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According to the 2011
National Diabetes Fact Sheet, 25.8 million children and adults have
diabetes in the United States, costing a total of $174 billion dollars in
diagnosis, $116 billion in direct medical costs, and $58 billion of indirect
costs (disability, work loss, premature mortality). But there is hope for the
millions of people with diabetes; researchers are growing ever closer to
developing an artificial pancreas.

Artificial pancreas. Image
Credit: JDRF
There are two types of diabetes; Type
1 is an autoimmune disease in which the body does not produce insulin, and type
2 is when the body doesn't produce or use the insulin adequately. In type 1 diabetes, the immune system attacks
beta cells in the pancreas and destroys the body's ability to produce insulin,
which is used to

metabolize carbohydrates from food to fuel the body's cells.
The disease is managed with insulin injections or a pump. The pump uses a tiny
catheter inserted under the skin to deliver insulin every few days.
This can become dangerous because the patient is guessing
how much insulin they'll need based on the food they eat and their activity
level. If the insulin level becomes too high they will become hypoglycemic (low
blood sugar) and pass out. Hypoglycemia can also result in death if left
untreated. Too little insulin causes hyperglycemia (high blood sugar), which
over time can cause additional complications, such as heart disease, and kidney
and eye problems.
Diabetes in the body. Image
Credit: medicinenet.com
The pancreas secrets several hormones, including insulin
and glucagon, for metabolic regulation within the body. An artificial
pancreas would remove the decision making process and adjust the insulin
level required at any given moment. Developing this device has proved
difficult. The artificial pancreas must detect the patient's blood sugar levels
and know whether it's trending up or down. It also needs to be able to hold and
deliver insulin and deal with low blood sugar levels.

Currently, a patient with type 1 diabetes will consume
food or sugar-containing drink to adjust for drops in blood sugar. Their device
may shut off or sound an alarm to let them know their blood sugar is getting
too low. One device currently in development contains the hormone glucagon,
which can quickly raise blood sugar levels. The device is being developed by
researchers at Boston University, Harvard Medical School, and Massachusetts General
Hospital. The team was able to present a prototype at the recent annual
American Diabetes Association meeting.
The prototype uses a continuous glucose monitor, an insulin pump, and
artificial pancreas software that couples with a low-powered Bluetooth device
and an app for the iPhone 4S. The device can fit in a pocket and it is
completely closed-loop because it includes both glucagon and insulin. This
device will be tested in hospital patients very soon with hopes of moving to a
large-sale six-month outpatient trial by 2015. Image Credit: Healthmatters2day.blogpot.com
Another artificial pancreas design is called the
Hypoglycemia-Hyperglycemia Minimizer. It was developed in partnership with the Juvenile
Diabetes Research Foundation and Animas (insulin-pump makers). This device can
automatically predict increases and decreases in the blood sugar, as well as
adjust the insulin dosage according. However, this device does not contain
glucagon.

Artificial pancreas device system. Image Credit: FDA
The artificial pancreas will likely be developed and
approved in steps, with constant improvements being made to the products on the
market.
Resources
More
progress made on artificial pancreas for diabetes patients
What is
the pancreas? What is an artificial pancreas system?
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