Improving the Artificial Pancreas: Is This the Way to Do It?

A Canadian research team is examining the use of pramlintide in conjunction with insulin on the artificial-pancreas platform, with the goal of further improving blood glucose management for type 1 diabetics. 

Maureen Kingsley

Medtronic recently announced FDA approval of the MiniMed 670G insulin pump, a first-of-its-kind "artificial pancreas" that both monitors blood glucose levels and provides appropriate basal insulin doses in Type 1 diabetes patients. Now the Canadian branch of JDRF has teamed with McGill University in Montreal to investigate ways to improve the system's glucose-control capabilities.

JDRF Canada granted $466,450 to Ahmad Haidar, a biomedical engineering and endocrinology professor at McGill. The grant is meant to help Haidar and his colleagues investigate the effects of delivering the hormone pramlintide along with insulin via artificial pancreas to regulate blood glucose levels in individuals with Ttype 1 diabetes.

Pramlintide is a pancreatic hormone that reduces the speed at which food moves from the stomach to the small intestine and suppresses the release of glucagon, which signals the liver to convert stored glycogen into glucose. By this mechanism, the hormone reduces blood glucose levels, thereby allowing patients to use less insulin.

JDRF says Haidar and his team will conduct a trial to determine the feasibility of using pramlintide in an artificial pancreas, such as the MiniMed 670G, to boost the device's ability to control glucose levels and better simulate an actual pancreas. The McGill team will investigate delivering the hormone between meals and after meals.

"We anticipate that the simultaneous infusion of pramlintide will help to improve glucose control, compared to other models of the artificial pancreas" that don't use that hormone, said Haidar in the JDRF statement.

Meanwhile, Medtronic plans a commercial launch of the MiniMed 670G insulin pump in spring 2017. The hybrid closed-loop system uses an algorithm to learn the wearer's glucose patterns and insulin needs; it measures the user's glucose levels every five minutes, and supplies or withholds insulin accordingly. Users will still need to manually request insulin doses ahead of mealtimes. Medtronic is working toward a fully automatic closed-loop system that will dose insulin for meals without manual data input.

In FDA's announcement of its approval of the MiniMed 670G, OIVD director Alberto Gutierrez pointed to Medtronic's interactive and early communication with the agency during the device's long development as a model for other medical device companies to emulate. "We encourage companies to work closely with the agency to ensure scientifically sound, highly efficient clinical study designs, helping to expedite the FDA's evaluation and subsequent approval of novel devices that can make a difference for patients," he said in the announcement.

Maureen Kingsley is a contributor to Qmed. 

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[Image courtesy of Diabetes Care, per Creative Commons 2.0 license]