Medtronic unit takes lead in work on ‘artificial pancreas’

Doctors are reporting a major step toward an “artificial pancreas,” a device that would constantly monitor blood sugar in people with diabetes and automatically supply insulin as needed.

A key component of such a system — an insulin pump programmed to shut down if blood-sugar dips too low while people are sleeping — worked as intended in a three-month study of 247 patients.

This “smart pump,” made by Minneapolisbased Medtronic Inc., is already sold in Europe, and the U. S. Food and Drug Administration is reviewing it now. Whether it also can be programmed to mimic a real pancreas and constantly adjust insulin based on continuous readings from a blood-sugar monitor requires more testing, but doctors say the new study suggests that’s a realistic goal.

“This is the first step in the development of the artificial pancreas,” said Dr. Richard Bergenstal, diabetes chief at Park Nicollet, a large clinic in St. Louis Park, Minn. “Before we said it’s a dream. We have the first part of it now and I really think it will be developed.”

He led the companysponsored study and gave results Saturday at an American Diabetes Association conference in Chicago. They also were published online by the New England Journal of Medicine.

The study involved people with Type 1 diabetes. Their bodies don’t make insulin, a hormone needed to turn food into energy. That causes high bloodsugar levels and raises the risk for heart disease and many other health problems.

Some people with the more common Type 2 diabetes, the kind linked to obesity, also need insulin and might benefit from a device like an artificial pancreas, too. For now, though, it’s aimed at people with Type 1 diabetes who must inject insulin several times a day or get it through a pump with a narrow tube that goes un- der the skin. The pump is about the size of a cellphone and can be worn on a belt or kept in a pocket.

The pumps give a steady amount of insulin, and patients must monitor their sugar levels and give themselves more insulin at meals or whenever needed to keep blood sugar from getting too high.

In the study, all patients had blood sugar monitors. Half of them had ordinary insulin pumps and the others had pumps programmed to stop supplying insulin for two hours when blood-sugar fell to a certain threshold. Over three months, low-sugar episodes were reduced one-third in people using the pump with the shut-off feature.