Research ArticleDiabetes

A Bihormonal Closed-Loop Artificial Pancreas for Type 1 Diabetes

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Science Translational Medicine  14 Apr 2010:
Vol. 2, Issue 27, pp. 27ra27
DOI: 10.1126/scitranslmed.3000619

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Using Math to Treat Diabetes: Automated Blood Glucose Control

People with Type 1 diabetes become experts at monitoring their own blood glucose levels, self-injecting insulin daily to compensate for the loss of their pancreatic islet cells. This lifelong vigilance is difficult, and stable blood glucose can often be elusive. An artificial pancreas would be a welcome development. El-Khatib and colleagues have now taken the first steps toward developing such a device and have shown that their system can keep blood glucose within an acceptable range, even after carbohydrate-rich meals.

Their artificial “pancreas,” really a closed-loop control system, is composed of a continuous blood sugar monitor, hormone pumps, and a laptop running a computer program that allows the two pumps to communicate and calculate how much hormone the patient needs at any given time. As in a real pancreas, two hormones with opposing actions on blood sugar—insulin and glucagon—were delivered into the subjects’ bloodstream. The computer algorithm incorporated a pharmacokinetic model for insulin so that it could accurately account for the decay of insulin levels in the blood. Of the 11 subjects, who were followed for 27 hours, six maintained a desirable mean blood glucose concentration of 140 mg/dl with no decreases. For the other five subjects, their slower insulin absorption required adjustment of the pharmacokinetic model to maintain stable a blood glucose concentration, but once this was done, they too showed no hypoglycemia.

Although in these experiments the algorithm was executed on a laptop computer, the device could eventually run on a computer chip as part of a fully wearable, portable artificial pancreas system. Such a device would provide better control of diabetics’ blood glucose concentrations and improve their quality of life.

Footnotes

  • * These authors contributed equally to this work.