Insulin pumps and blood glucose monitors have improved the lives of countless patients with diabetes, but no one has integrated the two — until now.
|Fouad R. Kandeel is gathering data for a new device for those with type 1 diabetes. (©2007 Philip Channing)|
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 Division of Diabetes, Endocrinology & Metabolism at City of Hope.
Patients still must vigilantly monitor and evaluate their own blood glucose levels before and after eating and exercising and then must administer insulin with their pumps to prevent blood glucose levels from wildly fluctuating. For some, this is a confusing, intimidating process.
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.”
Added Kandeel: “The dream of the 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.”
Before designers can link a pump and monitor, though, scientists must determine
the algorithms, or calculations, that can be used to link the two. Scientists do this by creating a mathematical model based on data from sensors worn by current diabetes patients. The researchers are collaborating with the potential device’s maker, Medtronic, to develop and refine the algorithms that will control the insulin pump using glucose-level information coming from the sensor, Kandeel explained.
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 will speak at the American Diabetes Association annual meeting in June about future applications of this system, and a month later, he will attend a workshop co-sponsored by the National Institutes of Health, the Juvenile Diabetes Research Foundation 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 see expanded studies of the artificial pancreas at City of Hope.
Of the more than 20.8 million people with diabetes nationwide, 5 to 10 percent have type 1. It is most common in children and young adults.