Artificial Pancreas Uses Insulin and Glucagons to Regulate Blood Sugar

Tests of the blood sugar control mechanism, developed by Boston University researchers and tested at Massachusetts General Hospital, confirm the feasibility of an approach utilizing doses of both hormones.

An artificial pancreas that closely mimics the body’s blood sugar control mechanism has been developed by researchers at Boston University and successfully tested by a team at Massachusetts General Hospital (MGH), which was led by Steven Russell, MD, PhD, of the MGH Diabetes Center, and Edward Damiano, PhD, of the BU Department of Biomedical Engineering.

The artificial pancreas combines a blood glucose monitor and insulin pump technology with software that directs the administration of insulin and glucagons. According to Damiano and Firas El-Khatib, PhD, lead author of the Science: Transitional Medicine article on the study, the system they developed “both accounts for the rate of insulin absorption and also incorporates glucagons” because any administration of insulin has been associated with hypoglycemia.

In the initial test of the system at MGH, the researchers “confirmed the feasibility of an approach utilizing doses of both hormones.” In addition, the researchers were able to account for differences in insulin absorbance among study participants by making changes to the system.

"This is the first study to test an artificial pancreas using both insulin and glucagon in people with type 1 diabetes,” Russell said. “It showed that, by delivering both hormones in response to frequent blood sugar tests, it is possible to control blood sugar levels without hypoglycemia, even after high-carbohydrate meals."

The pilot test of the system at MGH enrolled 11 adults with type 1 diabetes and “was primarily designed to test the software that controls the system.” In order to record the most accurate glucose levels, the system directly reads blood sugar through a system that is placed into a vein. The participants’ blood sugar was controlled by the system for 27 hours, during which time they were given three standardized, high-carbohydrate meals and spent the night in the hospital.

The system maintained glucose levels that were close to the target range for six of the participants, but five others experienced hypoglycemia significant enough that they had to be given orange juice to raise their blood sugar.