Wellness 

Artificial Pancreas Systems: The Future of Diabetes Management?

Understanding the human pancreas
The science behind artificial pancreas systems
Current APS research and breakthroughs
Challenges and considerations
The future landscape of diabetes management
References
Further reading

Diabetes is a chronic disease characterised by a failure of insulin to control blood glucose levels with two main types: type 1 and type 2.

Diabetes is a global concern, with 783 million adults expected to live with the disease by 2045, according to the IDF Diabetes Atlas.

The disease poses a substantial impact on public health due to health complications, economic burdens and reduced quality of life. It is linked to obesity and lifestyle choices, contributing to complications such as heart disease.

An artificial pancreas system (APS), also known as a closed-loop system, is an advanced medical technology designed to help diabetes patients manage their blood sugar levels, particularly those with type-1 diabetes.

Image Credit: mi_viri/Shutterstock.com

Understanding the human pancreas

The pancreas is an organ that has two main functions in the body. Its endocrine function involves insulin production to regulate blood sugar and glucagon production to raise it. On the exocrine side, it secretes digestive enzymes that aid in breaking down food for nutrient absorption in the small intestine.

Type-1 diabetes is an autoimmune condition where the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. Patients with type-1 diabetes must take insulin regularly to survive.

Type-2 diabetes occurs when the body doesn’t use insulin effectively or doesn’t produce enough insulin. It is the most common form of diabetes and is often linked to lifestyle factors like obesity, poor diet, and lack of physical activity.

Individuals with a malfunctioning or non-functioning pancreas face life-long insulin dependency, blood sugar management, and risks of complications.

The science behind artificial pancreas systems

APSs are designed to automate and optimize insulin delivery by mimicking the function of a healthy pancreas. The system continuously monitors blood glucose levels whilst adjusting insulin delivery accordingly.

An APS is made up of three main components: continuous glucose monitor (CGM), an insulin pump, and a control algorithm.

CGM’s are devices that continuously measure glucose levels in the body, often through a sensor placed under the skin. CGM’s provide real-time data about blood sugar levels, helping people with diabetes to better manage their condition.

The Insulin pump delivers insulin into the body when the CGM detects a rise in blood sugar levels (hyperglycemia). When it detects low blood sugar levels (hypoglycemia), the system can suspend or reduce insulin delivery to prevent further drops.

The control algorithm is a specialized software program that runs on a computer or microcontroller, processing the data from the CGM. It calculates the required insulin dose, instructing the insulin pump to deliver the appropriate amount of insulin.

The system operates in a continuous feedback loop, providing real-time data to the control algorithm.

Artificial Pancreas Helping Children With Type 1 Diabetes

Current APS research and breakthroughs

Current APS research explores advanced control algorithms. In a paper written in April of this year, an APS centered around an Android Smartphone is proposed. The system comprises two modular Android applications, App-A and App-B, each serving distinct purposes.

App-A acts as the user interface and facilitates hardware communication, while App-B employs a safety-critical model predictive control algorithm with constraints for precise insulin rate calculation.

This research introduces a smart way to build a system that can help people with diabetes control their blood sugar using an Android Smartphone. The design makes the development process faster and safer, ensuring that the system operates effectively while minimizing the risk of errors.

Challenges and considerations

Implementing APS in diabetes management presents technological hurdles related to interoperability and data security. Physiological challenges include patient variability in insulin response and unpredictable meal impacts.

Patient acceptance and education pose psychological obstacles. Healthcare professionals (HCPs) may worry about patients overly relying on APS and require training to support them. Concerns also arise about the cost and accessibility of APS technology.

Despite these challenges, APS offers enhanced disease management, improved glycemic control, and reduced patient burden. Collaborative efforts among patients, HCPs and technology providers are essential to overcome these hurdles and harness the full potential of APS.

The future landscape of diabetes management

Widespread adoption of APS holds promise for improving glucose control and quality of life for diabetes patients while reducing healthcare costs. However, obstacles such as device maintenance, data privacy, and initial costs must be addressed.

Healthcare providers may need to adapt to support and educate patients on APS technology. It's unlikely that APS will fully replace traditional diabetes management methods, as patient preferences and access barriers remain. Instead, APS is expected to coexist with traditional approaches, offering more options for tailored care.

The extent of APS transformation in diabetes care will depend on technological advancements, regulatory approvals, and patient choices.

APSs have the potential to revolutionize diabetes care by automating insulin delivery, improving glucose control, reducing hypoglycemia, and enhancing quality of life for patients.

While ongoing research continues to advance APS technology, it is important for individuals living with diabetes, healthcare professionals, and regulators to remain informed and open-minded about emerging innovations in diabetes management.

The future of APS holds promise for more accessible, effective, and patient-centric diabetes care, offering hope for improved outcomes and a brighter future for those affected by this chronic condition.

References

  • Chandrasekhar, A., Saini, D. and Padhi, R. (2023). An artificial pancreas system in android phones: A dual app architecture. Pervasive and Mobile Computing, p.101767. doi:https://doi.org/10.1016/j.pmcj.2023.101767.
  • International Diabetes Federation (2022). IDF Diabetes Atlas | Tenth Edition. [online] IDF Diabetes Atlas. Available at: https://diabetesatlas.org/#:~:text=Diabetes%20around%20the%20world%20in%202021%3A.
  • Nwokolo, M. and Hovorka, R. (2023). The Artificial Pancreas and Type 1 Diabetes. The Journal of Clinical Endocrinology & Metabolism. doi:https://doi.org/10.1210/clinem/dgad068.

Further reading

  • Diabetes Types
  • History of Diabetes
  • The Future of Diabetes Treatment

Last Updated: Nov 7, 2023

Written by

Jenna Philpott

Jenna graduated from Nottingham Trent University in 2022 with a BSc in Biochemistry. She achieved a first in her undergraduate research project which concerned the role of metabolic stress on pancreatic beta cell function, investigating its contribution to the development of type 2-diabetes mellitus (T2DM). The study highlighted the importance of understanding molecular pathways in beta cells for developing prevention measures and new therapeutic options for T2DM.