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Perfecting a 'Pancreas': Scientists Fine-Tune a Device to Be Used By Diabetics, Monitoring Blood Glucose, Sending Needed Insulin Amount

Posted on: Monday, 15 May 2006, 09:03 CDT

By Jamie Talan, Newsday, Melville, N.Y.

May 15--For decades, people with type-1 diabetes have been hearing about the possibilities of life with an artificial pancreas. Such a device would include a glucose sensor that would send warnings when blood glucose was too low or too high, and then it would alert an insulin pump - just like the real pancreas - to deliver the necessary amount of insulin.

That day may have finally arrived. Several studies are under way on a variety of technologies that mimic the pancreas, which produces insulin that regulates blood sugar. When blood glucose is too high or too low, patients can develop life-threatening complications.

Last month, the Food and Drug Administration approved the MiniMed Paradigm REAL-Time Insulin Pump and Conti- nuous Glucose Monitoring System, which provides real-time, continuous glucose monitoring.

It's a major advance for patients, but they still have to control their own insulin doses. Systems that "close the loop" are under study, said Aaron Kowalski, director of strategic research projects at the Juvenile Diabetes Research Foundation.

Such systems would mimic a pancreas by delivering insulin automatically in response to a sensor that monitors blood glucose. Such devices are about five years away, Kowalski said.

Drs. William Tamborlane and Stuart Weinzimer of Yale University School of Medicine have recently tested an artificial pancreas on 12 children with type-1 diabetes. While the children were monitored around the clock for 36 hours in a hospital, their blood glucose levels remained steady. The researchers hope to test more children, in their homes.

The scientists said one of the major surprises in the latest study of the artificial pancreas was that the children were so stable overnight. Weinzimer said nighttime is often difficult for patients and their families because if blood glucose dips and the patient is sleeping, the body doesn't send out distress signals. During the day, patients are routinely monitoring their blood glucose levels and then figuring out what to eat and when and how much insulin they need throughout the day to keep the blood sugars within normal range.

"It has changed our lives," said Leslie Burkhalter, whose 12-year-old daughter was diagnosed with type-1 diabetes in 2004. She is wearing yet another experimental glucose sensing device called the Navigator, which is made by Abbott Laboratories.

Before she began wearing it five months ago, the family would get up every two hours during the night to check their daughter's glucose levels. She was taking six finger sticks a day to monitor her blood glucose. Now, thanks to the device, she takes only one manual reading unless the machine beeps an alarm of an abnormal blood glucose reading.

The Yale scientists say the artificial pancreas is not yet perfected. It doesn't monitor blood glucose as precisely as would be needed in the world outside of a hospital-based experiment.

Good blood glucose control is the key to these devices. Spikes or drops in blood glucose can lead to complications, including heart disease, blindness, stroke, amputation and kidney problems.

For three weeks, Kowalski, 34, has been wearing a new device manufactured by Dexcom. This device monitors glucose around the clock. He's had type-1 diabetes since childhood. His brother also has diabetes.

It works like so: A patch is worn on the abdomen that carries a tiny wire through the skin to measure glucose. It is worn for several days, wirelessly transmitting information to a receiver the size of a cell phone. It is then replaced with a new sensor.

"People with diabetes have been waiting a long, long time for this," he said.

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Copyright (c) 2006, Newsday, Melville, N.Y.

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Source: Newsday, Melville, N.Y.

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