Sweet machine
Those with diabetes know this all too well, even beginning in childhood. The seemingly never-ending need to check blood sugar — and inject insulin to keep sugar levels from fluctuating wildly — can be confusing and burdensome.
City of Hope researchers intend to ease that burden with collaboration and modern engineering.
As scientists explain, today’s insulin pumps and blood glucose monitors have gone a long way to improve the lives of patients with diabetes. Insulin pumps deliver insulin to patients throughout the day, and blood glucose monitors use sensors to detect when patients need more insulin. Yet the devices work independently and “still don’t talk to one another,” said Fouad R. Kandeel, M.D., Ph.D., director of the Department of Diabetes, Endocrinology & Metabolism at City of Hope. That may soon change.
photo: ©2007 Philip ChanningFouad Kandeel
A study of a new, investigational system aims to close the loop between the monitor and the pump and, in the process, create an artificial pancreas, said Kandeel.
In a healthy person, Kandeel explained, “the pancreas senses the blood sugar from minute to minute and responds to it from minute to minute. The dream of scientists is to program the pump in a way that it can sense the blood glucose in the patient and adjust its rate of insulin infusion accordingly.”
To do this, scientists must determine the algorithms, or calculations, used to link pumps and monitors. They do this by creating a mathematical model based on data from sensors worn by current diabetes patients. The researchers are collaborating with Medtronic to develop and refine these algorithms, Kandeel said. Medtronic will make the device if the research efforts are successful.
City of Hope’s study will evaluate the effectiveness of the experimental system, which is called the Medtronic external Physiologic Insulin Delivery (ePID) system. It consists of an insulin pump, a glucose sensor placed under the skin and a handheld device to operate the algorithm that determines when insulin will be delivered.
The ePID aims to free patients from making constant insulin-dosing decisions and provide a safe, accurate and cost-effective way to help patients maintain healthy blood sugar levels.
Kandeel spoke at the American Diabetes Association annual meeting in 2008 about future applications of this system, and later attended a workshop co-sponsored by the National Institutes of Health and the United States Food and Drug Administration, or FDA. The FDA is developing safety standards for the system so that it can be licensed, Kandeel said.
Kandeel expects to develop expanded studies of the artificial pancreas at City of Hope.