Thirty-five years have passed since the first primitive artificial pancreas was developed, and it grows increasingly near its perfection. For many, this is the answer to solving the daily pressures caused by type 1 diabetes (T1D). The continual progress in the closed-loop insulin delivery system (CLIDS) is strived to become a fully automated artificial pancreas to put a stop to rigorous, daily manual insulin infusions. With the latest advancements in the technology such as overnight and meal announcements functions; T1Diabetics will be seeing a brighter future than once before.
T1D is an autoimmune disease which cannot recognise and attacks ‘self’ insulin producing beta cells in the pancreas. Insulin is an important hormone which when secreted, aids in the movement of glucose from the blood into the cells of the body (Driscoll, 2010). The lack of production of insulin causes hyperglycaemia - high blood glucose levels (high BGL), eventually leading to the onset of serious chronic ailments such as retinopathy which causes permanent blindness, and end stage kidney disease (JDRF, 2012).
Figure 1: BGL Chart (Sandrio, 2011)
The traditional method to treat diabetes was the finger stick method; continual monitoring of BGL accompanied by an average of 6 manual insulin injections a day. This demanding regime involving strict lifestyle and dieting caused T1Diabetics to withdraw from society, thereby suffering from anxiety and depression. This is seen where ¼ adult with T1D are diagnosed with varying levels of these symptoms (JDRF, 2012).
The CLIDS acts like an artificial pancreas, as it involves real time monitoring and controlled insulin infusion rates. Its sophisticated technology is beginning to become the mainstream method of treatment with the finger stick method becoming more rapidly out-dated. (Figure 2) Advantages include, a sensor placed in subcutaneous tissue that oxidases the glucose in the interstitial fluid; this produces an electric current that the machine can measure to provide an output BGL (Kumareswaran, 2012). From the reading, the algorithm can predict trends of future glycaemic excursions, thus calculates precise infusion rates of insulin to delicately control BGL. Another advantage to this system is that it will alarm the user if BGL begin to fall out of the normal range, therefore informing the user to take countermeasures before the onset of symptoms.
It can be seen that the advantages of the CLIDS overwhelm that of traditional manual treatments. However the technology is continually updated, now boasting features such as the overnight and meal announcement algorithms (Kumareswaran, 2012). These two modes activate specific algorithms that are modelled on the metabolic activity during these periods. The overnight mode causes the technology to run on an algorithm based on a long period in an inactive state, where fear of hypoglycaemia is greatest. Likewise, during meal announcement mode, the technology runs on an algorithm based on glucose absorption from the gut, which is when risk of hyperglycaemia is greatest. (Figure 1) These new additions allows the CLIDS to act before glucose levels fall out of the normal range, as insulin dispersion requires a delay time before lowering effects in the BGL begin (Driscoll, 2010).
The CLIDS is a miracle to those suffering from T1D. Its partially automated system puts an end to unmanageable self-motivation of constant BGL awareness. The technology makes dieting, exercising and lifestyle far easier to approach, as it produces all the calculations. This will make participation in events such as sports and socialising virtually hassleless; it is currently and will continually improve the quality of T1Diabetics health, socialness and life.
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Kumareswaran, K. (2012). Closed-loop Insulin Delivery: Towards Improved Diabetes Care. Available: http://www.discoverymedicine.com/Kavita-Kumareswaran/2012/02/23/closed-loop-insulin-delivery-towards-improved-diabetes-care/. Last accessed 17th Mar 2012.
Driscoll, P. (2010). Closed loop glucose monitor/insulin pump – Artificial Pancreas. Available: http://mediligence.com/blog/2010/01/13/closed-loop-glucose-monitor-insulin-pump-artificial-pancreas/. Last accessed 17th Mar 2012.
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