Artificial pancreas successful in type 2 diabetes tests
- Reference: 1674023406
- News link: https://www.theregister.co.uk/2023/01/18/artificial_pancreas_successful_in_type/
- Source link:
In a [1]paper published in Nature the team said their device halved the amount of time patients spent with high glucose levels, doubled the amount of time glucose levels were safe, lowered overall glucose levels and reduced levels of glycated hemoglobin – a compound that can cause diabetes-related complications.
To top it off, the researchers said they didn't have any patients experience hypoglycemia – dangerously low blood sugar levels – during the trials. Low blood sugar has been a complication for long-term users of insulin pumps.
[2]
Type 2 diabetes is often linked to lifestyle and develops over time, causing the body to make insufficient insulin or to become insulin resistant. Those with [3]type 1 diabetes are often born with the condition, which causes their immune system to attack the cells of their pancreas, preventing it from producing insulin.
[4]
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According to the researchers, some 90 percent of the 4.9 million people suffering from diabetes in the UK have type 2, costing the National Health Service (NHS) £10 billion ($12B) per year. Globally, the team said, 415 million people are believed to have type 2 diabetes, costing an estimated $760 billion per year.
A type 2 breakthrough
This artificial pancreas isn't the first. The Cambridge team behind the device previously designed an artificial pancreas for type 1 diabetes patients, which required the wearer to tell it when they planned to eat so it could adjust insulin levels accordingly.
The team has also trialed a similar device for type 2 diabetes patients undergoing kidney dialysis, Cambridge said. The latest device was the first trialed in a "wider" population (of 26 people) living with type 2 diabetes who don't require dialysis.
According to the university, It's also the first fully "closed loop" automated device that requires no intervention from the user.
[6]'Virtually no difference' between AI and humans in diagnosing prediabetes
[7]I'm diabetic. I'd rather risk my shared health data being stolen than a double amputation
[8]Study: AI designed to detect diabetic eye disease blinks in the real world, makes more work for doctors
[9]AI of the needle: Here's how neural networks could detect nighttime low blood-sugar levels using your heart beat
Consisting of an off-the-shelf continuous glucose monitor and insulin pump, the real innovation of the Cambridge design is its mobile app, CamAPS HX, which uses an algorithm developed by the team that Cambridge University [10]states "predicts how much insulin is required to maintain glucose levels in the target range."
"Many people with type 2 diabetes struggle to manage their blood sugar levels using the currently available treatments, such as insulin injections. The artificial pancreas can provide a safe and effective approach to help them, and the technology is simple to use and can be implemented safely at home," said study co-lead Dr Charlotte Boughton of Cambridge's Wellcome-MRC Institute of Metabolic Science.
Pump or, alternatively, dump
For the millions of people with type 2 diabetes who are beyond the help of more conservative treatment methods, the news from Cambridge is fantastic. Participant feedback makes it even better news, as the researchers said 89 percent of participants spent less overall time managing their diabetes.
But for millions of people with early type 2 diabetes – classified as within the first six years since diagnosis – the condition may be reversible through rapid weight loss, [11]says Roy Taylor, Newcastle University professor of medicine and metabolism.
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According to Taylor's research, each individual has a "fat threshold" that, if surpassed, can lead to type 2 diabetes. When that threshold is passed, fat can't be stored under the skin, so it's shifted to the liver and pancreas, and that fat buildup leads to type 2 diabetes.
This fat threshold theory isn't controversial. Previous studies have shown that fat accumulation on the liver and pancreas increases the [13]risk of type 2 diabetes . Which comes first – the type 2 diabetes or fat accumulation around the liver and pancreas – is less clear, though. According to the Mayo Clinic, health conditions like obesity, insulin resistance, prediabetes and diabetes "appear to [14]promote the deposit of fat in the liver."
Regardless, Taylor claims that an increase in weight after age 21 is a risk for developing type 2 diabetes, and losing that weight can prevent or reverse the condition.
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"If you've increased weight quite a lot above what you were at the age of 21, you're in the danger zone – and you should get out of it," Taylor said. He defines that increase as three BMI units or more since 21.
Taylor's crash diet solution to type 2 diabetes is simple: Eat 700-800 calories (3000–3400 kilojoules) a day for several weeks to force the body below its fat threshold rapidly.
While that sort of eating pattern is not pleasant, Taylor's [16]Newcastle diet [PDF] appears to have some evidence supporting its claims, at least according to Taylor. He told The Guardian that nine out of ten people who've undergone the diet "were cured after losing more than 15kg [33lbs]."
Other advice, [17]from the Harvard School of Public Health suggests "type 2 diabetes is largely preventable by taking several simple steps: keeping weight under control, exercising more, eating a healthy diet, and not smoking."
The Cambridge artificial pancreas offers another possibility to manage the disease, as the team behind it has reportedly submitted it for regulatory approval in the UK and plans to make it commercially available – eventually. ®
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[1] https://www.nature.com/articles/s41591-022-02144-z#Sec1
[2] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/science&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=2&c=2Y8fRV-SAx2agOegUjX-JcwAAANE&t=ct%3Dns%26unitnum%3D2%26raptor%3Dcondor%26pos%3Dtop%26test%3D0
[3] https://www.diabetes.org.uk/diabetes-the-basics/differences-between-type-1-and-type-2-diabetes#:~:text=The%20main%20difference%20between%20the,producing%20cells%20in%20your%20pancreas.
[4] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/science&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=4&c=44Y8fRV-SAx2agOegUjX-JcwAAANE&t=ct%3Dns%26unitnum%3D4%26raptor%3Dfalcon%26pos%3Dmid%26test%3D0
[5] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/science&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=3&c=33Y8fRV-SAx2agOegUjX-JcwAAANE&t=ct%3Dns%26unitnum%3D3%26raptor%3Deagle%26pos%3Dmid%26test%3D0
[6] https://www.theregister.com/2022/04/06/ai_prediabetic_screening/
[7] https://www.theregister.com/2021/10/13/healthcare_privacy_debate_wednesday/
[8] https://www.theregister.com/2021/01/12/eye_doctor_ai/
[9] https://www.theregister.com/2020/01/14/ai_blood_sugar/
[10] https://www.cam.ac.uk/research/news/artificial-pancreas-successfully-trialled-for-use-by-type-2-diabetes-patients
[11] https://www.theguardian.com/society/2021/may/15/how-to-cure-type-2-diabetes-without-medication
[12] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/science&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=4&c=44Y8fRV-SAx2agOegUjX-JcwAAANE&t=ct%3Dns%26unitnum%3D4%26raptor%3Dfalcon%26pos%3Dmid%26test%3D0
[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3643962/
[14] https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567#:~:text=NAFLD%20and%20NASH%20are%20both,prediabetes%20or%20type%202%20diabetes
[15] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offbeat/science&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=3&c=33Y8fRV-SAx2agOegUjX-JcwAAANE&t=ct%3Dns%26unitnum%3D3%26raptor%3Deagle%26pos%3Dmid%26test%3D0
[16] https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/201809%20Sample%20Recipes%20&%20meal%20plans.pdf
[17] https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/preventing-diabetes-full-story/#:~:text=Type%202%20diabetes%20is%20largely,healthy%20diet%2C%20and%20not%20smoking.
[18] https://whitepapers.theregister.com/
Re: To be honest
I wish you the best of luck. Diabetes is a pain because, although it is not painful in itself (as far as I know), it can kill you pretty quick.
In any case, I think this artificial pancreas has a great future in store and I hope it will help everyone afflicted with this condition.
Not being Picky but....
I think this is also being rolled out to certain Type 1 patients as well. At least the hospital I attend as an out patient for Type 1 is saying so...
I have been tempted to try the home brew method of this ("looping" with OpenAPS) but having an android phone calculating doses of a drig that can kill me is a step to far for me (probably comes from working in IT!) A lot of people do have great success with it though more info here if anyone is interested https://openaps.org/ (would make a link but i'm in a rush!)
Re: Not being Picky but....
I had to change hospital clinic to access a pump friendly team and have recently started with a funded hybrid closed loop system.
These systems are now part of a set of NICE guidelines that are out for consultation so hopefully more will be able to access them.
So far it is doing a better job of keeping my glucose levels in range than I was able to
As with everything medical, the answer to what causes Diabetes Type 2 is probably "due to a number of factors"...
I'd certainly believe that a large number of cases could be avoided if people took the weight off after the initial diagnosis. But then I would also believe that, for an equally large number of cases, taking the weight off would not have an effect, because the Diabetes was caused by some other effect (e.g. smoking, or predisposition to developing the disease).
Still if people were immediately put on a crash diet after diagnosis, then that would be a good start, and for those for whom weight loss doesnt cure the disease, then a device like this would be an excellent helper, for keeping them safe and healthy.
Multiple solutions for multiple factors...
Good work Boffins!
Diet
As a T2 who has done a lot of amateur research in the condition I can agree with what you have said.
My family has a genetic disposition, both active parents (outdoor manual jobs) had it for years, and my brother was diagnosed within a few months of me, (who at the time was digging trenches by hand all day long).
I had to take a compulsory (Desmond) course run by the NHS when I was diagnosed. I was the youngest attendee by about 2 decades and the lightest by at least 6 stones. When I was checked a couple of months before diagnosis, I was 5% body fat!
The biggest factor in the prevalence of T2 Diabetes is the NHS advice to cut down on fat. This has led to the population's diet becoming carbohydrate heavy, which leads to the extra weigh and places too much strain on the Pancreas causing it to become less efficient or stud down. It's the same as any engine - run it too hard and it will not last as long!
I am a T2. Definitely lifestyle reasons for me. I had a back injury that means I am not able to exercise and I became T2 within 18 months despite a 1200KC maintenance diet. After more than a decade I am around 8 pounds heavier than before the injury, but the muscle bulk has changed to visceral fat :-( The diabetes medication has cost many more times what the operation to fix my back would have cost (replacement disk and rods to hold it all in place), but NHS risk/benefit calculations were 50:50 at the time and the consultant was not inclined.
I use a Freestyle Libre2 to constantly monitor my blood sugar and find that the correctness of general advice on food types depends on the person and the type of day. However, £100/month is not something everyone is able to pay for :-( For instance, the Oat Porridge that is suggested by the experts has a similar effect on me to any other cereal, and bread, of any type, will raise my blood sugar by 2 for the rest of the day.
My boss, T1, tried an artificial pancreas in the Netherlands last year, but found that its AI/control loop would not adjust to the speed his body dealt with the sugar and had to give up.
To be honest
I was hoping for an organic working replacement for the failing organ...
(Sulking because I have recently started using insulin injections, and it's a pain. Though since moving to Germany a couple of years ago a change in medication from the NHS treatment led to the loss of fifteen kilos in three months, which was a surprise to all concern and required me to buy new trousers. The change to injected insulin has led to a small weight gain, I suspect because sugar in the blood is now being glommed onto by the liver, as it should, and safely tucked away as far, instead of just being peed out at (very) regular intervals.)