Diabetes: Towards “a therapeutic revolution” thanks to the artificial pancreas
For 30 years, World Diabetes Day, held this Monday, November 14, has raised consciousness of the illness, whether or not it’s kind 1, insulin-dependent, or kind 2, a illness of extra weight, inactivity and growing older. In France, 4 million individuals dwell with diabetes, a continual illness at the coronary heart of two realities: enormous advances in care, bringing hope and a every day life that’s nonetheless tough.
Professor Eric Renard is Head of the Department of Endocrinology-Diabetology at the University Hospital of Montpellier.
A communication from the US final month raised the risk of a totally automated bionic artificial pancreas for sufferers with kind 1 diabetes. You have been engaged on artificial pancreas for a very long time, are you able to imagine it?
It takes greater than religion. Artificial pancreas is now utilized in the routine care of sufferers with kind 1 diabetes In Montpellier alone, 260 persons are outfitted with an artificial pancreas that’s an insulin pump, a sensor that constantly measures glucose ranges. The movement charge of the pump might be tailored accordingly. The methods we use are already made in the USA. “Bionic” might be fairly shut to us. In France, three producers are used: Medtronic, Tandem and Diabellup, which have pump issues.
But they don’t seem to be absolutely automated…
Patients should announce to the gadget when they’re going to train, or when they’re going to eat, to activate the algorithm, as a result of the supply of insulin may be very gradual. But you do not want to tear at your fingertips anymore. For a totally automated system, we nonetheless have no idea how to account for advanced glycemic actions. However, the system works autonomously at night time.
Are we shifting in the direction of the democratization of those units?
Yes, it’s accessible to all kind 1 diabetics, so long as they understand how to depend carbohydrates and the way to use the system, however on this sense there’s therapeutic schooling, instructing them how to function the system. Many affected person candidates: in a single 12 months, 259 artificial pancreases have been put in in Montpellier, France has 10,000. This is the greatest system for individuals with kind 1 diabetes, who’re probably eligible from the age of 6. At the University Hospital of Montpellier, we furnished a bunch of 120 kids with passable outcomes whom we have now been following for almost three years.
Their lives change…
This morning, I noticed a number of sufferers in session, they’re really remodeled, they now not have to fear about their preliminary blood sugar points. They not often endure from hypoglycemia, and what’s spectacular is how a lot they rediscover a forgotten carelessness, a joie de vivre.
Is it actually the most spectacular technological advance?
For kind 1 diabetics, sure, that is really a therapeutic revolution that drastically relieves sufferers and a precedence, avoids retinal and renal problems in the future. As quickly as diabetes is identified, we are going to begin testing artificial pancreas in kids by way of pump patch. They won’t ever know the injection! At the University Hospital of Montpellier, we put in the first prototype of the artificial pancreas in 2002, the first in the world. And 1,750 kind 1 diabetics are on insulin pumps, a world first in 1981.
Have pump issues reported by sufferers on Medtronic pumps been resolved in recent times?
New molecules in opposition to kind 2 diabetes can also assist you to shed extra pounds
And for kind 2?
There are some who’re taking insulin, however at the second they don’t seem to be positioned on an artificial pancreas, the gadget shouldn’t be accredited. There are additionally many inventions, however the progress primarily comes from new medicine that handle diabetes but additionally defend the kidneys, the coronary heart… It’s a extra international method than simply controlling blood sugar.
Search nonetheless energetic?
Yes, new molecules will seem and even weight reduction might be doable, which is fascinating as a result of most kind 2’s are obese. It may be very spectacular, individuals can lose up to ten kilos, the analysis may be very superior. In about twenty years, issues that have been a part of primary analysis have entered on a regular basis life.
There are 4 million diabetics in France. Research has centered on this illness as a result of it causes loads of injury and may be very costly with its problems. Plenty of assets are put into financing innovation
The query that continues to be, and this can be a vexing one, is the development of the illness, whether or not kind 1 or kind 2…
Yes each. There is far to be accomplished to forestall kind 2 diabetes, the prevalence of which will increase on account of a sedentary way of life and poor food plan, somewhat in deprived social lessons, even when there’s a genetic determinant.
The statistics of kind 1 diabetes are additionally growing, particularly in very younger kids, underneath 1 12 months of age, for unclear causes. We do not know if there’s a viral trigger or an environmental trigger… There are individuals who have developed kind 1 after covid. We see that as extra international locations modernize, extra kind 1 diabetes develops. Type 1 diabetes is most typical in Scandinavian international locations.