NUTS AND BOLTS
insulin and glucose levels, but she had to count carbs and deliver the
bolus dose b y pushing buttons, just like using a regular insulin pump.
Wesner says the systems have gotten smaller, more streamlined,
and more reliable since she started participating in the trials. They’re
essentially modi;ed existing pumps and CGMs, worn on a belt or in a
The arti;cial pancreas is
pocket, that interact with a person’s body via an infusion set and a
groundbreaking, but it’s still at
sensor inserted under the skin. For someone who’s lived with
the gawky adolescent stage:
diabetes almost her entire life, the promise of a device that could
It depends on current insulin
reduce some of the daily burden of the disease is tremendous. “It’s
formulations and pump delivery
one thing to hear about technology that could change your life,” she
methods. With that in mind,
says. “It’s pretty different to actually wear it.”
smart people and companies
Many people with type;1 and type;2 diabetes could have access to
around the globe are focusing
more than a prototype soon. In September 2016, the Food and Drug
on these two areas ripe for
Administration (FDA) approved the ;rst partial arti;cial pancreas
system—Medtronic’s MiniMed 670G—for sale in the United States.
As of press time, it’s expected to release in late spring. At least
BE TTER INSULIN INFUSION.
;ve other companies are working on their own systems, hoping
Arti;cial pancreas systems
to bring them to market by 2020.
rely on infusion sets to ferry
The ;rst devices to hit the market will be so-called “partial”
insulin into the body, but
arti;cial pancreases, requiring user input and monitoring for
those come with their own
mealtime boluses and automatically adjusting only basal insulin.
challenges: variations in
A few years from now, developers hope to release systems that will
absorption at di;erent skin
i yr a
manage all insulin delivery automatically: The user can essentially
sites, tissue damage from poor
strap it on and then forget about it.
site rotation, kinks in cannulas,
and adhesive failure. Proper
+ DOING THE MATH
insertion technique and site
are subject to human error.
When it’s working properly, the pancreas is a wonder of balance and
management are crucial—but
sensitivity. Inside the hot dog–sized organ, millions of beta cells
monitor the levels of glucose in the bloodstream. When glucose
And until longer-wear products
climbs too high, the beta cells release insulin, a hormone that
are a reality, users still need to
prompts cells elsewhere in the body to absorb and store the glucose
change their set every few days.
and shuts off the release of glucose by the liver. If blood glucose
goes too low, a different set of cells in the pancreas—called alpha
cells—pump out the hormone glucagon, which tells the liver to
The rapid-acting liquid insulin
release stored glucose.
analogs currently on the market
Diabetes is what happens when the beta cells in the pancreas stop
are speedy. But especially
working as they should. Without the beta cells to sense rising (or
with the absorption issues
falling) blood glucose levels and to release insulin accordingly, people
mentioned above, they can’t
with diabetes are forced to rely on substitutes—from ;nger sticks
quite compete with ;rst- and
and insulin pens to CGMs and insulin pumps. These require users—
second-phase insulin release by
typically people with type;1—to master sometimes-tricky tools and
a healthy pancreas in response
techniques and carry around one or more devices all the time.
And then there’s the math. The latest generation of CGMs may
provide accurate, real-time readouts of glucose levels. But it’s still up
to users to program basal rates, count carbs, and reactively decide to