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General : Artificial pancreas  
     
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From: MSN NicknameTraveler100  (Original Message)Sent: 11/15/2008 12:21 AM

Artificial pancreas would dial up diabetes control

By Mary Brophy Marcus, USA TODAY

Ed Damiano wakes up three times a night to check on his son David. He just wants to make sure his 9-year-old's blood sugar levels are OK. David has type 1 diabetes and, like a lot of children with the condition, his blood sugar can dip dangerously low some nights and spike on others.

Damiano quietly checks David's blood sugar using a glucose monitor as he sleeps. With help from the school nurse, he and his wife do the same by day, when David's blood sugar can spike after eating.

STUDY: Number of kids on medication jumps sharply

But it may not always have to be like this, says Damiano, associate professor of biomedical engineering at Boston University. He and more than a dozen other scientists nationwide are developing artificial-pancreas technology that will reduce or do away with nighttime and daytime checks for parents and help adults and children with type 1 diabetes better control the disease. But it may be years before it's available.

In type 1 diabetes, the body produces little or no insulin, a hormone needed to convert sugar (glucose), starches and other food into energy. Patients must take insulin when they eat to fend off a glucose overload. They also experience abnormal swings between high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia), says Bruce Buckingham, professor of pediatric endocrinology at Stanford University. Children's fluctuating hormones and activity levels also can influence blood sugar. Eating well and getting the right amount of insulin to keep blood sugar close to normal is a fine art, he says.

The artificial pancreas, which would be worn externally and supplied with insulin, would reduce those highs and lows, Damiano says. "We call it a closed-loop system. It's comprised of three parts: a continuous glucose monitor, an insulin pump and a computer chip that allows the two devices to 'talk' to each other and calculate how much insulin a patient needs at any given time."

The first two elements ?the hardware ?already are being used by people with diabetes, says Steve Sabicer of Medtronic Diabetes, a California-based company that makes continuous glucose monitors and insulin pumps. What is new is the software, or a computer chip, that would allow the two devices to work together automatically. Versions of Medtronic's hardware and similar ones by other companies, including Abbott Laboratories and Johnson & Johnson, also are being tested, researchers say.

Damiano's lab is among those working on prototypes of the unifying computer software.

"With all three components, a user would not have to worry about dialing in the correct amount of insulin. The technology would do it," he says.

One out of every 300 children have type 1 diabetes. It accounts for up to 10% of U.S. diabetes cases, says the American Diabetes Association.

Experts say the technology will revolutionize treatment of type 1 diabetes and may help people with advanced type 2.

"Not to be too grandiose about it, but the artificial pancreas will dramatically transform diabetes care for people with type 1 who really depend on a very burdensome regimen to stay in good control," says Stuart Weinzimer of Yale University School of Medicine.

But closed-loop technology is five to 10 years off, estimates Buckingham. "The (software) needs to be perfected and it will need to be tested outside the lab in real-world settings for efficacy and safety."

Damiano says it can't come soon enough for David, who has had diabetes since he was 11 months old: "I hope it will be ready by the time my son goes off to college."



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