“Type 1 diabetes is a relentless disease that affects every area of life,” says Dr Roman Hovorka of Cambridge University. “It is incurable, so children diagnosed with it are looking at a lifetime of daily monitoring, injections, calibration and management. It’s an autoimmune disorder unrelated to diet and activity levels, and may have more than one cause.”

"Type 1 diabetes means a lifetime of daily monitoring, injections, calibration and management."

Innovations today have two main aims, he says: firstly, to improve control and get the patient’s glucose into the right range, which can be very challenging; and secondly, to improve the overall quality of life for patients.

Insulin-delivering pumps and glucose-monitoring sensors are already improving both aspects for Type 1 diabetics, while the ‘artificial pancreas’ is “becoming a reality faster than anyone ever imagined,” says Dr Hovorka.


Mimicking the pancreas of a person without diabetes


The artificial pancreas is a system that monitors and adjusts insulin levels as the pancreas does in a person without diabetes: a continuous glucose monitor (CGM) measures blood glucose levels on a minute-to-minute basis and transmits the information to an insulin pump that calculates and releases the required amount of insulin into the body.

“The artificial pancreas is not yet available in the UK, only in the USA, where it is commercialised,” says Dr Hovorka, whose team has developed a prototype.

“We could be seeing production, in the UK by the second half of 2018."

“The prototype is in clinical trials at Cambridge. One is among teenagers who are put onto it within six weeks of diagnosis. It’s due to run for three years with 10 participants, and will provide information about how the system works when used straight from diagnosis.”


Long-term funding plans


With new tech devices currently costing more than the multiple daily injections that form the basis of most treatment, funding is an issue, says Dr Hovorka – hence the value of long-term research. “We’re looking at the commercialisation aspect for the artificial pancreas, but want to create a reimbursement system within the NHS. We need joint ventures. Appropriate funding would help, but unfortunately there’s not so much of that in the UK.”

His hope and belief is that developing technologies will prove to be better value for money, and will therefore be made more widely available to patients. “Use of technology will continue to increase and we can expect to see significant improvements to quality of life as a result in the next decade or two.”