"Automated Insulin Delivery System," also known as "Artificial Pancreas": Essential Facts You Need to Understand
In the ongoing quest for improved diabetes management, several companies are making strides in the development of Automated Insulin Delivery (AID) systems. These systems, essentially insulin pumps connected to continuous glucose monitors (CGMs), aim to provide a more streamlined and effective approach to diabetes care.
In 2018, TypeZero Technologies' algorithms were acquired by Dexcom, a move that signified a significant step forward in AID development. The same year, Medtronic Diabetes, the insulin pump market leader, became the only company manufacturing both a pump and CGM device.
Medtronic's pioneering work culminated in the FDA-approval of the MiniMed 670G "hybrid closed loop" system in 2016. This system was the first-ever to automatically dose insulin based on CGM readings. The full retail price for this system ranges between $7,000 and $8,000, but with insurance coverage, most patients pay just over $1,000 to initially get on the system, with ongoing costs for pump and CGM supplies.
Other companies are also making their mark in the AID field. In 2020, Tandem Diabetes Care launched the second-ever FDA-cleared closed loop system, called Control-IQ. Insulet Corp. announced integration with the Dexcom CGM in 2014 and developed the Omnipod 5 system, which received FDA clearance in January 2022.
Notable developments include the iLet Bionic Pancreas, an automated insulin delivery system led by Dr. Ed Damiano and his team at Boston University. This system aims to manage type 1 diabetes by mimicking the function of a healthy pancreas. Beta Bionics' iLet system includes prefilled cartridges of both insulin and glucagon.
In addition, companies like DreaMed Diabetes, Pancreum, and Dose Safety are developing sophisticated algorithms and controllers for use in AID systems. These advancements are pushing the boundaries of what is possible in diabetes technology.
However, it's important to note that while these systems are generally safe and effective, out-of-range blood sugars can still occur. Users are advised to proceed with caution and monitor their blood sugar levels closely.
The FDA and JDRF have been pushing for progress in AID development for over a decade, and clinical trials on AID systems are abundant, many in outpatient settings. Despite these advancements, noninvasive diabetes technology does not yet exist.
In the DIY community, many are turning to self-built AID systems due to the lack of commercially available options. Projects like Tidepool Loop, an official version of the DIY Loop, paired with the Omnipod tubeless insulin pump, are a testament to the innovation and determination of the diabetes community.
As the field of AID systems continues to evolve, we can expect to see more companies entering the market and more advancements being made. Bigfoot Unity, for example, received FDA clearance for its pen version in May 2021. Lilly Diabetes is also working on a connected insulin pen system expected in 2022.
The development of AID systems represents a significant leap forward in diabetes management. With continued research and innovation, we can look forward to a future where diabetes care is more accessible, effective, and less burdensome for those affected by this condition.
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