Novel Device Improves Blood Sugar Control Post removal of pancreas

Researchers developed a combination of continuous glucose monitoring, two hormone pumps, and a device known as the bihormonal bionic pancreas (BHBP) to maintain stable glucose levels after removing pancreas.

New research demonstrates that an experimental device can improve blood sugar control in patients who have developed diabetes after their pancreas is removed to treat hyperinsulinism (HI). The findings are published in Diabetes Care.

Congenital HI is a genetic disorder in which the insulin cells of the pancreas, called beta cells, secrete too much insulin.Insulin helps to shuttle glucose from the blood into the cells.

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‘The Bihormonal Bionic Pancreas (BHBP) device improves glycemic control in individuals with hyperinsulinism and post-pancreatectomy diabetes.’

Excess insulin can cause low blood sugar, or hypoglycemia, a dangerous condition that can lead to seizures, brain damage, and possibly death.

Although approximately 50% of children with the condition respond to medical therapy, the other half require surgery for a partial or near total removal of their pancreas.

HI treatment after the removal of the pancreas involves waiting until the hypoglycemia associated with HI tips over to hyperglycemia due to the lack of insulin.

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At that point, patients can be treated with small amounts of insulin, the levels of which must be calculated by a caregiver.

However, that approach involves a delay in care, and the swings between hypo- and hyperglycemia, the proper calculation of dosage and timing can be stressful for families.

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To overcome this, researchers from CHOP, Massachusetts General Hospital, and Boston University used bihormonal bionic pancreas (BHBP) in HI patients for quick treatment.

The BHBP works by autonomously administering insulin and glucagon based on plasma glucose levels detected by a continuous glucose monitor (CGM); an algorithm calculates the exact dosage based on the CGM measurements.

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Researchers enrolled 10 patients with HI and PPD. The patients spent two periods of three nights each using two methods of blood glucose control: one period using their own insulin pump, and one using the BHBP.

Although the differences between the two periods were not large due to small sample size, the results showed a trend towards an overall improvement of blood sugar control in the BHBP period relative to the period in which patients used their own insulin pumps.

The patients in the study had varying levels of control of their blood glucose levels at the start of the study, but all patients were able to keep their levels in the appropriate range during the BHBP period. None of the patients experienced severe hypoglycemia during the BHBP period.

Large studies using these promising results about new BHBP device in this population can establish the long-term benefits and the risks of the BHBP can be pursued.

Source-Medindia