UNLV grads assist in artificial pancreas research
For people who struggle with diabetes, the ultimate cure is a replacement for a faulty pancreas.
While scientists are far from building an artificial organ, a breakthrough system being developed with the help of two alums from the University of Nevada, Las Vegas is bringing the diabetic community closer to one than ever before.
Diabetes specialists Tomas Walker and Aimee Jose, who graduated five years apart from UNLV’s nursing school, are each playing a role in the creation of a so-called artificial pancreas system, a mobile app-based tool that monitors and balances blood sugar levels. Walker — a 2012 doctoral graduate — uses patient feedback to work with researchers who are developing a key component in the system, while Jose — who got her bachelor’s degree in 2007 — is among hundreds of research subjects testing the system in clinical trials.
“It’s life-changing,” said Jose, a diabetes educator at the Palo Alto Medical Foundation in California who was diagnosed with the disease at age 12. “It’s not final, and it’s not perfect. But it’s so amazing not to worry about having low or high blood sugar.”
Using the system
The tool works like this: Three separate components with tiny needles are attached to the wearer’s abdomen. The first two are pumps — one is filled with the insulin hormone, and the second is filled with another hormone called glucagon. The third is a continuous glucose monitor, and that is the most important piece because it tells the pumps how frequently they should secrete hormones into the body to regulate blood sugar levels.
The system aims to perform the function of a healthy human pancreas, which releases the exact right amount of insulin into the bloodstream to allow glucose from food to enter the cells and be used for energy. When a person eats, the pancreas secretes more insulin. During exercise, it cuts back on insulin. When one doesn’t eat for a long time, the pancreas makes glucagon, which tells the liver to put more sugar into the bloodstream. People without diabetes already have a system that keeps blood sugar within a very precise range.
But people with type 1 diabetes and some with type 2 diabetes have a broken system, and the insulin has to be replaced manually with shots or a pump. Achieving that balance is very hard, and that’s where the continuous glucose monitors come in handy.
Monitoring glucose
Continuous glucose monitors, which have been widely available for a decade, have helped diabetics dramatically because they test blood sugar levels automatically every five minutes. Now the device is being modified so that it can control hormone pumps to regulate how much insulin and glucagon the body needs without much manual input from the user, diminishing room for error.
Hired last year to serve as the director of clinical projects at San Diego-based Dexcom Inc. — a leading manufacturer of the monitors — Walker uses patient feedback to help researchers at the company improve the devices. That’s crucial, because the effectiveness of the gadgets hinges largely on their ease of use.
“Being diabetic, I had to learn to have a lot of glucose monitors, and sometimes you see erratic numbers,” said Molly Condron, who began using a continuous glucose monitor in 2006 under Walker’s supervision. “Wearing the sensor really allowed me to track that better.”
Walker has helped in more than 30 clinical studies since partnering with Dexcom in 2006, and he was the first clinician in the state to secure insurance coverage for personal use of the continuous glucose monitors by a person with diabetes.
“We can develop something that works perfectly well, but a patient won’t touch it if they don’t like the interface,” Walker said. “When you’re dealing with a chronic disease, the patient has to see the benefit of it right away.”
Testing the system
As a type 1 diabetes sufferer, Jose was one of 11 people who tested an early version of the artificial pancreas system in January for a study conducted by Stanford University. More than 20 such trials are being conducted around the world.
Thanks to such heavy competition among continuous glucose monitor manufacturers, experts say the system could go to market as soon as 2017. It won’t be a perfect fix for diabetics, but it could transform the way they manage insulin levels.
“We’ve focused a lot on research in academia, and our next step is having a company commercialize it,” said Aaron Kowalski, vice president for research at the New York-based Juvenile Diabetes Research Foundation, a top funder of research into the systems. “Will this eliminate all problems? No. But it’s a very, very big step forward.”
Contact Ana Ley at aley@reviewjournal.com or 702-224-5512. Find her on Twitter: @la_ley.
