The Artificial Pancreas project at the Department of Paediatrics, University of Cambridge, will facilitate understanding of closed-loop control performance in children and adolescents and will pave the way for its widespread use.

Short- and midterm availability of other closed-loop control options in this population is unlikely. Traditionally, insulin is injected according to blood glucose levels measured with a spot glucose meter up to six times a day. However, insulin needs to be more accurately titrated to attain near-normal levels of blood glucose and to reduce the risk of greatly feared dangerous low blood glucose levels. This can be achieved by the, so called, electromechanical artificial pancreas. Glucose is measured on a minute-to-minute basis by a continuous glucose monitor. The signal is transmitted wirelessly to a handheld computer, which calculates the right amount of insulin for a given condition. The information on the insulin rate is then further transmitted wirelessly to an insulin pump delivering the insulin.

We will develop and test a prototype of artificial pancreas and specifically the control algorithm. Furthermore, we will develop a computer-based simulation environment, where we will evaluate and optimise the system performance prior to clinical testing. The computer environment will include the development of “synthetic” population of children and adolescents treated by insulin with accurate representation of the metabolic differences between subjects and within subjects. The clinical work will start by testing the prototype of the artificial pancreas in a controlled laboratory environment. Children and adolescents are known to have larger swings in insulin need than adults and laboratory experience is required to establish the feasibility and safety of glucose control with the artificial pancreas. Initially, overnight control will be our target as day control is confounded by meals. If feasible, and following on from laboratory evaluation, we will test night control at home. The children and adolescents will wear the artificial pancreas over 3 consecutive nights to determine the feasibility of home use.

The project is funded by the Juvenile Diabetes Research Foundation International from autumn 2006 for a period of three years. For more information about the JDRF Artificial Pancreas research initiative and continuous glucose monitoring please visit here.

Dr Roman Hovorka, Professor David Dunger and Dr Carlo Acerini

January 2007

Project Update, September 2008

In June 2008, a Focus Group was formed comprising 12 families recruited by INPUT (INsulin PUmp Therapy), a patient led support group for people using insulin pumps. They met to consider common problems presented by the management of Type 1 diabetes in children and adolescents and completed a questionnaire describing their attitudes towards overnight closed-loop glucose control. To view the report and analysis of the Focus Group questionnaire, please click here.

The Winter 2009/10 artificial pancreas newsletter is available here, 2011-2012 edition here and the 2012-13 edition here.