the CGM detects that the patient’s blood glucose levels are approaching a predefined low threshold, the insulin delivery is automatically suspended. This safety point helps prevent hypoglycemia( low blood sugar) by temporarily stopping insulin infusion until glucose levels rise back to a safe range.
Control- to- Range( CTR) Systems
Control- to- Range systems are a more advanced type of artificial pancreas. These systems aim to keep blood glucose levels within a target range rather than only precluding lows. CTR systems use a unrestricted- circle algorithm that continuously analyzes CGM data and adjusts insulin delivery rates to maintain glucose levels within a specified target range. When blood glucose levels shift towards the upper or lower limits of the range, the system automatically adjusts insulin delivery to bring them back into the target zone.
Control- to- Target( CTT) Systems
Control- to- Target systems are the most sophisticated type of artificial pancreas systems. These systems also use a closed- loop algorithm predicated on CGM data to regulate insulin delivery. still, instead of maintaining a range, CTT systems aim to achieve and maintain a specific target blood glucose value. The algorithm calculates the precise amount of insulin needed to bring glucose levels to the desired target and makes adjustments as needed to keep them there.
Companies providing FDA approved Artificial Pancreas
Over the years, many renowed companies have worked hardly to obtain FDA approval for their closed-loop insulin delivery systems, marking a golden moment in diabetes care.
There are now multiple artificial pancreas systems on the market: The Medtronic 670G (2016), Tandem Control-IQ™ (2019), Medtronic 770G (2020), Insulet Omnipod 5 (2022), Medtronic 780G (2023), and the iLet® Insulin-Only Bionic Pancreas System. (Tidepool Loop, an app that contains an algorithm that automates insulin dosing, has also been approved, but it has not yet announced its insulin pump manufacturer.)
Conclusion
The development and implementation of artificial pancreas systems plays a key role in the management of diabetes. These innovative technologies aim to replicate the functions of a healthy pancreas by continuously monitoring glucose levels and delivering precise doses of insulin required by patients. The potential benefits of artificial pancreas systems are endless, which include :offering improved glycemic control, less risk of hypoglycemia, and enhanced quality of life for patients living with diabetes.
