How an artificial pancreas is handing control back to Type 1 diabetics

Closed-loop system backed by health authorities to become more widely used as costs reduce

Dr Sarla Kumari says the closed-loop technology has evolved to become the most efficient form of insulin control. Pawan Singh / The National

An artificial pancreas to regulate insulin release in Type 1 diabetics could become more widely used to cut the risk of blindness or amputation after successful trials.

The closed-loop system uses a wearable glucose monitor that relays readings to a computerised insulin pump to calculate how much the body requires — replicating a fully functioning pancreas.

Regulators in the UK have approved the technology for use.

Doctors say the devices have been used at only a handful of hospitals in the UAE but are likely to become more widely adopted as they become cheaper.

At about Dh30,000 ($8,167) per unit and Dh2,000 monthly running costs, the technology is not cheap.

But it is taking those born with Type 1 diabetes a step closer to replacing their misfiring pancreases with a working man-made alternative.

“Studies and our routine practice proved that this device helps to achieve glycemic targets and better diabetes control,” said Dr Ines Barros, endocrinologist at International Modern Hospital, Dubai.

“Consequently, it avoids the development of complications, such as hypoglycaemia, diabetic retinopathy, renal disease, cardiovascular diseases or neuropathy.

“It should be offered first to patients with uncontrolled diabetes despite previous intensive treatment — pregnant woman, children and adolescents.”

The International Diabetes Federation says 537 million people are living with diabetes worldwide, a number expected to increase to 700 million by 2045.

While an estimated 990,000 people were living with diabetes in the UAE in 2021, most cases were lifestyle-related Type 2 with far fewer diagnosed with Type 1 — about 24,000.

Due to the frequent need to monitor blood sugar levels via a finger-prick test or glucose sensor, managing Type 1 diabetes is arduous and time consuming.

As a result, an automated system is particularly useful for children or the recently diagnosed who may be struggling to manage their blood sugars through their diet.

Once digested, carbohydrates turn to glucose so Type 1 diabetics count carbs to match their insulin dose to ensure they stay healthy and avoid complications.

The latest closed-loop system reduces human error and increases the frequency of blood glucose monitoring and correction, leading to better glycemic control.

Dr Sarla Kumari, a diabetologist at Canadian Specialist Hospital, Dubai, said the technology had evolved over the past decade to become the most efficient form of insulin control.

“It is very easy to use and delivers information to a smartphone so it is easy to track,” she said.

“Most people with Type 1 diabetes are young children so it can be hard for them to monitor, with serious consequences. The devices are reliable and will come down in price to make them more widely available.

“If you have low blood sugar, people can die so keeping an accurate track of this is hugely important so people can get on with enjoying their lives.”

Complications

Complications from poor insulin management can result in acanthosis nigricans, a blackening of the skin around the armpits, neck or groin caused by the body producing too much insulin.

Nerve damage can also occur via diabetic neuropathy from high blood sugar, usually occurring in the hands and feet.

The closed-loop insulin delivery technology can guard against such complications.

“This technology came to the UAE two years ago but has only been available at three or four centres as it is not the standard of care,” said Dr Ajith Kumar, endocrinologist at Burjeel Hospital.

“As competition increases and more patients use this, it will come down in price.

“Like any Bluetooth device there can be a break in the connection, which can interrupt the delivery. That can cause a potential problem.

“For those who have lived with Type 1 diabetes for a while and mastered their insulin management, this can make a huge difference.”

Foods that can help tackle Type 2 Diabetes — in pictures

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  People who have diabetes should eat plenty of fresh vegetables and avoid fried and sugary foods.

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  Tuna is rich in omega-3 fatty acids and helps to manage diabetes because it can lower inflammation and improve blood sugar control. Silvia Razgova / The National

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  Replacing processed foods with fresh, home-cooked meals brings many health benefits. Antonie Robertson / The National

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  Berries are beneficial for people with diabetes because they are packed with antioxidants and fibre. iStockphoto

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  Greek salads made with lettuce, onions, tomatoes and cucumbers are low in calories, high in nutrients and help regulate blood sugar levels.

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  The good fats in avocados can help you prevent diabetes complications, such as heart attacks and strokes, and help your body to use insulin more effectively.

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  Citrus fruits can lower blood sugar levels. Pawan Singh / The National

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  Walnuts can be a good snack for people with type-2 diabetes. They may help to prevent heart disease, control blood sugar levels and aid weight loss.