MORGANTOWN – If you hear the phrase “bionic pancreas,” you might flash back to those 1970s sci-fi TV shows. You may picture a cartoon anthropomorphic pancreas running in slow motion, with tinny synthesizer riffs adding dramatic emphasis.
In reality, a bionic pancreas is a relatively new and increasingly popular way for patients with Type 1 and Type 2 diabetes to manage their insulin delivery. Bionics refers generally to electromechanical enhancements to biological functions. The pancreas is the source of insulin in humans and doesn’t produce it in sufficient levels, or at all, for patients with diabetes.
WVU Medicine offers the bionic pancreas system for its patients with diabetes and WVUM endocrinologist Dr. Jessica Perini explained how it works.
It’s a three-part system. Two of them are familiar: the insulin pump and the continuous glucose monitor. The third part is the key: a proprietary software algorithm that links the two devices so they can communicate with each other to maintain proper insulin levels.
A glucose pump she said, attaches directly to the skin or via a tube and catheter. In either case, the pump holds insulin and delivers it subcutaneously via the catheter, the same as an insulin injection. Buttons on the pump allow the wearer to set delivery rates for 24/7 delivery and can allow the patient to get extra amounts – called a bolus – based on need, determined by patient.
Continuous glucose monitors – CGMs – also sit on the skin and have a catheter that pokes into the skin. They measure insulin levels in interstitial fluid that flows between cells rather than in the blood. She said you may see this yellowy-clear fluid when you cut yourself.
A CGM, she said, can run a little behind in terms of time relative to a finger stick that is up to the moment. Both have value. CGMs are good for monitoring trends.
“That’s an advantage over the finger stick,” she said. “Because unless you’re checking your finger sticks 24 hours a day, you’re never going to get so much data about what your blood sugars are doing.”
Alarms can be set by the patient into a CGM to alert them to approaching insulin level thresholds that will require insulin delivery.
The proprietary algorithm – several companies offer the bionic pancreas – allows the pump and CGM to communicate. The CGM will see a trend and tell the pump to deliver more or less insulin or stop for a time if a serious low blood sugar level is predicted. When it stops delivery, the patient has to intervene to tell the pump to go back to work.
“Anyone who needs insulin really could use these,” she said.
Perini said communication isn’t universal between CGMs and pumps. Certain brands will talk to certain brands.
The bionic pancreas tracks long-term data, she said, that doctors can print out and use to adjust and maintain dosage levels. Patients can also access the data if they wish.
“It really gives us great data,” she said, “These automatic systems really do work very, very well for many people. This population historically has been difficult for endocrinologists, and now we all have hope that it’s not going to be so bad for everybody.”
Perini pointed out that not every insurance provider covers the bionic pancreas, but that’s improving.
She didn’t have an exact number, but said her department has hundreds of patients using the setup.
But the bionic pancreas isn’t for everybody, she said. They work best when people trust them to do their job. People used to controlling their own pump and their boluses may find it hard to learn to let go and be confident with the system.
“Sometimes there’s a learning curve for people to learn to feel comfortable and confident in the system, but usually it can work really well for people.”
Email: dbeard@dominionpost.com
