Artificial Pancreas and Type 1 Diabetes

Research is underway to develop an artificial pancreas for children and adolescents with Type 1 (or juvenile) diabetes.

If successful, the mechanism will dramatically improve the quality of life for children with diabetes by making it significantly easier to manage the condition and reduce the risk of hypoglycaemia.

The University of Cambridge has received £500,000 from the Juvenile Diabetes Research Foundation (JDRF) to fund the research which will be led by Dr Roman Hovorka with the Department of Paediatrics. Clinical trials of the artificial pancreas in children are scheduled to begin in January.

Type 1 Diabetes (T1D) is an autoimmune disorder which causes the body to attack the beta cells of the pancreas, limiting its ability to produce the insulin necessary to regulate blood sugar levels. Currently, in order to regulate glucose levels, diabetics manually test their blood sugar levels with a glucose meter (the blood sample is taken by pricking the skin). They then inject the necessary amount of insulin up to six times a day either by using an insulin pump or syringes.

As a result of the current cumbersome and imprecise process and day-to-day variability, regulating the blood glucose of children and adolescents can be extremely difficult. Additionally, regulating blood sugar levels can be more complicated in juveniles as they are known to have more severe fluctuations in their insulin need.

A more precise regulation of blood glucose, which is healthier for the individual, could be achieved by the development of an artificial pancreas. The artificial pancreas would couple a glucose sensor with an insulin pump to create a 'closed-loop' apparatus.

Specifically, the artificial pancreas will measure blood sugar levels on a minute-to-minute basis with a continuous glucose monitor. The signal is transmitted wirelessly to a handheld computer, which calculates the right amount of insulin for a given condition. The information on the insulin rate is then further transmitted wirelessly to an insulin pump delivering the insulin.

Dr Hovorka said, "There has been research into artificial pancreases for adults, but we are the only researchers in the UK researching a device for children. Insulin needs to be more accurately released to attain near-normal levels of blood glucose and to reduce the risk of dangerous low blood glucose levels – the greatest fear for parents of diabetics as it can result in hospitalisation, coma, and (rarely) permanent brain damage or death if not treated in timely manner. An artificial pancreas would enable the juveniles to maintain healthier, more stable blood sugar levels."

The project will initially focus on overnight laboratory and home use. The regulation of overnight glucose levels is extremely important as it improves the body's ability to control glucose levels during the day.