Few categories of chronically ill people have benefited more from advances in medical technology than people with type 1 diabetes. An inherited autoimmune disease, type 1 diabetes occurs when the pancreas fails to process the hormone insulin in sufficient amounts to meet the body’s needs, and sometimes not at all. In the past type 1 diabetics had to carefully monitor and measure insulin levels, and inject themselves periodically, but now many patients can use devices that will do this automatically. An insulin pump no bigger than a cell phone automatically releases insulin at scheduled times, and can be used to bolster that dose as needed in addition.
Now some researchers are looking for ways to take this further. One problem even with insulin pumps is an inability to monitor, which can lead to administering insulin and then facing a dangerous drop in blood sugar. The wearer knows when to check blood sugar levels, and how to gauge whether this might be needed—for example, a lack of energy is an early sign of hypoglycemia, for which the person can then compensate. However, if blood sugar drops while a person is asleep, they can have a seizure, or even lapse into a coma, without ever realizing something is wrong. This is why currently doctors recommend diabetics make sure their blood sugar is slightly elevated at bedtime, to provide a greater margin.
The solution now being tested, however, is a closed-loop insulin delivery device that’s being called an artificial pancreas, with sensors that measure blood sugar on an ongoing basis wired to the insulin pump, adjusting the levels accordingly. This means that when the user is asleep, the machine provides safeguards against blood sugar dropping to dangerous levels— and, as a bonus, automates the monitoring process while they are awake.
In a three-month trial, patients using the experimental device had one-third fewer incidents of low blood sugar than those using ordinary pumps. The technology is still relatively crude, using only an automatic two-hour shutoff to regulate insulin levels, but researchers are hoping this will be the first step in developing a device that will precisely track blood sugar, responding immediately and discretely to smooth out highs and lows for diabetics.