The Loop Has Closed: The Artificial Pancreas Program Comes to Life in Israel

Kid with Backpack

Diabetes technology has vastly improved in the last decade, and most people with diabetes who have the opportunity to wear an insulin pump or a continuous glucose monitor are grateful for the assistance they provide.  But even with these advanced tools, the biggest burdens of diabetes – the insulin dosing and blood sugar testing – still lie on the person with diabetes or a caregiver. 

Just about every adult with diabetes  will tell you how much they’d like to eat without thinking about each and every bite.  Every parent of a child with diabetes wants their child to be able to eat without having to calculate and dose insulin for them.  And most of all, people with diabetes and their caregivers would like to sleep without the fear of hypoglycemia.  Thanks to the work of Professor Moshe Phillip and his team at the Institute of Endocrinology and Diabetes at Schneider Children’s Medical Center of Israel and Eran Atlas, head of the engineering team at the Diabetes Technology Institute at Schneider Children’s, we’re one step closer to carefree eating and peaceful nights.  We’re one step closer to being relieved of the continuous need to check blood glucose levels, calculate insulin requirements, and inject insulin.

Earlier this month, Prof. Phillip and his team invited 18 children with diabetes in Israel to be part of the world’s first out-of-hospital artificial pancreas trial.  The trial took place on Kibbutz Ma’ale Hahamisha in the hills outside of Jerusalem, and utilized the MD-Logic system developed at Schneider Children’s.  The MD-Logic system allows real-time control of the blood glucose levels based on readings from a continuous glucose sensor. It is based on a model which imitates the logic of diabetes caregivers.*

 

How did the Artificial Pancreas Program work?

 

1. 18 children between the ages of 12-15 years were invited to participate.

2. The children gathered to meet each other, play getting-to-know-each-other games, and talk about how many years they’d been living with diabetes. 

3. Nine children were connected to the program’s network.  (The other nine children were connected to the network a day later.)

4.  Each child was connected to an insulin pump, a continuous glucose sensor, and an artificial pancreas in the form of a laptop computer which communicated between the pump and the glucose sensor.  The artificial pancreas determined how many units of insulin to deliver, was responsible for suspending insulin delivery in case of low blood sugar, and made adjustments in basal rates.  All of this was done without any human input.  

5. Each child wore/carried a backpack which held the laptop computer/artificial pancreas.  When the child slept, the computer sat on a small table beside the bed. 

6. Throughout the experiment, including the nighttime hours, the doctors and engineers who developed the Artificial Pancreas Program sat in a control room where they observed and monitored all of the data for all of the children.  If a problem arose, they were able to detect it and correct it immediately. 

The trial was considered successful, and though there is still some way to go before the artificial pancreas becomes standard diabetes care, it’s an exciting and promising step.  It’s kind of like giving diabetes a brain, which is a wonderful thing for those of us who feel like our diabetes has a mind of its own.

*Closing the Loop – Towards an Artificial Pancreas – The Schneider Medical Center Experience
Revital Nimri, Eran Atlas, Shahar Miller, Eli Grunberg, Moshe Phillip, http://www.ies.org.il/abstracts09/Stem%20cell%20in%20Diabetes%20Mellitus%20symposia-HW103-106.pdf

Jessica Apple is the co-founder and editor-in-chief of ASweetLife.  She writes the blog The Natural Diabetic.

Comments (5)

  1. DavidWM at

    I have had Type 1 Diabetes since 1977.  Today I take 3 shots daily, until there IS a cure! Although I am under excellent blood sugar monitoring and control; I still WANT an artificial WORKING pancreas…NOW! I wish ALL the damn federal regulators would get off their combined ASSES and puch this through…ALREADY! Damn!

  2. Bill at

    Is there a place where we can read an actual full-length article on this trial? With more information and results?

  3. This is really great news! . Thank you.

  4. This is great news, can’t wait to see those algorithms in silicon so we don’t need a laptop.

  5. jeff schwartz at

    The past 10 years have been pretty much no progress with this.  I’m 51, so I don’t expect anything anymore, but I have seen enough and know enough about the science to have figured out that the development barriers are really economic.  in 2001, I got a paradigm pump and I am on model 3, which is really no different than model 1.  In 2008, I got an implanted sensor which communicates with the pump and so, give continuous monitoring and hi/lo alarms.  The thing was monstrous in its insertion for 2 days, with an already inserted pump infusion set and very user unfriendly with the beeps and alarms.  I did it for a month. 

    If the entire system were tied together in a package, the mega billion dollar test kit industry would be gone.  A1C’s would be all under 7 and endocrinology would be a rare field.  Lantus and other insulins would be history.  Many type 2′s would go to insulin and skip all the pills. 

    There has to be a money carrot and right now, the unspoken truth is noone wants to pay what it would take to shake loose from the existing Diabetes business.  To get this going, someone would need to see the promise of about $30-50K per patient up front and some additional payments for built in sensors each quarter or year. 

    That ‘s alot, even for self funding plans in large corporations.  Not enough type 1′s die or get work prohibiting complications before age 65 to make the $$ case for this alternative. 

    And medicare is certainly not going to take this on.  SSA is too busy processing the gargantuan phony “total disability” business.  E.g. a corporation in Puerto Rico  goes under, administrative judge in San Juan puts the entire plant on lifetime benefits. Really it works like that. 

    Sorry guys…good luck.  

Add a comment

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>