An Artificial Pancreas Will Likely Be Available by 2018


As researchers continue to pursue a cure for type 1 diabetes, by 2018 technology will ease the burden of those who suffer from it: with an artificial pancreas. Researchers at the University of Cambridge Metabolic Research Laboratories recently published a literature review in the journal Diabetologia of a dozen studies that document the efficacy of the artificial pancreas in outpatient adults, adolescents, and children.

An artificial pancreas isn't a replacement organ. It's a closed-loop system of blood glucose monitoring and insulin delivery, controlled by a special smartphone app, which can essentially take over the job of the pancreas. An algorithm helps two devices work together almost seamlessly: a continuous glucose monitor (CGM), which measures glucose in subcutaneous tissue, and an insulin pump, which administers insulin automatically.

The review looked at 12 early trials of the artificial pancreas that included nearly 340 people in different settings, such as participants' homes and diabetes camps. The review found that connecting the insulin pump to the glucose monitor is a game changer for diabetic patients, who spend much of their time monitoring and correcting their blood sugar. The pancreas automates these formerly manual tasks.

In current conventional therapy, diabetes patients use two separate devices to monitor and adjust their insulin levels: a CGM and an insulin pump, usually worn at the waist or hip, where it connects subcutaneously. This system requires constant attention, especially because, as the review points out, the insulin requirements of someone with type 1 diabetes vary considerably in a 24-hour period, changing on average by 20 percent during waking hours and 30 percent overnight. It's also influenced by what a person eats.

“So you have the patient who still has to do all the calculations themselves and to manually give a bolus depending on what they eat, and adjust the infusion rate if they’re going low or increase it if they’re sick,” study author Hood Thabit, a diabetologist, tells mental_floss.

With the artificial pancreas system, however, the glucose sensor is attached to the pump and then blood glucose information is relayed to the smartphone app algorithm "automatically and wirelessly," Thabit says. In response to the data, the algorithm controls the amount of insulin released by the pump.

Thabit and colleague Roman Hovorka developed one of the algorithms that make this system possible—one of several that different manufacturers can use to build their devices. Thabit's testing of this algorithm and the artificial pancreas system is one of the 12 studies included in his Diabetologia literature review. In that 2015 study, published in the New England Journal of Medicine, “we used the system in our patients day and night for three months, and it actually showed an improvement in [hemoglobin levels] and a reduction of hypoglycemia, and that has never been shown before by using conventional pump therapy or even injection therapy,” Thabit describes.

By improving glucose control, the artificial pancreas "will be a very cost-effective way of treating your condition because you will avoid having complications, which make you unable to work, go to school, et cetera,” Thabit says.

Currently, the medical devices, which are made by several companies, are in a medical device trial with the FDA awaiting approval, which may come by 2018. Thabit is hopeful about the outcome because the FDA "has been very supportive of this whole field.”

While this is very exciting for the future of type 1 diabetes care, Thabit makes clear that “this is not a cure. This is something that patients have been waiting for for a very long time because managing their diabetes is very challenging. It’s a lot of work. This is, at least at the moment, a bridge to a cure until a biological cure is found.”

Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation
Bill Gates is Spending $100 Million to Find a Cure for Alzheimer's
Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation
Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation

Not everyone who's blessed with a long life will remember it. Individuals who live into their mid-80s have a nearly 50 percent chance of developing Alzheimer's, and scientists still haven't discovered any groundbreaking treatments for the neurodegenerative disease [PDF]. To pave the way for a cure, Microsoft co-founder and philanthropist Bill Gates has announced that he's donating $100 million to dementia research, according to Newsweek.

On his blog, Gates explained that Alzheimer's disease places a financial burden on both families and healthcare systems alike. "This is something that governments all over the world need to be thinking about," he wrote, "including in low- and middle-income countries where life expectancies are catching up to the global average and the number of people with dementia is on the rise."

Gates's interest in Alzheimer's is both pragmatic and personal. "This is something I know a lot about, because men in my family have suffered from Alzheimer’s," he said. "I know how awful it is to watch people you love struggle as the disease robs them of their mental capacity, and there is nothing you can do about it. It feels a lot like you're experiencing a gradual death of the person that you knew."

Experts still haven't figured out quite what causes Alzheimer's, how it progresses, and why certain people are more prone to it than others. Gates believes that important breakthroughs will occur if scientists can understand the condition's etiology (or cause), create better drugs, develop techniques for early detection and diagnosis, and make it easier for patients to enroll in clinical trials, he said.

Gates plans to donate $50 million to the Dementia Discovery Fund, a venture capital fund that supports Alzheimer's research and treatment developments. The rest will go to research startups, Reuters reports.

[h/t Newsweek]

A New Analysis of Chopin's Heart Reveals the Cause of His Death

For years, experts and music lovers alike have speculated over what caused celebrated composer Frederic Chopin to die at the tragically young age of 39. Following a recent examination of his heart, Polish scientists have concluded that Chopin succumbed to tuberculosis, just as his death certificate states, according to The New York Times.

When Chopin died in 1849, his body was buried in Paris, where he had lived, while his heart was transported to his home city of Warsaw, Poland. Chopin—who appeared to have been ill with tuberculosis (TB)—was terrified of the prospect of being buried alive, and nostalgic for his national roots. He asked for his heart to be cut out, and his sister later smuggled it past foreign guards and into what is now Poland.

Preserved in alcohol—likely cognac—and stored in a crystal jar, Chopin's heart was laid to rest inside Holy Cross Church in Warsaw. (It was removed by the Germans in 1944 during the Warsaw Uprising, and later returned.) But rumors began to swirl, as the same doctor tasked with removing the heart had also conducted an autopsy on the composer's body, according to the BBC.

The physician's original notes have been lost, but it's said he concluded that Chopin had died not from TB but from "a disease not previously encountered." This triggered some scholars to theorize that Chopin had died from cystic fibrosis, or even a form of emphysema, as the sickly musician suffered from chronic respiratory issues. Another suspected condition was mitral stenosis, or a narrowing of the heart valves.

Adhering to the wishes of a living relative, the Polish church and government have refused to let scientists conduct genetic tests on Chopin's heart. But over the years, teams have periodically checked up on the organ to ensure it remains in good condition, including once in 1945.

In 2014, a group of Chopin enthusiasts—including Polish scientists, religious officials, and members of the Chopin Institute, which researches and promotes Chopin's legacy—were given the go-ahead to hold a clandestine evening meeting at Holy Cross Church. There, they removed Chopin's heart from its perch inside a stone pillar to inspect it for the first time in nearly 70 years.

Fearing the jar's alcohol would evaporate, the group added hot wax to its seal and took more than 1000 photos of its contents. Pictures of the surreptitious evening procedure weren't publicly released, but were shown to the AP, which described Chopin's preserved heart as "an enlarged white lump."

It's unclear what prompted a follow-up investigation on Chopin's heart, or who allowed it, but an early version of an article in the American Journal of Medicine states that experts—who did not open the jar—have newly observed that the famed organ is "massively enlarged and floppy," with lesions and a white, frosted appearance. These observations have prompted them to diagnose the musician's cause of death as pericarditis, which is an inflammation of tissue around the heart. This likely stemmed from his tuberculosis, they said.

Some scientists might still clamor at the prospect of testing tissue samples of Chopin's heart. But Michael Witt of the Polish Academy of Sciences—who was involved in this latest examination—told The Guardian that it was unnecessary to disturb what many consider to be a symbol of national pride.

"Some people still want to open it in order to take tissue samples to do DNA tests to support their ideas that Chopin had some kind of genetic condition," Witt said. "That would be absolutely wrong. It could destroy the heart, and in any case, I am quite sure we now know what killed Chopin."

[h/t The New York Times]


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