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Endocrinologist explains how the “Artificial Pancreas” works

Dr. John Dornan, Chief of Staff, Horizon Health Network

As an endocrinologist, I have been treating patients with diabetes for over 30 years. In those 30 years there have been plenty of changes and advancements, but the development of the "artificial pancreas" was not something I expected to see in my lifetime.

An artificial pancreas has been a dream for endocrinologists for as long as I can remember, well before I entered the field.

But, let's back up for a minute and talk type 1 diabetes.

Type 1 diabetes is not as common as type 2 diabetes, representing about 10 per cent of all people with diabetes. Because the numbers are smaller, the public is less familiar with type 1 diabetes and it's often misunderstood. 

There is currently no cure for type 1 diabetes, and the cause is still unknown. It is not preventable and is not caused by diet or lifestyle.

In the past, type 1 diabetes was commonly referred to as juvenile diabetes, but now we know a large portion of the population diagnosed with type 1 diabetes are adults.

This is a disease where the pancreas does not produce insulin, and insulin is a vital hormone that helps control glucose levels.

Approximately 20 years ago health care providers started giving people with type 1 diabetes insulin through a pump, and then about eight to ten years ago continuous glucose sensors were introduced.

That meant we could be aware of what the blood sugar was doing at all times, and we had a device that was giving insulin continuously. However, health care providers and patients faced a software challenge: the pump and the glucose sensor didn't communicate with each other.

Now, there is a hybrid closed loop system - or what we refer toas the "artificial pancreas" - which solves these problems. This was developed by Medtronic.

Artificial Pancreas Blog Post

Dr. John Dornan, Horizon's Regional Chief of Staff, and patient Alicia Hunt are photographed in Dr. Dornan's office at Horizon's Saint John Regional Hospital. Alicia is one of the first patients in Atlantic Canada to receive the new pump system.

Diabetes experts are trying every day to get as close to a healthy pancreas function as possible and the Medtronic MiniMed 670G Insulin Pump System is very close.   

This new insulin pump technology will give insulin automatically and safely. Now, people's blood sugars will not drop too low while they sleep or rise dangerously high during the day.

The pump itself is a relatively a small device (weighing only a few ounces) that is worn permanently on the outside of the body and is connected by a radio signal to a glucose sensor. The sensor is inserted below the skin to measure glucose levels and can be worn for several days.

One of the biggest values of the new technology is that it will cut down on complications. Diabetes comes with significant complications, including heart disease, kidney disease and eye disease.  If we can reduce the onset of these complications we've helped our diabetic patients tremendously, which is our primary goal.

Equally importantly is the ability to help patients in a safe way. I believe this will allow for better control and fewer complications in a safe manner.  

In endocrinology there is a lot of research in hormone replacement therapy in the diagnosis of diseases and understanding diseases.

There have been a lot of changes in the technologies used for diabetes over the years, and most of them are incremental. However, I would call this a revolutionary change. It will make a big difference in controlling the complications from diabetes.

There are a number of patients in New Brunswick waiting to start using this new technology. If you or someone you know has type 1 diabetes talk to your local diabetes team to see if this system could work for you.

In the two years since it was introduced in the Unites States over 10,000 Americans have begun using it and we expect a similar rapid implementation in Atlantic Canada.

With these significant advancements we are going to see people with diabetes have normal life expectancies and live normal lives. That is very exciting. 

 

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