Looping and Artificial Pancreas - The Diabetes Kitchen

Looping and Artificial Pancreas

Closed-loop insulin delivery (artificial pancreas) is a recent medical innovation, aiming to reduce the risk of hypoglycemia while achieving tight control of glucose.

This is a very exciting innovation - but you need to be using an insulin pump - currently costing around $7000 and the government will not subsidise it.

Without any jargon, the artificial pancreas works with the insulin pump to deliver insulin based on an individual's blood sugar levels which are checked every 15 mins (approx). 

When using an insulin pump on it's own the pump is pre-programmed to deliver insulin. When looped with the artificial pancreas (thus the word Looping) insulin delivery is modulated at intervals of 1 to 15 minutes.

Here's a pic to help explain.

Diabetes management with looping

Renza S explains how it has helped her here.

Here's how looping works:

  1. Continuous Glucose Monitor (CGM): A CGM is a device that continuously measures glucose levels in the interstitial fluid (the fluid between cells). It provides real-time information about glucose trends and patterns, allowing individuals to monitor their blood sugar levels without the need for frequent fingerstick tests.

  2. Insulin Pump: An insulin pump is a device that delivers a continuous supply of insulin to the body through a small tube inserted under the skin. It allows for more precise insulin dosing and the ability to adjust basal (background) insulin rates throughout the day.

  3. Algorithm: The heart of the closed-loop system is a sophisticated computer algorithm that processes the glucose data from the CGM and makes decisions about insulin delivery. The algorithm calculates the individual's insulin needs based on factors such as current glucose level, rate of change, and individual insulin sensitivity.

  4. Closed-Loop Control: The algorithm communicates with the insulin pump to adjust insulin delivery automatically. If the CGM indicates that blood sugar is rising, the algorithm may increase the basal insulin rate to bring it down. Conversely, if blood sugar is dropping, it may decrease or suspend insulin delivery to prevent hypoglycemia.

  5. User Input: While the closed-loop system makes automatic adjustments, it still requires some input from the user. Users need to enter information such as mealtime carbohydrate intake and exercise plans to help the algorithm make more accurate predictions.

Looping aims to mimic the functions of a healthy pancreas, which continuously releases insulin in response to changing blood sugar levels. By automating insulin delivery based on real-time data, looping can help individuals with type 1 diabetes achieve better glucose control, reduce the risk of hypoglycemia and hyperglycemia, and improve overall quality of life.

It's important to note that while looping technology can be very effective, it still requires careful monitoring and involvement from the individual with diabetes. Regular calibration of the CGM and ongoing communication with healthcare professionals are crucial to ensure safe and effective use of the closed-loop system. Additionally, looping may not be suitable for everyone, so discussions with healthcare providers are essential before adopting this approach.

 

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