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Does anyone need an artificial pancreas?

That may soon become a reality for people with type 2 diabetes in the United Kingdom.

Researchers from the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge developed an artificial pancreas that they tested on patients with type 2 diabetes who were on dialysis due to end-stage renal failure. Type 2 diabetes is a metabolic disorder that occurs when the body cannot process insulin properly. Insulin is a hormone produced by the pancreas.

According to the Centers for Disease Control and PreventionTrusted Source, the “pancreas makes more insulin to try to get cells to respond…eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes.”

Obesity is a significant precursor to developing type 2 diabetes.
Sometimes making healthier lifestyle changes can improve the symptoms, but some people with type 2 diabetes may need to take medications to keep their blood sugar levels stable.
The CDC notes that around 37 million people in the United States have diabetes, with 90–95% of these cases being type 2 diabetes.

Back to the study–
When the researchers found that the artificial pancreas worked well with the dialysis group, they wanted to determine whether it could be effective in other people with type 2 diabetes. With the number of people living with type 2 diabetes on the rise, researchers are always looking for more efficient treatments. They hope this could be it.

The artificial pancreas is not an artificial organ that requires surgical implantation but a technological device the user wears on the body that mimics how the pancreas works. It combines an insulin pump and glucose monitor, which link to an app that uses an algorithm to analyze blood glucose levels and deliver insulin as needed to keep levels stable.

For this study, the researchers observed 26 people with type 2 diabetes. The scientists divided the participants into two groups.
The first group used the artificial pancreas for eight weeks and then switched to eight weeks of standard therapy. The second group started by receiving standard injection therapy for eight weeks and then switched to the artificial pancreas.

The goal was to see how much time patients of each group spent with their glucose in the target range of 3.9 and 10 millimoles per liter (mmol/L), the glucose range considered acceptableTrusted Source for people with diabetes.

By the end of the trial, the participants who used the artificial pancreas stayed in their target glucose range for twice as long as they did without the device.

The authors wrote, “The present study shows that fully closed-loop insulin delivery is a safe and effective approach to improve glycemic control in people with type 2 diabetes during 8 weeks of use in the outpatient setting.”

They also noted that one area of concern using an artificial pancreas was the risk of hypoglycemia, which is when the body’s blood sugar is too low. Fortunately, that did not happen.

Co-lead author of the study, Dr. Charlotte Boughton, points out, “Many people with type 2 diabetes struggle to manage their blood sugar levels using the currently available treatments, such as insulin injections.”
The artificial pancreas can provide a safe and effective approach to help them, and the technology is simple to use and can be implemented safely at home.”

Dr. Boughton is hopeful that the device will be available within the year, stating, “Our main message from this study is that this fully automated closed-loop system is a safe and much more effective way for people living with type 2 diabetes to manage their glucose levels than current standard treatment with insulin. The device has been submitted for regulatory approval in the U.K. and we anticipate that this may be commercially available for people with type 2 diabetes in the next 12 months.”

Dr. Ishita Prakash Patel, an endocrinologist with Texas Diabetes and Endocrinology in Austin who was not involved in this study, commented on the successful trial. She called the study an “interesting topic”. She noted that “the fully automated — vs. the hybrid currently available — closed-loop insulin pump is the next step we are all looking toward with excitement in the insulin pump world.”

While Dr. Patel is excited about this step, she cautioned that the study was “a small single-center study over a short time period.” Nevertheless, she commented, “In the future, it will be exciting to see multicenter data over longer periods of time, which will certainly come. It will also be interesting to see type 1 diabetics studied, as they typically have more insulin sensitivity, to see if hypoglycemia rates are increased in this population. The diabetic device research field is moving steadily toward fully automated closed-loop insulin pumps. This is a very exciting frontier for our insulin-dependent patients.”

“We have already seen great success with the hybrid models of pumps, but these newer models will not require input of carbohydrate intake,” she noted. “Once optimized, this will make the disease more manageable and less time-consuming while improving blood sugar control in our patients.”

Who knows what that means for us over here across the pond? Maybe more efficient treatments like this one are on our horizon as well. I suppose only time will tell.

Sources:
https://diabetes.org/diabetes/type-2
https://www.healthline.com/health/dialysis
https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/symptoms-causes/syc-20354532
https://www.cdc.gov/diabetes/basics/type2.html
https://www.nature.com/articles/s41591-021-01453-z
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645943/