While tight regulation of blood glucose levels is important to avoid complications from diabetes, it is difficult to achieve good glycemic control without occasional low blood glucose, or hypoglycemia. In fact, one of the biggest barriers to regulatory approval of an artificial pancreas is the inability of these insulin delivery systems to effectively prevent hypoglycemia.
One approach to this problem is the development of automatic systems that monitor glucose levels and stop the flow of insulin if blood glucose falls too low. This approach may limit the impact of hypoglycemia, but cannot prevent it entirely.
Association-funded researcher Dr. Steven Russell, at Massachusetts General Hospital, is studying another way to address this serious hurdle by developing automated systems that deliver glucagon to prevent hypoglycemia. Dr. Russell’s research has shown that low doses of glucagon delivered automatically by a system that uses continuous glucose monitoring, similar to the closed-loop insulin systems being developed for insulin administration, are effective at preventing hypoglycemia.
Dr. Russell has extended this study to a system using a combination of closed-loop glucagon together with closed-loop insulin delivery. In a recent publication in the New England Journal of Medicine, he reports that this so-called “bionic pancreas,” which administers both insulin and glucagon, improves mean glycemic levels with less frequent hypoglycemic episodes compared to insulin pumps in both adolescents and adults with type 1 diabetes. These promising results will be expanded to larger studies to confirm safety and efficacy of this approach, important for future development and regulatory approval of an artificial pancreas that can effectively prevent hypoglycemia.
Study co-author Dr. Ed Damiano at Boston University is a biomedical engineer and father to a teenage son with type 1 diabetes. He was recently interviewed about the bionic pancreas project for a National Public Radio program, where he described his drive to invent a solution to his son’s diabetes management burden before his son goes to college.
The study was presented at the American Diabetes Association’s 74th Scientific Sessions in San Francisco and has been featured on several additional news outlets, including CBS News and Time magazine.
Steven Russell, MD, PhD
Massachusetts General Hospital
ADA-Novo Nordisk Award in Hypoglycemia and Diabetes
Funded for 3 years at $500,000
Supported by Novo Nordisk Inc.