What Is an Artificial Pancreas Delivery System?

An artificial pancreas is a medical device that is used to better control blood sugars in individuals with diabetes. It is called an artificial pancreas because it mimics some of the functions of a healthy pancreas. It is also called a closed-loop system, an automated insulin delivery system, or an autonomous system for glycemic control.

Functions of the Pancreas

Your pancreas is located in your abdomen near your stomach and liver, and it has an elongated shape. It is an organ and a gland. It functions to produce and release the vital hormones insulin and glucagon, which play an important role in regulating blood sugar levels.

While insulin is released into the bloodstream, the digestive enzymes of the pancreas are released into the pancreatic duct. They eventually reach the small bowel, where they help to break down the food we eat.

The islets of Langerhans are the cells within the pancreas that create and secrete insulin and glucagon, while Acinar cells within the pancreas create and secrete digestive enzymes.

Diabetes and the Pancreas

Diabetes can occur for one of two reasons:

• The pancreas doesn't produce enough insulin to regulate blood sugar
• Insulin resistance

Diabetes due to a lack of insulin is described as type 1 diabetes. and it is more common among children or younger people who are not overweight. It is thought to be caused by an autoimmune disease that causes the immune system to attack and destroy the islets of Langerhans, which are the specialized cells in the pancreas that make insulin.

It is also possible that some people are simply not born with enough of these cells to keep up with insulin production.

Insulin resistance is when the body is making insulin, but the cells do not respond to it or use it the way that should. This type of diabetes often tends to occur in older people and people who are overweight, and it is called type 2 diabetes.

The Artificial Pancreas Device System

The artificial pancreas is a device that mimics some (but not all) of the functions of the pancreas and is typically used to treat Type 1 diabetes.

Type 1 diabetes is managed by frequently checking your blood sugar levels, and then taking insulin when your blood sugar level is too high or taking glucose when your levels are too low. The artificial pancreas consists of several devices which perform these functions automatically.

The artificial pancreas that was approved by the U.S. Food and Drug Administration (FDA) in 2016 is called the MiniMed 670G. It is not considered a "fully automatic" artificial pancreas because some input is still required by the person wearing the device. For example, you may have to input the amount of carbohydrates that you consume during a meal and still check your blood sugar to calibrate the device. Current research is underway to develop a fully automatic pancreas.

Continuous Glucose Monitoring System

This device continuously and automatically monitors your blood sugar and sends the information to the computer-controlled algorithm device. The continuous glucose monitoring (CGM) system eliminates the need to prick your finger and manually test your blood sugar multiple times throughout the day.

It is a sensor that is inserted just below your skin (subcutaneously). The MiniMed 670G checks your blood sugar every five minutes.

The device can also detect increasing or decreasing blood sugar levels and alert you before your blood sugar reaches a critical level.

Computer Controlled Algorithm Device

This can be a smartphone, home computer, or another type of computer that functions to communicate between the continuous glucose monitoring system and the insulin infusion device. It performs complex mathematical equations and tells the insulin pump how much insulin you need based on the results.

Insulin Infusion Device

The insulin infusion device can deliver insulin subcutaneously and eliminates the need for multiple insulin shots throughout the day. Insulin pumps are also available separately (not as part of an artificial pancreas), but you usually have to manually input the dose.

The MiniMed 670G/770G and Tandem Control IQ are capable of automatically decreasing your insulin dose if your CGM detects low blood sugar or increasing it when your blood sugar is high.

It has a manual mode and an auto mode and it will do this in either mode.

• The manual mode allows you to program the insulin pump to deliver a specific basal dose of insulin.
• In auto mode, the MiniMed 670G/770G or Tandem Control IQ will adjust the basal rate of insulin according to the results coming from the CGM.

Who Can Get an Artificial Pancreas

Currently, the only artificial pancreas devices approved by the FDA are the MiniMed 670G/770G and Tandem Control IQ. In the future, other more advanced and "fully automated" devices may be approved and may have different benefits from their use.

It should not be used in people under the age of 7. The effectiveness of its use in people ages 7 to 14 is currently being studied.

You must have a prescription to get an artificial pancreas, and you will need to maintain close contact with your physician. You also need to be willing to check your blood sugar periodically to calibrate the CGM and carry a medical identification card with you.