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Diabetes Charity e trabalho de Médico Dispositivo Companhia para “o Pancreas artificial”

por Brendon Nafziger, DOTmed News Associate Editor | January 18, 2010
Insulin pump/CGM
being developed
The Juvenile Diabetes Research Foundation announced this week it will team up with Animas Corporation, a subsidiary of Johnson and Johnson, to create an "artificial pancreas."

The New York-based JDRF has pledged $8 million to develop the device, which would combine an insulin pump with a continuous glucose monitor (CGM), running algorithms that would automatically control the amount of insulin dripped throughout the day.

Although pump-and-CGM tandems already exist, such as the Medtronic MiniMed Paradigm REAL-Time System, they are not fully automated, JDRF says.

In type 1 diabetes, patients need one-time spikes of insulin around meals, but also a steady, constant delivery, the background or basal rate, to mimic the continuous supply given by the healthy pancreas. CGMs-and-pumps deliver this background rate through schedules plugged in by the user, who has to plan them based on trends that vary with physical activity, illness and other factors, when insulin needs fluctuate.

According to JDRF, this demands rigorously diligent compliance.

"If you think about someone with diabetes who is wearing an insulin pump, it 'runs' through their brain: they're thinking about their dosing decisions all the time," Aaron Kowalski, Ph.D., assistant vice president for glucose control at JDRF, tells DOTmed News. "They think about how much they're going to sleep, how much exercise they have, when they're eating."

Because of this, Dr. Kowalski says even the most motivated people with the best equipment only spend 30 percent of their day in the glucose ranges of those without diabetes.

"What we're trying to do here is, we have this continuous glucose information, and we have engineers developing algorithms - the sophisticated computer software coming into the the pump. Based on that information, the insulin dosing becomes automated," he says.

The goal of the new device, Dr. Kowalski says, would be to keep blood sugar within a target range. This means if blood sugar dips low overnight, the pump would shut off, preventing the continuing dosing of insulin which could lead to a dangerous hypoglycemic episode. And if during the day, say in the morning, blood sugar spikes, it could automatically turn the pump up to deliver more hormone.

Currently, glucose monitors will sound alarms if blood sugar levels become dangerously low, but Dr. Kowalski thinks auto-dosing would be better, especially if the drop happens while the patient is sleeping.

"We know from a lot of research, [people with diabetes] don't wake up from alarms, because the hypoglycemia, the low blood sugar, blunts their ability to do that. And they're asleep," he says.