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Bionic pancreas cuts diabetes stress
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Bionic pancreas cuts diabetes stress Massachusetts General Hospital offers hope of a more normal life for people with diabetes. The digital pancreas takes over the task of monitoring and regulating blood sugar levels. Every 5 minutes, a signal is sent wirelessly from a glucose monitor under the user’s skin to an iPhone app. The app calculates the amount of insulin or glucagon needed to balance blood sugar and then sends a signal to pumps carried by the user to administer
ED DAMIANO’S son was 11 months old when he was diagnosed with type 1 diabetes. By the time he heads off to college in 2017, his father hopes to have freed him – and millions of others – from the burden of managing the disease. Damiano, a biomedical engineer, has created a digital pancreas that automatically regulates sugar levels in the blood via a smartphone. The latest clinical trials of the device suggest he might just hit his deadline. Type 1 diabetes occurs when insulin-producing cells in the pancreas die off. Without insulin, the body cannot regulate blood sugar, and levels can skyrocket. The disease can be managed with careful control of what food is eaten and when, modifying physical activity, and the use of pumps or injections to deliver insulin and the glucose-raising hormone glucagon. Controlling diabetes is allconsuming, requiring attention around the clock. Damiano, who works at the University of Boston, says the device his team has developed with colleagues at the
Snowball Titan solves methane mystery? SATURN’S largest moon may once have been a giant snowball. Titan is already a frigid moon made mostly of ice. But methane gas in its atmosphere keeps the surface just warm enough for a scattering of lakes filled with liquid hydrocarbons. Scientists have puzzled over Titan’s atmospheric methane because the molecule is easily broken down by 12 | NewScientist | 21 June 2014
Brian Snyder/Reuters
Bob Roehr
sunlight. Calculations suggest that all the methane Titan seems to possess should have been used up within tens of millions of years – a blip in the moon’s roughly 4-billion-year lifetime. Adding to the mystery, the methane breakdown creates other compounds that rain over the surface, helping to fill the lakes. If used-up methane was replaced, this process would happen constantly, so Titan should be covered not by lakes, but by a global ocean hundreds of metres deep. Michael Wong at the California Institute of Technology says snowballs may be the missing piece (Icarus,
the required dose via a catheter. Having performed well in hospital-based clinical trials in 2010, the digital pancreas is now being tested in a real-world environment. In the latest study, 20 adults wearing the device were put up in a hotel for five days but were otherwise free to spend their time as they pleased, including eating in restaurants and going to the gym. Thirty-two young people, aged 12 to 20, were also monitored for five days at a camp for children with diabetes. For both groups, the results were compared with five days of the participants’ usual method of controlling the disease – fingerprick blood tests and a manual insulin pump.
“The device performed beyond expectation, it did a wonderful job of controlling their blood sugar,” says Damiano. High and low sugar levels were both better controlled using the device than when the participants managed on their own, he says (NEJM, doi.org/s7w). In many cases, the participants were reluctant to give the devices back, says Damiano. “They got a glimpse of life without diabetes, and that is pretty profound.” “It’s fantastic that research on the artificial pancreas is forging ahead, both in the US and in the UK,” says Alasdair Rankin, director of research at Diabetes UK, a charity that is supporting the development of a similar device with researchers at the University of Cambridge. “There is now real hope that this technology has the potential to transform the lives of people within a generation,” he says. Damiano hopes that a series of longer trials starting this month and next year will pave the way for the device to be approved by the US Food and Drug Administration. With any luck, this will happen before his son (pictured in 2011) goes to college in three years’ time. The results of Damiano’s study and those of several other groups working on artificial pancreases were presented at the American Diabetes Association meeting in –Hope for a normal life – San Francisco last week. n
doi.org/s7z). Scientists suspect Earth went through a snowball phase about 2 billion years ago, when the planet became covered in ice. A similar event could have taken place on Titan, says Wong. Methane levels may rise and fall if the gas is periodically released from inside the moon. If at some point the methane dropped by a factor of 100, temperatures would fall, and surface
“If Titan’s methane levels dropped by a factor of 100, temperatures would fall and its lakes would freeze”
liquids would freeze over. A different mix of compounds would also be produced in the atmosphere. So this cold snap would mean the moon’s surface should host lots of compounds called nitriles, which would be solid rather than creating an ocean. The New Horizons mission to Pluto could offer early clues, says Wong: “Like Titan, Pluto has an atmosphere that is mostly nitrogen with some methane.” Pluto’s atmosphere is much thinner and colder, but the physics are similar enough that examining its composition could boost the snowball model. Jeff Hecht n
Bionic pancreas cuts diabetes stress Massachusetts General Hospital offers hope of a more normal life for people with diabetes. The digital pancreas takes over the task of monitoring and regulating blood sugar levels. Every 5 minutes, a signal is sent wirelessly from a glucose monitor under the user’s skin to an iPhone app. The app calculates the amount of insulin or glucagon needed to balance blood sugar and then sends a signal to pumps carried by the user to administer
ED DAMIANO’S son was 11 months old when he was diagnosed with type 1 diabetes. By the time he heads off to college in 2017, his father hopes to have freed him – and millions of others – from the burden of managing the disease. Damiano, a biomedical engineer, has created a digital pancreas that automatically regulates sugar levels in the blood via a smartphone. The latest clinical trials of the device suggest he might just hit his deadline. Type 1 diabetes occurs when insulin-producing cells in the pancreas die off. Without insulin, the body cannot regulate blood sugar, and levels can skyrocket. The disease can be managed with careful control of what food is eaten and when, modifying physical activity, and the use of pumps or injections to deliver insulin and the glucose-raising hormone glucagon. Controlling diabetes is allconsuming, requiring attention around the clock. Damiano, who works at the University of Boston, says the device his team has developed with colleagues at the
Snowball Titan solves methane mystery? SATURN’S largest moon may once have been a giant snowball. Titan is already a frigid moon made mostly of ice. But methane gas in its atmosphere keeps the surface just warm enough for a scattering of lakes filled with liquid hydrocarbons. Scientists have puzzled over Titan’s atmospheric methane because the molecule is easily broken down by 12 | NewScientist | 21 June 2014
Brian Snyder/Reuters
Bob Roehr
sunlight. Calculations suggest that all the methane Titan seems to possess should have been used up within tens of millions of years – a blip in the moon’s roughly 4-billion-year lifetime. Adding to the mystery, the methane breakdown creates other compounds that rain over the surface, helping to fill the lakes. If used-up methane was replaced, this process would happen constantly, so Titan should be covered not by lakes, but by a global ocean hundreds of metres deep. Michael Wong at the California Institute of Technology says snowballs may be the missing piece (Icarus,
the required dose via a catheter. Having performed well in hospital-based clinical trials in 2010, the digital pancreas is now being tested in a real-world environment. In the latest study, 20 adults wearing the device were put up in a hotel for five days but were otherwise free to spend their time as they pleased, including eating in restaurants and going to the gym. Thirty-two young people, aged 12 to 20, were also monitored for five days at a camp for children with diabetes. For both groups, the results were compared with five days of the participants’ usual method of controlling the disease – fingerprick blood tests and a manual insulin pump.
“The device performed beyond expectation, it did a wonderful job of controlling their blood sugar,” says Damiano. High and low sugar levels were both better controlled using the device than when the participants managed on their own, he says (NEJM, doi.org/s7w). In many cases, the participants were reluctant to give the devices back, says Damiano. “They got a glimpse of life without diabetes, and that is pretty profound.” “It’s fantastic that research on the artificial pancreas is forging ahead, both in the US and in the UK,” says Alasdair Rankin, director of research at Diabetes UK, a charity that is supporting the development of a similar device with researchers at the University of Cambridge. “There is now real hope that this technology has the potential to transform the lives of people within a generation,” he says. Damiano hopes that a series of longer trials starting this month and next year will pave the way for the device to be approved by the US Food and Drug Administration. With any luck, this will happen before his son (pictured in 2011) goes to college in three years’ time. The results of Damiano’s study and those of several other groups working on artificial pancreases were presented at the American Diabetes Association meeting in –Hope for a normal life – San Francisco last week. n
doi.org/s7z). Scientists suspect Earth went through a snowball phase about 2 billion years ago, when the planet became covered in ice. A similar event could have taken place on Titan, says Wong. Methane levels may rise and fall if the gas is periodically released from inside the moon. If at some point the methane dropped by a factor of 100, temperatures would fall, and surface
“If Titan’s methane levels dropped by a factor of 100, temperatures would fall and its lakes would freeze”
liquids would freeze over. A different mix of compounds would also be produced in the atmosphere. So this cold snap would mean the moon’s surface should host lots of compounds called nitriles, which would be solid rather than creating an ocean. The New Horizons mission to Pluto could offer early clues, says Wong: “Like Titan, Pluto has an atmosphere that is mostly nitrogen with some methane.” Pluto’s atmosphere is much thinner and colder, but the physics are similar enough that examining its composition could boost the snowball model. Jeff Hecht n