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What if eating were a balancing act, every meal, every day? This is indeed the case for people with Type 1 diabetes, because they must adjust their insulin very carefully so their glucose levels don’t go too low or high. People with Type 1 diabetes must manage their disease 24 hours a day, seven days a week, testing blood glucose levels and administering insulin vigilantly multiple times a day while determining correct doses with diet and activity. 

In exciting new studies, Benaroya Research Institute is testing an artificial pancreas which automatically dispenses insulin based on real-time changes in blood glucose levels. The hope is that this would someday relieve adults, children and their families from the arduous 24/7 manual maintenance of their diabetes. This past year, BRI tests of the artificial pancreas showed that blood glucose levels under highly controlled conditions could be better managed through the artificial pancreas than participants likely could do on their own. Most patients with diabetes cannot achieve tight glucose control with traditional diabetes tools and spend less than half of their days at healthy glucose levels. Studies show that tight control of levels significantly reduces or delays the development of complications.

The artificial pancreas combines a continuous glucose monitor with an insulin pump and a computer software program. The monitor and pump are devices worn on the outside of the body and contain a tube or sensor that goes inside the body. The monitor provides real-time information on the body’s blood glucose levels and reports this to the computer software program. When the program determines insulin is needed, it sends a message to the insulin pump to provide a certain amount of insulin.

“If this device is successful, people can reduce the constant monitoring of their disease and relieve a huge mental burden,” says BRI Director of the Diabetes Research Program Carla Greenbaum, MD. “This type of system would also keep blood glucose levels much tighter, reducing diabetes complications which can be very serious. While we search for new methods to prevent and even cure diabetes, we need to provide better ways to improve the lives of people who currently have diabetes.”

While other systems are being tested at selected locations worldwide, BRI is the only center nationally testing this unique software program for the artificial pancreas. The program was developed by Richard Mauseth, MD, a long-time Pacific Northwest pediatric endocrinologist, currently at Seattle Children’s and two Boeing software engineers, Robert Kircher and Don Matheson. Their software program applies “fuzzy logic” to the glucose data to direct appropriate amounts of insulin to be delivered. Fuzzy logic is a technical term describing how a computer uses imprecise information to make a decision. It is used in a wide variety of applications ranging from airplanes and consumer products to medical diagnostic systems.

This BRI artificial pancreas study is funded by JDRF who has designated 15 centers internationally to test various approaches to these devices. The JDRF is aiming to develop a first-generation artificial pancreas with the hopes of helping millions of people with diabetes.

Type 1 diabetes occurs when insulin producing cells of the pancreas are destroyed by the immune system. The discovery and use of insulin therapeutically has enabled people to survive. But the disease remains an enormous burden on individuals and their families. A successful artificial pancreas will enable better, safer and easier diabetes control and thus lessen long-term complications.

Clark Webber, a participant in the artificial pancreas clinical research trial wears an insulin pump on his arm and a continuous glucose monitor on his abdomen. His glucose information is related by the sensor to a computer. The hopes are that the computer software can eventually be contained in a smaller device such as a smart phone. Clark was diagnosed with Type 1 diabetes at age 12 and is now 23. “The artificial pancreas looks to be the next big, decisive innovation in diabetes management and care,” says Clark. “It will bring a new found level of freedom to people with diabetes.” Carla Greenbaum, MD, (right) is principal investigator of the BRI artificial pancreas studies.