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!
Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University
Direct conversion of non-neuronal cells into nerve cells
03.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.
Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
17.07.2018 | Information Technology
17.07.2018 | Materials Sciences
17.07.2018 | Power and Electrical Engineering