FDA approves first "artificial pancreas" for
type 1 diabetes
The U.S. Food and Drug
Administration on Wednesday approved the first automated insulin delivery
system -- a so-called “artificial pancreas” -- for people with type 1
diabetes.
Medtronic’s MiniMed 670G hybrid
closed looped system, the first FDA-approved “artificial pancreas” device
for people with type 1 diabetes.
Medtronic
“This first-of-its-kind technology
can provide people with type 1 diabetes greater freedom to live their lives
without having to consistently and manually monitor baseline glucose levels and
administer insulin,” Dr. Jeffrey Shuren, director of the FDA’s Center for
Devices and Radiological Health, said in an agency news release.
The device -- Medtronic’s MiniMed
670G -- is what’s known as a hybrid closed-loop system. That means it monitors
blood sugar and then delivers necessary background (also known as basal)
insulin doses. The device will also shut off when blood sugar levels drop too
low.
However, this device isn’t yet a
fully automated artificial pancreas . People with type 1 diabetes will still
need to figure out how many carbohydrates are in their food, and enter that
information into the system, the agency noted.
Medtronic said the new device will
be available by Spring 2017. The FDA approval is currently only for people aged
14 and older. The company is now conducting clinical trials with the device in
younger patients.
Type 1 diabetes is an autoimmune
disease caused by a mistaken attack on healthy insulin-producing cells in the
body, destroying them. Insulin is a hormone necessary for ushering sugar into
cells in the body and brain to provide fuel for the cells. People with type 1
must replace the insulin their bodies no longer produce, through multiple daily
injections or through a tiny catheter attached to an insulin pump.
However, figuring out exactly how
much insulin to give is no easy task. Both too much and too little insulin can
have dangerous, even deadly consequences.
And that’s where this new technology
will help. The device has a continuous glucose monitor that constantly measures
blood sugar levels. A sophisticated computer algorithm then figures out if
someone’s blood sugar levels are too low or too high, and when too high, will
give the correct insulin dose to bring the blood sugar level down.
The device does this via a small
catheter inserted beneath the skin and attached to a tube that’s attached to an
insulin pump. This insulin delivery site needs to be changed approximately
every three days.
If blood sugar levels are too low,
the device will shut down insulin delivery.
In a statement, Aaron Kowalski,
chief mission officer for JDRF (formerly the Juvenile Diabetes Research
Foundation), said until there’s a cure for type 1 diabetes, “I know that the
artificial pancreas will change many lives for the better.”
“People who have participated in
artificial pancreas clinical trials have not only attained better overall
[blood sugar] control, but have experienced the relief of sleeping through the
night and waking up in the morning with blood glucose levels within target
range. That’s an improvement in quality of life that will be available to
others living with type 1 diabetes very soon as a result of the FDA’s
decision,” he said.
Melinda Rose -- who has a grown son
with type 1 , diagnosed diabetes when he was just 13 years old -- expressed
excitement over the approval. The artificial pancreas “will revolutionize the
way in which a person with type 1 diabetes manages this disease. In human
terms, the parent of a child with the [artificial pancreas] system will now be
able to sleep through the night and worry less.”
Dr. Gerald Bernstein, an
endocrinologist and coordinator of the Friedman Diabetes Program at Lenox Hill
Hospital in New York City, also expressed enthusiasm for the new device.
“With the development of electronic
devices to deliver insulin and measure blood glucose, the dream has been to tie
everything together and have an ‘artificial pancreas,” he said. “The greatest
inhibitor has been the complexity of insulin delivery and the development of
algorithms that can come close to what the normal body does,” Bernstein
explained.
“This is a welcome step forward for
people with type 1 diabetes,” he added. “It will be many years for a biologic
cure or prevention, and it is exciting to know that life can be better until
the next best thing comes along.”
According to JDRF, there are
currently 18 artificial pancreas systems in various stages of development, with
Medtronic’s being the first to receive FDA approval.
Medtronic was also the first, and so
far only, company to receive approval on what’s known as a “low-suspend” pump.
That device, approved in late 2013, shuts off automatically when blood sugar
levels go too low. However, unlike the newly approved device, the low-suspend
pump did not provide insulin delivery.
According to the agency, the FDA
approval is based on data from a clinical trial of 123 people with type 1
diabetes. The study volunteers wore the device for three months. No serious low
blood sugar (hypoglycemia) events occurred. And no one experienced diabetic
ketoacidosis, a serious complication that can occur if someone doesn’t get
enough insulin, according to the American Diabetes Association.
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