Sep 04, 2023 06:00:00

A home-made insulin delivery device could change the treatment of type 1 diabetes

There are multiple types

of diabetes , one of which is type 1 diabetes . In type 1 diabetes, the beta cells in the pancreas are destroyed and insulin is no longer produced, leading to chronic hyperglycemia and diabetes. To manage type 1 diabetes, it is necessary to administer insulin into the body using a pen-shaped syringe, but some type 1 diabetes patients manage this by creating their own software or devices that automatically administer insulin. I am.

A DIY 'bionic pancreas' is diabetes changing care — what's next?
https://doi.org/10.1038/d41586-023-02648-9

In people who do not have diabetes, the beta cells in their pancreas secrete insulin in response to fluctuations in blood sugar levels to keep blood sugar levels within an appropriate range. However, in patients with type 1 diabetes, the beta cells in the pancreas die for some reason, making it impossible to secrete insulin. Therefore, it is necessary to take insulin regularly, but insulin,

a peptide hormone , is digested and broken down in the stomach when taken orally like regular medicine. Therefore, to administer the correct amount of insulin, it must be given directly into the bloodstream by injection.

Some communities of type 1 diabetics are building their own wearable devices that include insulin delivery devices and devices that allow them to constantly monitor their blood sugar levels. However, early devices had to predict meals and exercise based on fluctuations in one's own blood sugar levels, and then calculate the appropriate insulin dose themselves. Therefore, the community was hoping for an algorithm to be developed that could analyze blood sugar data and automatically administer the appropriate amount of insulin.

In February 2015, community member Dana Lewis and others shared the code for OpenAPS, an algorithm that automatically administers insulin, and began testing it. OpenAPS has received feedback from many people with type 1 diabetes.

Since the release of OpenAPS, many open source algorithms related to automated insulin administration (AID) have been developed and published. According to Katarina Braun of Charité Berlin University, at the time of writing, approximately 30,000 type 1 diabetics were using open source algorithms for AID. In addition to OpenAPS, the algorithms used include ``AndroidAPS'', which is a development of Lewis et al.'s algorithm, and the smartphone application `` Tidepool Loop ''.

In January 2023, the US Food and Drug Administration (FDA) granted

approval for the first time to the AID system ``Tidepool Loop'' based on open source algorithms.

However, although the safety of AID systems based on open source algorithms has been confirmed many times, the field of homemade devices responsible for administering insulin has not progressed. This is because blood glucose monitors and insulin administration pumps developed by different companies must be compatible, and cooperation between various manufacturers is required.

On the other hand, AID-related device manufacturers are cautious about providing technology to third parties. 'If the algorithm is running on a smartphone app rather than on the insulin pump, smartphone malfunctions or connectivity issues can pose a risk to treatment,' California pump maker Tandem said in a statement. I am. In addition, British medical technology company Medtronic has decided to abandon the design and development of devices that can interoperate with open source algorithms in favor of designing its own system.

Meanwhile, a research team at the University of Otago

successfully conducted a clinical trial of an open source insulin delivery pump. The research team's future goal is to provide the pump design plans free of charge to qualified manufacturers, who can manufacture the pumps at a fraction of the cost of commercial AID system manufacturers.

Unlike commercial AID systems, algorithms that are developed in open source format are constantly inspired by new ideas and innovations from the community. Sufyan Hussain of King's College London points out, ``Compared to open source AID systems, commercial AID systems do not have advanced features.'' Open source algorithms fully automatically monitor blood sugar levels and administer the appropriate amount of insulin. On the other hand, commercial AID systems require manual input of ``meals eaten'' etc. in order to adjust the appropriate amount of insulin. Additionally, some open-source algorithms can automatically adjust and administer the appropriate amount of insulin, regardless of the patient's diet, adrenaline level, stress, or excitement level.

'Some patients want to calibrate their own AID devices developed with open source, while others want the support and simplicity of commercial AID manufacturers,' said Raihan Lal of Stanford University. 'The key is for each individual patient to find the AID system that works best for them.'