Bionic Pancreas Better for Managing Type 1 Diabetes

Your pancreas is like a little digestive engine, working hard to keep your body fueled and running. Just six inches long, it’s responsible for turning lunch into the energy that gets you through the afternoon and making sure your blood sugars stay balanced.

But in people with type 1 diabetes, the pancreas fails in the second job. The organ doesn’t produce enough insulin, a hormone necessary for converting and storing sugars. Without it, those sweet carbs can’t enter cells, leaving sugars stuck in the bloodstream and people with type 1 diabetes feeling thirsty, hungry, and tired. In the long term, diabetes can cause heart disease and damage the eyes, kidneys, feet and skin. Patients must constantly monitor their blood sugar levels and inject insulin to keep them in check.

There’s no cure for type 1 diabetes. But a bionic pancreas, invented by BU biomedical engineers and in the works for two decades, is moving closer to giving the nearly two million Americans with the chronic disease fresh hope. In a study published in the New England Journal of Medicine, researchers found the wearable automated insulin delivery device, iLet, was better at managing blood glucose levels than existing standardof-care methods.

The iLet was developed in the lab of Professor Ed Damiano (BME). In 2015, he cofounded a public benefit corporation, Beta Bionics, to advance the technology and bring it to market. His coinventor was Firas El-Khatib, previously a senior research scientist at BU and now Beta Bionics’ VP of research and innovation. Both are authors on the latest paper.

In a 13-week clinical trial at 16 sites across the United States, the iLet improved glycated hemoglobin (A1C) levels—a measure of blood glucose control—reducing them on average from 7.9 percent to 7.3 percent.

“It sounds so modest, you drop the entire cohort on average a half of one percent, but it’s actually pretty meaningful,” says Damiano. “Every percentage point reduction in A1C has been shown to confer meaningful reductions in long-term health complications for people with type 1. Across a population, that can be huge.”

The 15-mm-thick iLet is about the size of a credit card. Worn on a belt clip—or even in a bra strap or shoved in a pocket— the device communicates with a separate Bluetooth-enabled monitor to continuously track a subject’s glucose levels. Through a thin tube connected to the body, the iLet automatically delivers a tailored dose of insulin every five minutes, which it calculates based on current and past glucose levels; it can also learn and adapt to changing needs based on the body’s response to past insulin deliveries. By contrast, other methods for managing type 1 diabetes require patients to prick a finger or use a monitor to measure their glucose levels, then administer insulin by injection or with a pump—it’s up to them, with help from their physician, to calculate the correct dose.

“The iLet is designed to require hardly anything of you,” says Damiano. “As much as possible, it’s designed to be like a self-driving car—as opposed to holding the wheel and making all the insulin-dosing decisions. That’s a categorically different experience.” — ANDREW THURSTON