The Bionic Pancreas for Diabetes…and Hopefully A Good Step for Chronic Pancreatitis

Big news in the world of diabetes was announced this week:  Researchers at Mass General Hospital and Boston University invented a “bionic pancreas” that can help diabetes patients regulate their blood sugar.  The device includes a sensor implanted under the skin and two pumps, all controlled by an iPhone app.  The sensor measures blood sugar every five minutes.  When it detects that blood sugar is too high, the app signals one pump to deliver fast-acting insulin to the bloodstream; if blood sugar is too low, it signals the other pump to provide glucagon that will raise it.

bionic pancreasCurrently, patients can use insulin pumps that deliver an amount of insulin based on their blood sugar and what they eat, which they program into the pump.  The addition of the sensor takes this to another level…though users still enter some data about what they are eating into the app (such as whether they are eating breakfast, lunch or dinner, and whether they are eating more or less than usual), which then drives an algorithm to determine how much medicine should be needed.

The device showed some promising results in a five-day human trial involving 20 adults and 32 teenagers with type 1 diabetes.   For example, when using the bionic pancreas, all of the adults had mean glucose levels at the therapeutic target compared with 9 out of the 20 when using the insulin pump.  (See a New England Journal of Medicine article discussing methods and results in detail.)

One implication for those suffering with chronic pancreatitis is that it can help deal with diabetes following a pancreatic resection, or removal of the pancreas.  More and more patients opt to undergo this serious procedure when quality of life suffers due to CP.  The state of the art procedure includes transplantation of insulin-producing cells to the liver with the goal of avoiding diabetes, but it is a significant risk.  (You can see a video discussing the results of the TP/IP procedure in this post.)  It is good to know that those patients will likely have additional tools available to them to deal with that risk.

The greater hope is that it is a step in the direction of a true bionic pancreas — an implantable device that performs the critical functions of the pancreas and can supplement or replace the defective organ that causes so many of us pain and suffering.  That step will likely require stem cells, perhaps in combination with 3D printing of tissue — both of which are the subject of research now.  (See a recent post on growing insulin-producing cells.)  Those developments cannot come soon enough…but are likely -10 years away.  In the meantime, hopefully incremental solutions like this will continue to emerge.

For more information on the bionic pancreas, see the researchers’ website at http://www.artificialpancreas.org/ or see a recent Time Magazine piece on the development here.