Diabetes Dateline
Fall 2008

Artificial Pancreas Expected to Improve Quality of Life for People on Insulin

An artificial pancreas is a system of mechanical devices that mimics, as closely as possible, the way a healthy pancreas detects changes in levels of blood glucose, also called blood sugar, and responds automatically to infuse appropriate amounts of insulin. Though not a cure, an artificial pancreas is expected to enable better blood glucose control, thereby improving the quality of life for people on insulin.

People with type 1 diabetes—especially children and adolescents—are particularly likely to benefit from an artificial pancreas. People with type 1 diabetes must receive insulin therapy because their pancreas produces little or no insulin, the result of an autoimmune attack on the insulin-producing beta cells within the pancreatic islets. Many people with type 2 diabetes also eventually need to take insulin to manage the disease.

Achieving adequate blood glucose control remains a significant challenge for most diabetes patients on insulin. A common and serious side effect of insulin treatment is hypoglycemia, or low blood glucose. Severe hypoglycemia often occurs at night during sleep and can be life threatening.

Fear of hypoglycemia is a barrier to tight blood glucose control, which has been shown to reduce the risk of complications of diabetes in major studies such as the Diabetes Control and Complications Trial. An artificial pancreas has the potential to allow tighter blood glucose control while reducing or eliminating these dangerous episodes of hypoglycemia.

An artificial pancreas will consist of a continuous blood glucose sensor, an insulin delivery system, and a way to link them together in a closed-loop system. A closed-loop system will function automatically and generally not require the user to make calculations, enter additional information, or adjust insulin doses manually.

Much progress has been made in the development of continuous glucose monitoring (CGM) devices and insulin pumps. Several CGM devices and a number of insulin pumps from various manufacturers are available, and other devices are in development. One system from Medtronic integrates a CGM device with an external insulin pump, representing the first step in joining glucose monitoring and insulin delivery systems using available technology.

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NIH Publication No. 09–4562
December 2009