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Stanford University School of Medicine

Almost an artificial pancreas: Technology makes it easier to live with Type 1 diabetes

Insulin-illustrationFor 10 years, starting when she was diagnosed with Type 1 diabetes as a 19-month-old, Jamie Kurtzig's parents took turns waking up every three hours, every night of the year, to check her blood sugar. In Type 1 diabetes, the body doesn't make insulin, the hormone that ushers sugar into the cells. The disease can be treated with injected insulin, but it's tricky to match the insulin dose to the body's needs, and a mismatch can cause dangerously low or high blood sugar levels.

Kids with Type 1 diabetes are especially vulnerable to low nighttime blood sugars, which can quickly lead to a coma. That's why Jamie's mom and dad woke up so often. But the years of vigilance were exhausting and stressful.

Lately, however, the Kurtzigs have been sleeping much better. Starting in 2016, Jamie began participating in a clinical trial via Lucile Packard Children's Hospital Stanford of a hybrid closed-loop insulin delivery system. The system wirelessly links a blood glucose monitor to an insulin pump. It automatically checks Jamie's blood sugar and adjusts her insulin levels while she sleeps. The technology is giving Jamie more independence, according to a story from the hospital:

Twelve-year-old Jamie Kurtzig, now old enough to want the freedom to do things like attend sleepovers at a friend’s house, said, 'When the system is in auto mode, it monitors my blood sugar every five minutes and keeps up the proper basal rate [of insulin]. Now I only have to check blood sugar four times a day. In the past, I had to check it a lot more, even up to 12 times a day.'

The closed-loop system, which was approved by the FDA in October, isn't yet sophisticated enough to mimic all the functions of the pancreas, the body's natural insulin factory. At present, patients must still check their sugar levels manually before meals and calculate how much insulin to give to balance sugars in the foods they'll be eating. But that will change in the future, as pediatric endocrinologist Bruce Buckingham, MD, who directs Stanford's clinical trials of closed-loop technology, explains:

In today’s closed-loop systems, the insulin comes on a little slower and lasts a little longer than we would like. Those lag times make it difficult to provide insulin delivery for a meal in a full closed-loop system. We are looking forward to working with fast-acting insulins — and more rapid delivery — to improve meal glucose control and decrease the daytime burden of diabetes.

Jamie and her family are happy they've contributed to research that is making life better for kids and families living with diabetes. "Because of the trial, I really feel like I get to be a part of diabetes history," Jamie said.

Previously: A picture is worth a thousand words: Researchers use photos to see how Type 1 diabetes affects kids, Can a safe, cheap pill prevent type 1 diabetes? and Rat-grown mouse pancreases reverse diabetes in mice, say researchers
Illustration by Amanda Woodward

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