Date:17/09/16

How an Android-powered artificial pancreas could revolutionise diabetes management

A team researching artificial pancreas technology at the University of Cambridge has produced a prototype of an artificial pancreas closed-loop system.
 
"The basic idea is to improve glucose control in people with type I diabetes, and the reason is, because it's not very good! It's not very good because our body does an amazing function of keeping glucose control very tight, by changing the amount of insulin and other hormones in the body every hour and every minute, and also day to day. That's really difficult to achieve in people with type I diabetes," Dr Roman Havorka, who leads the Cambridge University research, told ZDNet.
 
While diabetics might not be able to adjust their own insulin levels overnight, artificial pancreases can keep glucose levels within the desired range from hour to hour. Over the course of one night to the next, a person's insulin requirement can be anything from 30 percent of their average requirement to 300 percent of it. "This underlying variability makes conventional therapy difficult, and it's why people have episodes of low glucose," Havorka said.
 
While the components of the artificial pancreas have all been singly available for some time, no commercially available system has been able to link them all together.
 
The Cambridge prototype system, however, has. "We really tried to move quickly with available technology. There have been lot of big promises made and then reality kicks in," Havorka said. "Our idea, and the whole [artificial pancreas] movement is to reduce the existing components -- which is the continuous glucose monitor and to use the insulin pump and have a COMPUTER PROGRAM which links the glucose measurement to insulin delivery," Havorka said. "It takes away the syncing process from people and does it behind the scenes."
 
The algorithm was built using the researchers' mathematical computer models of glucose metabolism, which are then individualised to reflect the particular diabetic patient that will wear the system, and how different doses of insulin will affect them. The optimal insulin levels are trialled in a simulation environment to test the various settings of the system.
 
 While ultimately the aim would be to make a system that's far smaller than the existing prototype, for now, artificial pancreas researchers are keen for time to market to take precedence over form factor.
 
In the prototype, the Cambridge University-developed system uses an Android smartphone to run the homegrown insulin-syncing algorithm. "The mobile phone is the hub for the COMPUTER PROGRAM and all the communication is wireless." For trials of the prototype, the phone is locked down, but it could ultimately be made available as a common-or-garden app.
 
By using the phone as the lynchpin of the system, the prototype can also give diabetics or their physicians an insight into their condition through the data it gathers. "People can always see what their glucose volume is and how much insulin is being given," Havorka said.
 
Of course, with any technology, there's a risk of failure -- the phone needing a reboot at a critical time, a sensor goes dark, a cannula gets blocked. If something goes wrong the system will set off an alarm to let the wearer know their glucose level has dropped too low. Researchers are currently working out the best way to use those alarms to alert patients of problems without causing "alarm fatigue", where users grow too accustomed to the warnings and begin to ignore them.
 
Before the artificial pancreas systems can be released, they'll need to undergo clinical studies to prove they're safe for use. The Cambridge group has already had diabetics use the system in their own homes without medical supervision, in groups including children, adults, and pregnant women.

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