IRCM researchers, led by endocrinologist Dr. Rémi Rabasa-Lhoret, were the first to conduct a trial comparing a dual-hormone artificial pancreas with conventional diabetes treatment using an insulin pump and showed improved glucose levels and lower risks of hypoglycemia.
Their results, published today in the Canadian Medical Association Journal (CMAJ), can have a great impact on the treatment of type 1 diabetes by accelerating the development of the external artificial pancreas.
The artificial pancreas is an automated system that simulates the normal pancreas by continuously adapting insulin delivery based on changes in glucose levels. The dual-hormone artificial pancreas tested at the IRCM controls glucose levels by automatically delivering insulin and glucagon, if necessary, based on continuous glucose monitor (CGM) readings and guided by an advanced algorithm.
“We found that the artificial pancreas improved glucose control by 15 per cent and significantly reduced the risk of hypoglycemia as compared with conventional insulin pump therapy,” explains engineer Ahmad Haidar, first author of the study and doctoral student in Dr. Rabasa-Lhoret’s research unit at the IRCM and at the Department of Electrical and Computer Engineering at McGill University. "The artificial pancreas also resulted in an 8-fold reduction of the overall risk of hypoglycemia, and a 20-fold reduction of the risk of nocturnal hypoglycemia."
People living with type 1 diabetes must carefully manage their blood glucose levels to ensure they remain within a target range. Blood glucose control is the key to preventing serious long-term complications related to high glucose levels (such as blindness or kidney failure) and reduces the risk of hypoglycemia (dangerously low blood glucose that can lead to confusion, disorientation and, if severe, loss of consciousness).
“Approximately two-thirds of patients don’t achieve their target range with current treatments,” says Dr. Rabasa-Lhoret, Director of the Obesity, Metabolism and Diabetes research clinic at the IRCM. “The artificial pancreas could help them reach these targets and reduce the risk of hypoglycemia, which is feared by most patients and remains the most common adverse effect of insulin therapy. In fact, nocturnal hypoglycemia is the main barrier to reaching glycemic targets.”
"Infusion pumps and glucose sensors are already commercially-available, but patients must frequently check the sensor and adjust the pump’s output," says Mr. Haidar. “To liberate them from this sizable challenge, we needed to find a way for the sensor to talk to the pump directly. So we developed an intelligent dosing algorithm, which is the brain of the system. It can constantly recalculate insulin dosing based on changing glucose levels, in a similar way to the GPS system in a car, which recalculates directions according to traffic or an itinerary change.”
The researchers’ algorithm, which could eventually be integrated as software into a smart phone, receives data from the CGM, calculates the required insulin (and glucagon, if needed) and wirelessly controls the pump to automatically administer the proper doses without intervention by the patient.
“The system we tested more closely mimics a normal pancreas by secreting both insulin and glucagon,” adds Dr. Laurent Legault, peadiatric endocrinologist and outgoing Director of the Insulin Pump Centre at the Montreal Children’s Hospital, and co-author of the study. “While insulin lowers blood glucose levels, glucagon has the opposite effect and raises glucose levels. Glucagon can protect against hypoglycemia if a patient with diabetes miscalculates the necessary insulin dose.”“Our work is exciting because the artificial pancreas has the potential to substantially improve the management of diabetes and reduce daily frustrations for patients,” concludes Dr. Rabasa-Lhoret. “We are pursuing our clinical trials to test the system for longer periods and with different age groups. It will then probably be introduced gradually to clinical practice, using insulin alone, with early generations focusing on overnight glucose controls.”
Dr. Rabasa-Lhoret’s research is funded by Diabetes Québec, the Canadian Diabetes Association, and the IRCM’s J.A. De Sève Chair in clinical research. IRCM collaborators who contributed to study include Maryse Dallaire, Ammar Alkhateeb, Adèle Coriati, Virginie Messier and Maude Millette. For more information on the study, please refer to the article summary published online by CMAJ: http://www.cmaj.ca/content/early/2013/01/28/cmaj.121265.abstract.About diabetes
According to the Canadian Diabetes Association, an estimated 285 million people worldwide are affected by diabetes, approximately 10 per cent of which have type 1 diabetes. With a further 7 million people developing diabetes each year, this number is expected to hit 438 million by 2030, making it a global epidemic. Today, more than 9 million Canadians live with diabetes or prediabetes.About Dr. Rémi Rabasa-Lhoret
For more information and to schedule an interview with Dr. Rabasa-Lhoret or Ahmad Haidar, please contact:Julie Langelier
Julie Langelier | EurekAlert!
Real-time imaging of lung lesions during surgery helps localize tumors and improve precision
30.07.2015 | American Association for Thoracic Surgery
Experimental MERS vaccine shows promise in animal studies
29.07.2015 | NIH/National Institute of Allergy and Infectious Diseases
Verdichterscheiben für Flugzeugturbinen werden aus einem Materialstück herausgefräst. Bei der Bearbeitung fangen die Schaufeln an zu schwingen. Ein neuartiges Spannsystem steigert die Dämpfung der Schaufeln nun auf mehr als das 400-fache. Es lassen sich bis zu 5000 Euro Kosten bei der Fertigung einsparen.
Mal eben schnell in den Urlaub jetten oder für ein langes Wochenende nach Rom, Paris oder Madrid fliegen? Der Flugverkehr steigt, insbesondere der...
Der Gletscherschwund im ersten Jahrzehnt des 21. Jahrhunderts erreicht einen historischen Rekordwert seit Messbeginn. Das Schmelzen der Gletscher ist ein globales Phänomen und selbst ohne weiteren Klimawandel werden sie zusätzlich an Eis verlieren. Dies belegt die neueste Studie des World Glacier Monitoring Services unter der Leitung der Universität Zürich.
Seit über 120 Jahren sammelt der World Glacier Monitoring Service, mit heutigem Sitz an der Universität Zürich, weltweite Daten zu Gletscherveränderungen....
Glacier decline in the first decade of the 21st century has reached a historical record, since the onset of direct observations. Glacier melt is a global phenomenon and will continue even without further climate change. This is shown in the latest study by the World Glacier Monitoring Service under the lead of the University of Zurich, Switzerland.
The World Glacier Monitoring Service, domiciled at the University of Zurich, has compiled worldwide data on glacier changes for more than 120 years. Together...
Mit ultrakalten Atomen lässt sich ein neuer Materiezustand beobachten, in dem das System nicht ins thermische Gleichgewicht kommt.
Was passiert, wenn man kaltes und heißes Wasser mischt? Nach einer Weile ist das Wasser lauwarm – das System hat ein neues thermisches Gleichgewicht erreicht....
Using ultracold atoms trapped in light crystals, scientists from the MPQ, LMU, and the Weizmann Institute observe a novel state of matter that never thermalizes.
What happens if one mixes cold and hot water? After some initial dynamics, one is left with lukewarm water—the system has thermalized to a new thermal...
03.08.2015 | Veranstaltungen
03.08.2015 | Veranstaltungen
31.07.2015 | Veranstaltungen
03.08.2015 | Veranstaltungsnachrichten
03.08.2015 | Seminare Workshops
03.08.2015 | Seminare Workshops