As we usher in an age of artificial intelligence, the health industry is tapping into the newest technology to treat and manage different diseases. According to the American Diabetes Association, about 1.25 million people in the U.S. with diabetes have type 1, and researchers are studying advanced technology to make treatment more effective. In 2006, the JDRF launched the Artificial Pancreas Program (APP) to develop technology that is smaller, more user-friendly and has increased accuracy for type 1 diabetes management.
What is going wrong?
While the exact cause of type 1 diabetes is still not entirely known, there are several factors at the root of the problem. In a healthy person, the immune system guards the body and fights off infection. However, a glitch in the system triggers an immune response, signaling the immune system to attack its own pancreatic beta cells, which create hormones that control blood sugar. Unlike a “normally” functioning pancreas, the pancreatic cells in a type 1 diabetes patient are destroyed due to this autoimmune response, causing them to lose their ability to create insulin. Because of this, type 1 diabetics require insulin injections throughout the day or an insulin pump to keep blood sugar levels within recommended range. Without insulin, glucose remains in the bloodstream, building up over time, damaging blood vessels and vital organs.
In spite of the many steps taken to manage this disease, people can still experience dangerously high or low blood-glucose levels that are potentially life threatening. Maintaining normal blood sugar levels can reduce the risk of short- and long-term complications. Some short-term complications include hypoglycemia, low blood sugar, and hyperglycemia, high blood sugar. According to Mayo Clinic, when a diabetic experiences hypoglycemia, they feel rapid heartbeat, sweating, paleness, numbness in the fingers, toes, and lips, lightheadedness, confusion, and slurred speech. Additionally, diabetics can experience high blood sugar or hyperglycemia. This occurs either when an insulin injection is not given or the dose was not high enough. Early signs of high blood sugar include frequent urination, increased thirst, blurred vision, fatigue, and headache. The longer glucose levels stay elevated, the worse the symptoms get. As time goes on, symptoms appear as fruity-smelling breath, nausea, shortness of breath, dry mouth, weakness and confusion, abdominal pain, and, even more severe, coma
Over time, high blood glucose levels can cause severe damage to organs and blood vessels, so proper maintenance of sugar levels is vital in order to avoid complications down the road.
User Friendly Technology
In 2016, after years of clinical trials, the Food and Drug Administration (FDA) approved the use of the partial artificial pancreas system, the first of its kind to replace a hormone secreting organ. Researchers have moved their focus from antiquated pumps that require constant outside monitoring to real-time glucose monitoring that places the control back into the users hands. Miniature devices allow the patient to make adjustments to their insulin based on food intake and physical activity, monitoring glucose values and responding to low and high alerts. The research Director at the JDRF, Daniel Finan, works to create more advanced, device-based treatments. The technology in this method includes a continuous glucose monitor (CGM) that measures glucose levels in the blood at any given time, an insulin pump, like the OmniPod, and a control algorithm that uses the data from the CGM to automatically dose the appropriate amount of insulin.
Dr. Finan works with artificial pancreas technology to develop closed-loop control algorithms. In closed-loop insulin pumps, the patient carries a wireless device that sends information to an insulin pump which accurately doses insulin directly into the patient’s body through a tube connected through the skin based on blood glucose levels. Throughout his research, he and other researchers have developed technology to change peoples’ lives. He is hopeful that they will be able to continue to advance the technology to improve the lives of people with type 1 diabetes. According to Dr. Finan, the ultimate goal is to find a cure, but in the meantime, he says “we will continue to drive meaningful advancements in treatment options.”
Sydney's Story
Its New Year’s Eve, 2012 at Seattle Children’s Hospital. The patient: Sydney Sheets, 16 year old female, presenting with sudden lightheadedness, frequent urination, excessive thirst, and fatigue. The diagnosis: type 1 diabetes. Treatment: Insulin injections, continuous monitoring of blood glucose levels, and dietary management.
After being diagnosed with type 1 diabetes, Sydney spent a week in the hospital, learning how to manage her disease. She says she was overwhelmed after her diagnosis and had a difficult time adjusting. “High school is hard enough as people aren't sure of themselves and haven't found their place in the world…” She continues, "on top of that I was diagnosed with a life-altering, terminal illness.” Her diagnosis was just the beginning of an entirely new way of life - one that would, frequently, be an uphill battle with many difficulties. Her doctors sought ways for her to maintain her glucose levels as well as her emotional levels that were dramatically impacted by the diagnosis and the disease.
Every day for Sydney is different - in reality, every hour is different. She describes the pattern of her day-to-day management before being put on a pump: “I constantly have to check my blood sugar throughout the day. I wake up, and I check and dose. I want to eat food, I check and dose. I want to walk across campus, I check, and I make sure I have enough insulin and enough snacks to keep myself stable” she says. “I constantly have to be thinking 500 steps ahead to be sure whatever potential situation I could run into is taken care of and handled.”
In the summer of 2018, her doctors recommended the OmniPod Insulin Management System, a monitor that adheres to the skin with a single needle that is able to test glucose levels and dose her insulin. The system helps patients have more freedom from tubes and needles while keeping their numbers more stable. Recent studies have shown that patients can effectively and easily monitor their numbers, eliminating manual injections and allowing for more customized insulin delivery. In addition to the pump, she uses a closed glucose monitoring device called Dexcom that monitors her glucose levels and reports them directly to an app on her phone that sends her notifications whenever her levels are getting too high or too low.
She wears her OmniPod on her arm for easier accessibility. It automatically doses throughout the day, so she can go about her activities without as much worry. She says that it gives her the freedom to participate in normal activities without the burden of excessive tubing and needle sticks, outside of replacing the pod after the recommended 72 hours of use.
Sydney says that her new treatment plan, while not perfect, has changed her life: “I do not actively feel like there's something wrong with me. It helps me feel much more normal…” she explains that, finally, she is feeling like a person rather than just a diabetic.
As scientists have become more aware of the complications and caveats of the disease, they worked to find more effective and convenient treatment technology to reduce the burden of the disease. The Artificial Pancreas Project has been in the headlines recently as more and more physicians are learning about the technology. While the JDRF continues to search for a cure for type 1 diabetes, their goal is to "cure the body’s inability to control glucose, reversing insulin dependence; prevent the progression of the disease in those at risk or recently diagnosed; and treat people living with T1D with new drugs, therapies and devices that make it easier to stay healthy until the cure comes."
For more information, click on the links I provided above.
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