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MATT HARBICHT/TANDEM DIABETES CARE/GETTY IMAGES
As it's known, diabetes is a disease which affects a significant amount of people in our society. According to data from 2021, 537 million (20-79 years old) suffer from type 1 or type 2 diabetes, a number estimated to increase significantly over time. Diabetics essentially face the problem of hyperglycaemia due to an insufficient production of insulin that is responsible for the metabolism of carbohydrates, fats and proteins. In type 1 diabetes, the pancreas does not produce any insulin and in type 2 diabetes, a small functionality is maintained, but insufficient to meet the needs of the body.
People with diabetes need to be very careful with blood glucose concentration as it can change abruptly. Effects of these changes are polyuria, polydipsia, weight gain, frequent urinary tract infections and in extreme cases coma.
In the past, in order to avoid episodes related to low glucose concentration, patients were trying to hold glucose at relatively high levels. However, as a result the patient had long-term complications such as neuropathy, retinopathy and myocardial infarction. Patients also had to measure often their blood glucose levels by piercing their fingers for some drops of blood.
So what’s the solution? An artificial pancreas! A device that regulates blood sugar levels (glucose levels) by giving more insulin. Most devices on the market are still "hybrid", ie. not fully automated. The patient must adjust the amount of carbohydrates at his meal and therefore helps the system to regulate glucose.
https://bio.libretexts.org/Learning_Objects/Worksheets/Book%3A_The_Biology_Corner_(Worksheets)/Anatomy_Worksheets/Feedback_Loops%3A_Glucose_and_Glucagon
To create a completely automated system, many parameters need to be considered. Essentially, the sugar level is affected by nutrition, exercise, various other diseases and external factors that affect the metabolism of an organism. The basis for dealing with these problems was presented by Richard Bergman and Claudio Cobelli bioengineers, who described human metabolism as a series of equations. In practice, however, finding a solution is difficult for the following three reasons:
Insulin Action Delay: As a healthy person, insulin is secreted by the pancreas and is pushed directly into the circulatory system. As a result, glucose levels may change slightly before and after a meal. When injected under the skin, it takes 40 minutes up to 1 hour to reach the peak of its action because pharmaceutical does not have the same "strength" as that secreted by the body. For this reason, there must be a provision by the artificial pancreas to reduce blood glucose levels, 1 hour earlier.
Inconsistency: Insulin activity varies from person to person, even in the same person, because it is affected by other hormones that may reduce or even stop its action.
Inaccuracy of sensors: Even the best continuous tracking sensors can experience bugs, which can take for hours.
In addition, the system must be capable of including complex external factors in order to work effectively for any age and lifestyle.
CHRIS PHILPOT
As it seems, those problems could be overcome after many years of research and testing. In detail, CONTROL-IQ technology after simulations and clinical studies showed that it can predict blood glucose concentration, with almost complete autonomy but it can also regulate, based on the device’s prediction, the insulin doses to be provided to the patient. The patient has the ability to enter his own data to the device (that he is eating or exercising) at the touch of a button just to "help" with the prediction. It is worth noting that this technology does not need an external device for its use as the algorithm is built to work into the pump.
Control-IQ technology from Tandem has been approved by the FDA (14 years after autonomy was presented as something impossible) and has been tested in more than 270,000 patients from 21 countries. Managing glucose levels is a painful and stressful process for these people. Many patients may skip their measurements (resulting in severe and severe symptoms for their lives). Last but not least, the financial ascpect should also be considered. Diabetic patients spend large amounts of their money on their treatment, while with the device may long achieve an improvement.
In the future, there may be a potential to implant an artificial pancreas into the abdominal cavity, so it functions almost as the original. Who knows what comes in the future, perhaps something we now think is unattainable ...
