Artificial pancreas developed to treat diabetes in children

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Cairo: Dr. Hani Ramzi Awad

The most recent study examining the efficiency of an artificial pancreas in treating children with “type 1 diabetes” was published at the end of last August in the New England Journal of Medicine. She indicated that this method of treatment could be the ideal method.
Of course, these results are promising for parents and clinicians. Diabetes is one of the most common chronic diseases that children suffer from. For several decades, the main treatment for this type has been insulin injections. Due to the inability of the body to excrete it sufficiently or not to excrete it in the first place; Both for genetic reasons, and certain tumors destroy the part responsible for secretion in the pancreas.
– “Smart” artificial pancreas
Although the idea of ​​a device as a substitute for the pancreas appeared a few years ago, controlling the device through artificial intelligence systems is the new thing.
The device is called “artificial pancreas Control – IQ system” and it is able to treat children as young as six years old. The idea of ​​the device is based on the temporary treatment of sugar levels by continuously measuring glucose levels in the blood, and it delivers insulin automatically, unlike the old types, in case it is needed when blood sugar levels rise, by means of an automatic pump that replaces those that depend on manual operation After monitoring glucose levels, insulin injections, or pumps that are controlled by another person, whether the patient or the medical provider.
A trial of the device was conducted on 101 children with type 1 disease; They are between the ages of six and thirteen in 4 diabetes centers in the United States. The children were divided into two groups: the first used an artificial pancreas that relies on pumping insulin automatically, and the other group used a device to continuously measure the level of glucose in the blood, but with a separate insulin pump. They were followed up on a weekly basis for a full 4 months.
The result showed that the first group using an artificial pancreas had improved glucose levels by 7 percent during the day and the percentage increased to 26 percent at night. Which is very important; Whereas controlling blood sugar levels (without a sudden significant rise or fall) protects the patient from a sudden drop in glucose (hypoglycemia), which can lead to convulsions or the patient into a coma; And it may end in death if not treated quickly.
In the aggregate; The survival rate of glucose at normal levels in the placebo group (which relied on the separate pump) was 11 percent greater. When translating this ratio into hours, it was about 2.6 hours per day.
Safety and efficacy
The early tests conducted on this device proved that it is safe and effective for children from the age of fourteen and over. But this experience clearly indicates the efficiency of the device in treating younger children, especially with regard to the night period, which is the most important period. As the child is asleep and does not show any symptoms or indications of low blood sugar.
It is known that all diabetics, children and adults, must keep sweets or drinks that contain a large proportion of sugar to be consumed quickly in the event of feeling dizzy or lack of focus.
It is known that the artificial pancreas works in a way similar to that of the real pancreas, which secretes the hormone insulin, which is very important to control levels of glucose in the blood and enter it into the cells of the body so that it is used as a main source of energy.
And glucose to the body is the fuel to a car. Excess glucose is stored in the liver until it is needed. And the device is a small sensor chip (sensor) that is implanted under the skin, and it measures the level of glucose in the blood all the time, and an insulin pump (that can be worn under clothes) and delivers insulin to the body through a small piece (patch) adhesive, and it is controlled based on these levels. Whether through the patient, parents and medical service providers.
What is new in this experiment is the mechanism that controls the pump on its own in response to changing sugar levels. The device was approved by the US Food and Drug Administration (FDA) in its previous form in 2016 for use on adults and children over the age of 14. Based on the results of the new experience, younger children can benefit from it.
The researchers explained that the artificial pancreas is the future of treatment for type 1, especially, and that the current treatment with insulin does not maintain ideal and normal blood glucose levels continuously except by about 20 per cent, which means that only one child out of every 5 has special normal levels. . Children in this age group have different eating habits from adults. Meaning that they can eat a number of meals more, and the control of carbohydrates and starches in food is less, of course, as well as the practice of more physical activity in the study or stopping this activity during the holidays, which requires changing the doses constantly to keep pace with Increase and decrease in glucose levels in order to protect children from complications of the disease.

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