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Bionic Pancreas Outperforms Insulin Pump

People with type 1 diabetes – a lifelong condition — who used a bionic pancreas instead of manually monitoring glucose using fingerstick tests and delivering insulin using a pump were more likely to have blood glucose levels consistently within the normal range, with fewer dangerous lows or highs. The full report of the findings, funded by the National Institutes of Health, was published June 15th 2014 in the New England Journal of Medicine.

A release from the National Institute of Diabetes and Digestive and Kidney Diseases reports that the researchers at Boston University and Massachusetts General Hospital say the process of blood glucose control could improve dramatically with the bionic pancreas. Currently, blood glucose levels can veer dangerously high and low for people with type 1 diabetes the pancreas doesn’t make the insulin. Several times a day, the patients have to use fingerstick tests to monitor blood glucose levels and inject insulin by injection or get the insulin from a pump.

In two scenarios, the researchers tested a bihormonal bionic pancreas, which uses a removable tiny sensor located in a thin needle inserted under the skin that automatically monitors real time glucose levels in tissue fluid and provides insulin and its counteracting hormone, glucagon, via two automatic pumps. In one scenario, 20 adults wore this device combination and carried a cell phone sized wireless monitor around Boston for five days, unrestricted in their activities. In the other, 32 youths wore the device combination for five days at a camp for children with type 1 diabetes. Both groups were also monitored for five days wearing their own conventional pumps that deliver insulin.

“The bionic pancreas system reduced the average blood glucose to levels that have been shown to dramatically reduce the risk of diabetic complications,” said co-first author Steven Russell, M.D., Ph.D., assistant professor of medicine at Massachusetts General Hospital. “This is tremendously difficult with currently available technology, and so most people with diabetes are unable to achieve these levels.”

The researchers found about 37 percent fewer interventions for low blood glucose (hypoglycemia) and a more than twofold reduction in the time in hypoglycemia in adults using the bionic pancreas than with the manual pump. For adolescents using the bionic pancreas, results showed more than a twofold reduction in the need for interventions for hypoglycemia. Not only that, but both groups had significant improvements in glucose levels with the bionic pancreas, particularly during the night.

“The performance of our system in both adults and adolescents exceeded our expectations under very challenging real-world conditions,” said Ed Damiano, Ph.D., the paper’s senior author, an associate professor of biomedical engineering at Boston University and the parent of a son with type 1 diabetes.

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