The FDA’s recent approval of another continuous glucose sensor brings us one step closer to the development of an artificial pancreas, a groundbreaking achievement in the management of insulin-dependent diabetes.

The new device is called the STS Continuous Glucose Monitoring System, from San Diego-based DexCom, Inc.

More than 21 million Americans have diabetes and must check their blood glucose levels throughout the day. Maintaining good control of blood glucose levels is critical to avoid the complications of diabetes including blindness, kidney failure, heart attacks and amputations.

Continuous glucose sensors read glucose levels on a real-time basis using a small sensor inserted under the skin, which transmits data to a hand-held device. They can also tell a patient whether their glucose level is trending upward or downward, so patients can adjust their medication, diet and exercise accordingly.

These sensors, when combined with insulin pumps and a computer controller, are part of a closed-loop system, also known as an artificial pancreas. A closed-loop system will control a person’s glucose levels by providing the right amount of insulin at the right time, much like the pancreas does in people without diabetes.

“The development of the artificial pancreas is going to be a quantum leap forward for people with diabetes,” said Aaron Kowalski, director of strategic research projects at the Juvenile Diabetes Research Foundation in New York. “The burden of living with diabetes is twofold. First is the day-to-day caring for the disease, and the second is knowing that high blood sugar is damaging your body every day and that damage will significantly increase your likelihood of serious complications.”

Insulin pumps and continuous glucose sensors are already in use. All that is left to complete the closed-loop system is the algorithm, or computer controller, that allows one to speak to the other.

“This closed-loop system will have tremendous influence, because it will reduce blood sugar levels to near normal and the risk of complications will go down significantly,” said Kowalski. “That will be a tremendous step forward for people with diabetes and for the U.S. health-care system.”

Kowalski said he expects to see the first-generation closed-loop system within five years. “It will happen in steps. We’ll tie insulin delivery to glucose sensing and make the administration of insulin automatic, initially during portions of the day – overnight for example – then move toward complete automation.”

By Terri Yablonsky Stat

Special to the Tribune