Artificial Pancreas Improves Type 1 Diabetes Management

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The Control-IQ artificial pancreas system. Tandem Diabetes Care
Health Editor’s Note: With type 1 diabetes the body makes no natural insulin due to a genetic issue or as has been found, an autoimmune reaction. This can happen during childhood and after.  The body uses insulin to place sugar (glucose) into the body cells.  Body cells need sugar to properly function. The difference between type 1 diabetes and type 2 diabetes is that as formerly mentioned in type 1 the body produces NO insulin and needs total replacement or supplementation of insulin. Type 1 is like a key is lost to a lock in the cell that lets glucose into the cell. With type 2 diabetes the pancreas makes insulin but the body no longer recognizes the insulin, as if a lock has been changed and a key no longer works. 
High levels of glucose in the body, over time, causes many problems such as hearing loss, skin infections, vision problems, kidney failure, neuropathy, gum disease, sex difficulties , high blood pressure, amputation and more.  It is of utmost importance for the body to have the correct amount of glucose  at all times to avoid the above issues. The optimal result would be for insulin to be administered as it is needed, such has after a meal. Negative issues are caused with blood glucose levels are out of control with abnormal highs over periods of time. 
A functioning pancreas will release insulin as the blood glucose level increases after a meal is ingested.  Diabetics must check their blood glucose levels after meals, at bedtime, after excessive exercising, or at any time the body will have or need an increase in glucose levels. This testing is done by sticking the finger and getting a drop of blood to test for glucose level. To use a unit/artificial pancreas to decide when insulin should be administered (day or night without a finger stick) would make a diabetic’s life more normal and keep his or her health optimal due to the fact that glucose levels should remain where they should be. In essence the artificial pancreas will simulate a healthy pancreas…..Carol
Artificial pancreas improves type 1 diabetes management
by National Institutes of Health

At a Glance

  • An artificial pancreas system improved blood glucose control throughout the day and overnight for people with type 1 diabetes.
  • This technology may help reduce the daily burden of managing diabetes and lessen complications from the disease.
Eating healthy foods and controlling glucose levels with new technologies can help people with diabetes manage their condition.

 

Diabetes is a disease that happens when your blood glucose, or blood sugar, is too high. Glucose is the body’s main source of energy. Insulin, a hormone made by the pancreas, tells the body’s cells to take in glucose. If you have type 1 diabetes, your body doesn’t make insulin, and glucose builds up in your blood. Over time, high levels of blood glucose can cause serious health problems.

People with diabetes must test their blood glucose regularly with a fingerstick or use a continuous glucose monitor. They take insulin when needed by giving themselves injections or using an insulin pump. Researchers have developed all-in-one diabetes management systems. These “artificial pancreas” systems track blood glucose levels using a continuous glucose monitor, calculate when insulin is needed, and automatically deliver it using an insulin pump. Artificial pancreas systems don’t entirely eliminate the need for patient input, but substantially reduce the level of effort.

To test the efficacy and safety of an artificial pancreas, a team led by Drs. Sue A. Brown and Boris Kovatchev at the University of Virginia and Dr. Roy W. Beck at the Jaeb Center for Health Research carried out a six-month study of the Control-IQ technology system from Tandem Diabetes Care. They enrolled 168 people with type 1 diabetes. The study was funded by NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Results were published online on October 16, 2019, in the New England Journal of Medicine.

Participants were randomly assigned to use either the Control-IQ artificial pancreas or sensor-augmented pump (SAP) therapy. SAP uses a continuous glucose monitor and insulin pump, but still requires frequent input and decisions from the user about when and how much insulin to administer. The Control-IQ system uses advanced computer algorithms to automatically adjust insulin doses based on glucose levels.

The Control-IQ artificial pancreas system. Tandem Diabetes Care

People who used the artificial pancreas system showed a significant increase in the amount of time their blood glucose levels stayed in the target range of 70 to 180 mg/dL—from 61% at start of the study to 71%. This translated to an additional 2.6 hours per day in range. In contrast, the control group remained unchanged at 59%. Artificial pancreas users also showed improvements in time spent with high and low blood glucose and other measurements related to diabetes control.

No severe low blood sugar (hypoglycemia) events occurred in either group. Diabetic ketoacidosis—a life-threatening complication—occurred in one participant in the artificial pancreas group due to an issue with the insulin pump setup called pump infusion set failure.

“This artificial pancreas system has several unique features that improve glucose control beyond what is achievable using traditional methods,” says Kovatchev. “In particular, there is a special safety module dedicated to prevention of hypoglycemia, and there is gradually intensified control overnight to achieve near-normal blood sugar levels every morning.”

“Artificial pancreas technology has tremendous potential to improve the day-to-day lives of people with type 1 diabetes,” says NIDDK Director Dr. Griffin P. Rodgers. “By making management of type 1 diabetes easier and more precise, this technology could reduce the daily burden of this disease, while also potentially reducing diabetes complications including eye, nerve, and kidney diseases.”


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