What is an artificial pancreas and how does it work?
An artificial pancreas is a device that mimics the function of the pancreas, an organ that produces insulin, a hormone that regulates blood sugar levels. People with type 1 diabetes have an autoimmune condition that destroys the insulin-producing cells in their pancreas, making them dependent on external sources of insulin.
An artificial pancreas consists of three main components: a sensor that measures blood sugar levels, a pump that delivers insulin, and a computer algorithm that calculates the optimal dose of insulin based on the sensor data. The device can automatically adjust the insulin delivery according to the changing needs of the body, without requiring manual input from the user.
An artificial pancreas can help people with type 1 diabetes achieve better control of their blood sugar levels, reducing the risk of complications such as heart disease, kidney failure, nerve damage, and vision loss. It can also improve the quality of life of people with type 1 diabetes by eliminating the need for frequent finger-prick tests and injections, and reducing the burden of constant calculations and adjustments.
Why is England rolling out artificial pancreas tech for free?
England is planning to offer free artificial pancreas tech to thousands of people with type 1 diabetes over the next five years, through the country’s public health system, the National Health Service (NHS). The decision was based on the recommendation of the National Institute for Health and Care Excellence (NICE), an advisory body that evaluates the cost-effectiveness of drugs and medical devices for the NHS.
NICE found that artificial pancreas tech, also known as hybrid closed loop systems, was a cost-effective measure for people with type 1 diabetes who have difficulty managing their condition with other methods. The body reviewed data from real-world trials involving NHS patients, and concluded that the devices improved blood sugar control, reduced hypoglycaemic episodes (where blood sugar levels fall too low), and enhanced quality of life.
The NHS will need to negotiate a reasonable price with the manufacturers of the devices, which currently cost around £5,750 ($7,000) a year. The devices are expected to benefit more than 100,000 people with type 1 diabetes in England and Wales, who meet the eligibility criteria set by NICE.
What are the benefits and challenges of artificial pancreas tech?
Artificial pancreas tech has been hailed as a “life-changing” innovation for people with type 1 diabetes, as it can significantly improve their health outcomes and well-being. The devices can reduce the variability of blood sugar levels, which can have a positive impact on the long-term complications of diabetes. They can also reduce the stress and anxiety associated with managing diabetes, and allow people to enjoy more freedom and flexibility in their daily activities.
However, artificial pancreas tech is not a cure for type 1 diabetes, and it still requires some input and monitoring from the user. For example, the user will need to inform the device when they eat food containing carbohydrates, and check the sensor and pump regularly for accuracy and functionality. The user will also need to carry a backup insulin delivery system, such as a pen or syringe, in case of device failure or malfunction.
Additionally, artificial pancreas tech may not be suitable or accessible for everyone with type 1 diabetes, depending on their individual circumstances and preferences. Some people may prefer to use other methods of insulin delivery, such as continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI), which may offer more flexibility and personalisation. Some people may also face barriers to accessing or using artificial pancreas tech, such as cost, availability, education, or support.
How does artificial pancreas tech compare to other diabetes technologies?
Artificial pancreas tech is one of the most advanced and sophisticated diabetes technologies available, but it is not the only option for people with type 1 diabetes. Other diabetes technologies include:
- Continuous glucose monitoring (CGM) systems, which measure blood sugar levels continuously and display them on a device or a smartphone app. CGM systems can alert the user when their blood sugar levels are too high or too low, and provide trends and patterns over time. CGM systems can be used with or without an insulin pump, and some can communicate with the pump to adjust the insulin delivery.
- Flash glucose monitoring (FGM) systems, which measure blood sugar levels by scanning a sensor worn on the upper arm. FGM systems do not require finger-prick tests, and can show the current blood sugar level, as well as the direction and rate of change. FGM systems do not provide alerts or alarms, and do not communicate with insulin pumps.
- Smart insulin pens, which are devices that deliver insulin injections and record the dose and time of each injection. Smart insulin pens can connect to a smartphone app or a CGM system, and provide reminders and recommendations for the user. Smart insulin pens can help the user keep track of their insulin intake and avoid errors or missed doses.
What are the future prospects of artificial pancreas tech?
Artificial pancreas tech is a rapidly evolving field, and researchers are working to develop and improve the devices to make them more effective, reliable, and user-friendly. Some of the areas of research and innovation include:
- Developing fully closed loop systems, which can deliver insulin without any input from the user, even when they eat or exercise. Fully closed loop systems would use more advanced algorithms and sensors to detect and respond to changes in blood sugar levels and other factors, such as hormones, stress, and illness.
- Integrating glucagon delivery, which can raise blood sugar levels when they are too low. Glucagon is a hormone that counteracts the effect of insulin, and can be used to treat severe hypoglycaemia. Integrating glucagon delivery into artificial pancreas systems would provide an additional layer of safety and protection for the user.
- Incorporating artificial intelligence (AI) and machine learning, which can enhance the performance and personalisation of artificial pancreas systems. AI and machine learning can analyse large amounts of data and learn from the user’s behaviour and preferences, and provide more accurate and tailored insulin delivery.