Type 1 diabetes in the patient

Juvenile (or type 1) diabetes means that the pancreas is attacked by its own immune system, steadily reducing the amount of insulin it produces until it produces none at all. What if sufferers of this autoimmune condition could have artificial pancreas attached to their body to correct the hormonal deficiency? England’s National Health Service (NHS) came up with one – a glucose sensor which can be placed under the skin to continuously monitor insulin levels, with a pump that replenishes the deficient amount at the right time, just like a normal pancreas. This would eliminate the daily insulin battle and more finger pricks for millions of children around the world.
Charlotte, a six-year-old from Lancashire, was among more than 200 children tested with the NHS technology (known as closed loop hybrid system), with life-changing results. “Before we had the loop, everything was manual. At night we would have to set the alarm every two hours to do finger pricks and insulin fixes to deal with the highs and lows,” her mother Ange Abbott told the BBC. Children with type 1 diabetes are at risk of developing hypoglycemia (when blood sugar drops too low) overnight. But the artificial pancreas was like a miracle, she said.
India has the highest number of children and adolescents with type 1 diabetes, according to a 2022 Lancet study citing data from the International Diabetes Federation’s (IDF) Diabetes Atlas 2021. Indian doctors also recommend homegrown artificial pancreas such as Medtronic India’s MiniMed 780G system. , a closed loop insulin pump with Bluetooth connectivity and real-time glucose data, which comes for Rs 6 lakh.
Doctors say the artificial pancreas improves patient outcomes compared to traditional ways of managing insulin. This is due to their ability to deliver insulin based on real-time blood glucose levels. This also reduces the number of finger pricks and insulin injections. Dr Sweta Budyal, consultant endocrinologist and diabetologist at Fortis Hospital in Mumbai, says the artificial pancreas pumps insulin based on need, so overall insulin consumption is less. “This can help reduce weight gain. More importantly, patients experience far fewer episodes of low blood sugar and the risks of heart complications, retinopathy, kidney disease and neuropathy.”
The NHS Hybrid Closed Circuit is a unique insulin system that keeps blood glucose levels in the target range by automatically increasing or decreasing the amount of insulin delivered based on continuous glucose monitor (CGM) readings. But you need to enter your carbohydrate intake and calculate insulin doses for all meals and snacks. Then there’s the threshold-suspend system (which stops insulin delivery when blood sugar drops to a preset level) and the predictive-suspend system (which calculates your blood glucose level and stops pushing insulin before the level drops too low).

So why don’t many people use such devices? Dr Budyal says, “Basic models of insulin pumps cost at least Rs 2.5 lakh, the most sophisticated ones are around Rs 6 lakh. This is far beyond the reach of most Indians.” Among those who can afford it, some find it too complicated to use. “Already in a comfort zone with daily insulin, it’s unknown territory they prefer to avoid,” says Dr. Budyal. Rich young patients are loathe to reveal that they are diabetic, they feel the pump is a disadvantage because it sticks out from their crop tops and sleeveless outfits.
With contributions from agencies