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Last updated: 28 juin 2020 – 12 h 56 min (+01:00)
For the approximately 250,000 Canadians living with type 1 diabetes, the ongoing fight to stabilize blood sugar levels may soon be a thing of the past. A research team from McGill University’s Faculty of Medicine is working to optimize an artificial pancreas that promises to minimize the extreme fluctuations in blood glucose levels that affect patients’ quality of life and cause long-term complications.
Smart insulin pumps
In use for over 30 years, portable insulin pumps allow people with diabetes to manually establish the amount of insulin injected into their blood systems. The most common method for determining the optimal dose is to measure blood sugar by finger prick, but automated sensors are becoming more popular. Even with this type of device, blood sugar targets are reached on average less than 50% of the time. As a result, patients spend most of the day either in hyperglycemia, a condition that causes headaches and weakness, or in hypoglycemia, resulting in dizziness, confusion, and difficulty expressing themselves.
Assistant Professor Ahmad Haidar began his doctoral studies at McGill University just as automated blood glucose meters came to market. “It was the happiest coincidence in my life, because it was the automated sensor that made it possible to create an artificial pancreas system,” said the researcher. Building on his experience in automatic control engineering, Professor Haidar has designed an algorithm which tells the pump how much insulin to inject, based on the reading entered by the user. He then partnered with three clinicians from McGill’s Faculty of Medicine – Doctors Laurent Legault, Michael Tsoukas and Jean-François Yale – to form the Artificial Pancreas Laboratory at McGill. Bringing together 12 full-time and 45 part-time researchers, their team is the only one in Canada to develop artificial pancreas systems.
Advances to improve quality of life
In a recent study published in Diabetes Care, the laboratory team presents a breakthrough in understanding the effectiveness of artificial pancreas systems. With funding from the Juvenile Diabetes Research Foundation, the group has tested the administration of a second hormone, pramlintide, in addition to insulin, in the hopes that the drugs will combine give better results than insulin alone. The study found that this method significantly increased the proportion of time that patients’ blood sugar remained within the target range. Pramlintide, by slowing the absorption of food, gave insulin more time to work.
“The results surprised me: I did not expect them to be as positive?” Admits Professor Haidar. Patients who received insulin and pramlintide during the study were very satisfied with the new treatment regimen. “By allowing them to better control their blood sugar, we greatly improve their quality of life,” says the researcher.
For the McGill Artificial Pancreas Laboratory, the next big challenge is creating a fully automated artificial pancreas, which would eliminate the steps of manually entering carbohydrate amounts and activating the insulin pump at mealtimes. “The development of this second generation technology is generating a lot of interest among patients,” says Professor Haidar. While working to perfect the artificial pancreas system, the researcher thinks of his colleagues living with type 1 diabetes and the patients he meets on a daily basis. “? I am optimistic for the future?”, He concludes. “We are working so that our research has an impact far beyond our laboratory.”