.fperrywilson explains how the dream of a functional cure to type 1 diabetes, a true artificial pancreas, is closer than ever with the bionic pancreas.
Broadly, it's another closed-loop system. The bionic pancreas integrates with a continuous glucose monitor and administers insulin when needed. But the algorithm appears to be a bit smarter than what we have in existing devices. For example, the patient does not need to provide any information about their usual insulin doses — just their body weight.
But new technology is never without its hiccups. Those randomized to the bionic pancreas had a markedly higher rate of adverse events This is actually a little misleading, though. The vast majority of these events were hyperglycemic episodes due to infusion set failures, which were reportable only in the bionic pancreas group.
Nevertheless, these adverse events — not serious, but common — highlight the fact that good software is not the only key to solving the closed-loop problem. We need good hardware too, hardware that can withstand the very active lives that children with type 1 diabetes deserve to live. In short, the dream of a functional cure to type 1 diabetes, a true artificial pancreas, is closer than ever, but it's still just a dream. With iterative advances like this, though, the reality may be here before you know it.
F. Perry Wilson, MD, MSCE, is an associate professor of medicine and director of Yale's Clinical and Translational Research Accelerator. His science communication work can be found in the Huffington Post, on NPR, and here on Medscape. He tweets
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