Source : INDIA TODAY NEWS
The world’s first large-scale rollout of an artificial pancreas has shown encouraging results, not just in helping people with type 1 diabetes manage their blood sugar better, but also in making access to the technology more equal across different communities.
The findings come from the first two years of the National Health Service (NHS) rollout in the UK, where the artificial pancreas has been offered to people with type 1 diabetes.
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Earlier rollouts of diabetes technologies had often seen lower access among people from poorer backgrounds and minority ethnic groups. But the latest figures show that this gap has become much smaller.
The artificial pancreas, officially known as a hybrid closed-loop system or automated insulin delivery (AID) system, combines three devices into one connected system. It includes a continuous glucose monitor (CGM), an insulin pump and a computer algorithm powered by artificial intelligence (AI).
Together, these work round the clock to monitor blood sugar and automatically deliver the right amount of insulin.
HOW IT WORKS
Unlike a CGM, which only tracks blood sugar levels, an artificial pancreas also responds to those readings. It increases insulin delivery when blood sugar rises and reduces or stops insulin when sugar levels fall.
This helps keep blood sugar within the target range without the person having to constantly calculate insulin doses.
The system also reduces the stress of managing diabetes, especially during meals and at night, when blood sugar levels can fluctuate suddenly. Clinical trials have already shown that these systems manage diabetes better than using a CGM alone.
Explaining the difference, veteran diabetologist and researcher Dr V Mohan said an artificial pancreas is “nothing but an automated insulin delivery system.” The CGM continuously sends blood sugar readings to the insulin pump, which then adjusts insulin delivery automatically using AI.
The technology is mainly meant for people with type 1 diabetes, where the body stops producing insulin because the immune system destroys the insulin-producing cells in the pancreas.
These patients need insulin throughout their lives.
This is different from type 2 diabetes, which is far more common. In type 2 diabetes, the body still produces insulin but either does not make enough or cannot use it effectively. Most people with type 2 diabetes manage their condition with lifestyle changes, tablets or a small number of insulin injections. However, those who require several insulin injections every day may also benefit from automated insulin delivery systems.
It is estimated that India has about 9.5 lakh people living with type 1 diabetes, with over 3 lakh of them being children and adolescents.
INDIA CHALLENGES
The AID technology is already available in India, but access remains limited because of its high cost, say experts.
At present, only one commercially available automated insulin delivery system is available in the country, the MiniMed 780G from Medtronic. According to Dr Mohan, the pump costs around Rs 6.5 lakh, while monthly expenses for consumables and insulin are about Rs 20,000.
This makes the treatment unaffordable for many patients.
Despite the cost, Dr Mohan said he has several hundred patients using the system in India and they are doing “extremely well.” He described automated insulin delivery systems as a major breakthrough for treating type 1 diabetes.
He added that some people with type 2 diabetes who need multiple insulin injections every day can also benefit from the technology.
The NHS experience is also significant because it shows that a nationwide public health programme can improve access to advanced diabetes care across different sections of society.
During the first two years of the rollout, the difference in uptake between people from the most and least deprived backgrounds narrowed to just 3 percent. A similar improvement was seen among people from minority ethnic communities compared with white patients.
Experts believe such systems could transform diabetes care by reducing dangerous episodes of very high and very low blood sugar while improving quality of life. As newer and more advanced versions are developed, automated insulin delivery systems are expected to become even more effective.
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SOURCE :- TIMES OF INDIA
