Anne L. Peters, MD, explains why the term artificial pancreas is wrong and why automated insulin delivery system is correct.
I'd like to clear up the confusion about whether or not there is such a thing as an artificial pancreas. First, we know that we have pancreases and beta-cell transplants that work. An artificial pancreas is different, and it's actually an old term for what we now call automated insulin delivery . Those systems are not an artificial pancreas; they are ways to deliver insulin to patients with type 1 and type 2 diabetes.
This makes spontaneity in life difficult, and if done wrong, people can end up being either hypo- or hyperglycemic. It would be really great to have a system that was a fully closed-loop system that didn't require that someone to do all of these things. Whatever algorithms you use for giving insulin as glucose levels are going up, whatever wristband you can have someone wear to see if they're eating or not eating, and for anything you do to help reduce the postprandial rise, you then have to figure that there is no brake.
There are some really cool things on the horizon that will help people do better. There is the Tidepool Loop algorithm that's been approved and should be ready to be used in the not-too-distant future. There's also a new pump. Beta Bionics has been working on developing an insulin pump. Originally, it was going to be insulin and glucagon together, and it will be in the future. Right now, what's up for approval is the insulin-alone pump.
I have many patients who were very good at adjusting their own insulin and doing it on their own, but this is for people who don't want to or can't make those adjustments, whose time in range is much lower, who perhaps are transitioning from multiple daily insulin injections, or who are adolescents, for instance. There's a whole group of people for whom I think this kind of system will really be a relief. It will help take away some of the burden.
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