For type 1 diabetics, managing blood sugar levels is a full-time job.
Before each meal they must first calculate how much insulin to inject, a process that requires them to know their current blood sugar level, how many grams of carbohydrates they're about to eat, how high in fat the meal is, how much they weigh, and the size of the meal, among other things.
Researchers hope a "bionic pancreas," a pocket-sized device with tubes attached under the skin of the abdomen, could change that.
The device only asks for three pieces of information: the patient's weight, when they're eating and whether the meal is small, large or average. A built-in algorithm is updated every couple of minutes with the patient's blood sugar levels and dispenses the correct amount of insulin automatically.
The device is both easier for patients and, according to a clinical trial published last week in the New England Journal of Medicine , better at regulating blood sugar levels. Dr. John Buse, a UNC diabetes researcher who helped run the clinical trial, said the device could reduce the "cognitive burden" of a chronic illness that affects more than 1.6 million Americans.
"It gives people the freedom not to focus on their diabetes 24 hours a day, seven days a week for the rest of their life," he said.
In the trial, researchers gave 219 participants the bionic pancreas for 13 weeks and compared their blood sugar levels to another group of people who injected insulin using existing methods.
They found that blood sugar levels fell from 7.9% to 7.3% in the group using the new device while blood sugar levels remained at 7.7% in the control group. Experts generally recommend levels below 7%.
Beta Bionics, which manufactured the bionic pancreas, will submit the results of the clinical trial to the Food and Drug Administration as part of a petition to approve the device.
Over time, high blood sugar can cause a number of complications like blindness, heart disease and nerve problems. Only about a fifth of people with type 1 diabetes meet recommended blood sugar levels.
Buse said that's partly because some people in rural areas aren't near a doctor who can teach them the complexities of managing type 1 diabetes. He hopes an automated insulin delivery could level the playing field for those who don't have access to top-tier health care.
The device won't necessarily make diabetes care more accessible for people who struggle with blood sugar because they can't afford proper treatments. Buse said the device will likely be priced similarly to less sophisticated insulin pumps on the market, which can cost $10,000 a year. Edward Damiano, the founder of Beta Bionics, could not say precisely how much the device would cost but said the company does not plan to "place a price premium" on the device.
The bionic pancreas will still require patients to maintain the device: the tubing needs to be changed out every three days and the sensor needs to be replaced every 10 days.
"It sounds like a big hassle but this is so much better than the other systems," he said.
Teddy Rosenbluth covers science for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work