Tuesday, January 10, 2012

Artificial Pancreas Could Revolutionize Diabetic Care

Prof. Moshe Phillip, director of the Institute of Endocrinology and Diabetes at Schneider
Children's Medical Center, demonstrates MD-Logic on a young patient.
Article by Karen Kloosterman and re-posted from Israel 21c on January 1, 2012.


In people with diabetes, the pancreas doesn't produce or release insulin as it should, so the body can't metabolize sugars properly. That means blood sugar levels have to be monitored continuously, even (and especially) at night, when diabetics' blood sugar can get dangerously out of control. But nighttime monitoring and dosing is a sleep-stealing activity, particularly for parents of diabetic children.

A new artificial pancreas developed in Israel may allow them sweeter dreams. The MD-Logic was recently tested on Israeli children at an overnight diabetes summer camp, to resounding success. The key is that the device's software "thinks" like a physician, says one of its developers, Eran Atlas of the Schneider Children's Medical Center in Tel Aviv. Using existing insulin pump technology, MD-Logic closes the loop between a continuous glucose monitor and insulin pump, allowing patients to self-regulate their glucose levels and deliver the exact amount of insulin needed, when needed -- even at 3 o'clock in the morning.

First diabetes system of its kind for home use Developed by Atlas along with Prof. Moshe Phillip, Dr. Revital Nimri and Shahar Miller at Schneider, the artificial pancreas was tested on 18 Israeli kids between the ages of 12 and 15. It was also tested on groups of children in Slovenia and in Germany.  MD-Logic is the first system of its kind to be tried outside the hospital and it may be the first to offer relief and freedom to diabetics.


"A bigger problem is not just for the seven-year-old with diabetes but for the parents," says Atlas. "They are very stressed about the diabetes and often hire someone to be with the kids at school to administer insulin. But these caregivers don't always know diabetes so well.  "And then there are nights -- the most frightening when parents and patients are asleep. We wanted the nighttime to be easier to manage, so we focused on that," he tells ISRAEL21c.

Setting up a control room at the hotel where the kids were staying, the researchers were able to safely measure the efficacy of the device, and to ensure it could deliver insulin at the moment when the body needs it. The medical device is still in the prototype stage, so for now it requires connection to a laptop computer that can be carried in a backpack or set beside the bed. The general idea is to turn it into a mobile device so it can work night and day to regulate glucose levels. The more well regulated the blood sugar, the less likely that diabetes patients will suffer dangerous consequences including eye, kidney and nerve damage. 

Thinks like a doctor

"We have automated the way physicians think and the way people are taught for treating their own diabetes," Atlas tells ISRAEL21c. "The breakthrough is the ability to actually connect sensors to a system that changes insulin infusion rate safely and efficiently to create better glucose control than what they would achieve by themselves," he says.

The next stage is to test the artificial pancreas at home under supervised conditions. It will need to gain approval from the US Food and Drug Administration before being sold in the United States. In the meantime, the team is working to commercialize the technology along with Prof. Thomas Danne from Kinderkrankenhaus auf der Bult in Germany and Prof. Tadej Battelino from University Children's Hospital in Slovenia. They are working under a multicenter collaboration called the DREAM Project, for Diabetes wiREless Artificial Pancreas consortiuM.  The researchers believe that this is the first step in giving kids with diabetes -- and the adults who supervise them -- a worry-free night's sleep.

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