For the first time, the FDA has approved an insulin delivery system produced by Medtronic. This is solely meant for patients aged 14 and older suffering from type I diabetes. Type I diabetes is a condition that results in a person’s autoimmune system destroying the beta-cells responsible for producing insulin in their pancreas. The product is set to start shipping in the spring of 2017, according to Medtronic. Up until now, patients with type I diabetes had to consistently and manually monitor baseline glucose levels and administer insulin. Now, with this device that is being dubbed the “artificial pancreas,” patients will have their blood sugar automatically tested and adjusted by the machine.
The device’s (technically known as MiniMed 670G) insulin-delivery system relies on 3 elements:
- a coin-size transmitter attached to a tiny needle inserted into the skin that continuously tracks glucose levels in the body
- a pump that delivers precise doses of insulin as they are needed through a separate catheter inserted into the skin
- a computer chip that uses data from both to optimize the delivery of insulin on a minute-by-minute basis.
Maintaining the right amount of glucose in the body is no easy task so thankfully, for people without type I diabetes, our body (pancreas) automatically monitors and adjusts our blood sugar levels. Patients with type I diabetes, however, have a much more difficult task in monitoring their blood-sugar levels. Since their insulin-producing cells are destroyed, they need to manually make sure their body is given the right amount of insulin. Although there are monitors that help them measure their blood-sugar levels, they didn’t always perfect the treatment of giving insulin to patients. Glucose levels in our body are always changing, and this variability depends on many factors, such as age, the meal we last ate, gender, and our activity levels. In patients with type I diabetes, however, an abnormally high glucose level can result in damage to important organs over an extended period of time, such as the kidneys, heart and nerves.
Because of this immense variability, only 28% of teens and young adults with type 1 diabetes meet the targets for maintaining the blood sugar levels needed to reduce the risk of complications. The 670G aims to avoid some of the variability in blood sugar by using a predictive model. It can estimate where blood sugar levels are likely to be in the next few minutes, and re-evaluate that level every 5 minutes. If blood sugar is plummeting, the system can shut off insulin delivery, or increase it to control a spike in blood-sugar levels. The device isn’t perfect however–people with type 1 diabetes will still need to figure out how many carbohydrates are in their food, and enter that information into the system.
Did you know that type I diabetes may be caused by genetics? The largest contribution to the cause of type 1 diabetes comes from a single locus called IDDM1, which comes from several genes. This is believed to be responsible for at least 40% of the disease’s familial aggregation. Additionally, nearly 30% of type I diabetes patients are heterozygous for several HLA-DQ2 (specifically HLA-DQ2/DQ8) alleles. Knowing if you or your children will be at an increased risk for type I diabetes is extremely important, so that is just one of the many genes that New Amsterdam Genomics tests for in their whole exome sequencing test.