Artificial pancreas changing lives of patients with Type 1 diabetes

Juvenile (or Type 1) diabetes means the pancreas are attacked by one’s own immune system, steadily reducing the amount of insulin it produces till it stops producing any at all. What if those suffering from this autoimmune condition could have artificial pancreas attached to their body to correct the hormone deficit? England’s National Health Service (NHS) has come up with one — a glucose sensor that can be placed under the skin to continuously monitor one’s insulin levels, with a pump replenishing the shortfall amount at the right time, just like a normal pancreas does. This would remove the hassle of a daily insulin jab and multiple finger pricks for millions of kids across the world.

Charlotte, a six-year-old from Lancashire, was among more than 200 children tested with the NHS technology (known as the hybrid closed loop system), with life-altering results. “Prior to having the loop, everything was manual. At night, we’d have to set the alarm every two hours to do finger pricks and corrections of insulin to deal with the ups and downs,” her mother Ange Abbott told BBC. Kids with type 1 diabetes are particularly at risk of developing hypoglycemia (when blood sugar drops too low) overnight. But the artificial pancreas was like a miracle, she said.

India has the highest number of children and adolescents suffering from type 1 diabetes, according to a 2022 Lancet study that quotes data from the International Diabetes Federation (IDF) Diabetes Atlas 2021. Indian doctors are also recommending homegrown artificial pancreas like Medtronic India’s MiniMed 780G system, a closed loop insulin pump with Bluetooth connectivity and real-time glucose data that comes for Rs 6 lakh.

Doctors say that artificial pancreas improve patient outcomes, compared to traditional ways of managing insulin. This is because of their ability to deliver insulin according to one’s blood-glucose levels in real-time. This also reduces the number of finger pricks and insulin injections. Dr Sweta Budyal, consultant endocrinologist and diabetologist at Mumbai’s Fortis Hospital, says artificial pancreas pump in need-based insulin, so overall insulin consumption is lesser. “This can help reduce weight gain. More importantly, patients experience significantly fewer episodes of low blood sugar, and the risks of cardiac complications, retinopathy, kidney disease and neuropathy.”

NHS’s hybrid closed loop is an insulin-only system that keeps blood glucose levels within target range by automatically increasing or decreasing the amount of insulin delivered, based on your continuous glucose monitor (CGM) values. But you must input carb intake and calculate insulin doses for all meals and snacks. Then there’s the threshold-suspend system (which stops delivering insulin when blood glucose drops to a pre-set level), and the predictive-suspend system (which calculates blood glucose level and stops pushing insulin before the level drops too low).



So why aren’t many people using such devices? Dr Budyal says, “Basic insulin pump models cost at least Rs 2.5 lakh, the more sophisticated ones are around 6 lakh. That’s far beyond the reach of most Indians.” Among those who can afford it, some feel it’s too complicated to use. “Already in a comfort zone with daily insulin, it’s unknown territory they’d rather avoid,” says Dr Budyal. Rich young patients loathe to reveal that they are diabetic feel the pump is a dead giveaway as it sticks out of their crop tops and sleeveless outfits.


With inputs from agencies