For people with type 1 diabetes who follow medical research, development of a closed-loop, “artificial pancreas” has always been the Holy Grail. Such a system would combine an insulin pump with a continuous glucose monitor to provide constant control of blood glucose levels. But what if such a system was only a start? What if it might work better when combined with another therapy altogether?
Near-optimal control could be established through adding ultra-fast acting inhalable insulin to work alongside the artificial pancreas at mealtimes. That’s the fascinating suggestion of early results from a clinical trial by the Sansum Diabetes Research Institute and the College of Engineering at University of California, Santa Barbara, funded by the JDRF.
Why would such a thing be necessary? It has to do with basic limitations of subcutaneous insulin delivery, the way all type 1s get their insulin, right underneath the skin. When injected or pumped that way, insulin takes time to be absorbed in the body. An actual pancreas is able to work much more quickly.
New varieties of inhalable insulin act far more quickly, and seem to be especially effective at keeping down post-meal blood sugars. The usefulness with a closed-loop regimen seems clear: the system would handle blood glucose control for most of the day, but at mealtimes a quick puff of inhaled insulin would take care of possible blood sugar spikes.
Howard Zisser, the study’s main investigator and the director of research and technology at Sansum Diabetes, said the “study addresses one of the big questions in diabetes research, which is, ‘How do we manage meals with the artificial pancreas?'”
Zisser was enthused by the outcomes of the clinical research trial.
“Our preliminary results on the artificial pancreas working in tandem with the administration of mealtime ultra-fast-acting inhaled insulin are most promising,” he said. “It’s very straightforward to load the inhaler device and take the insulin. There’s no needle involved, and the small dose of inhaled insulin prevents the blood glucose from rising very quickly just after eating or falling too fast an hour or two later. In this way, the subcutaneous insulin being supplied by the artificial pancreas’ pump has the chance to actually work better.”