Double Intraperitoneal Artificial Pancreas

An easier life with diabetes: The balance between sugar and insulin is a perpetual challenge for diabetics. It quickly becomes too much or too little. An artificial pancreas will ensure proper blood glucose levels around the clock.

The balance between sugar and insulin is a perpetual challenge in diabetes. It quickly becomes too much or too little. An artificial pancreas will ensure proper blood glucose levels around the clock.

Insulin from the pancreas ensures that your body always has the right amount of glucose (sugar) in the blood. Patients with type 1 diabetes lack this ability to regulate their sugar levels and are dependent on insulin injections many times a day.

The first artificial pancreas that is about to come on the market, has limited effect. It consists of a sensor under the skin that measures sugar level, and a pump outside the body that infuses insulin under the skin. However, such a device is not able to compensate for rapid changes in blood sugar, such as after a meal or strenuous exercise, leaving the patient with either too low or high glucose level.

Scientists in Trondheim work on a completely new way to control glucose levels. They will measure the glucose level inside the abdominal cavity and deliver insulin to the same place. The insulin pump and insulin are placed in a small device on the outside. From this device, an optical fibre for glucose sensing and a thin tube for insulin delivery goes through a small port in the abdominal wall. The port will have a connection that allows for removal of the device whenever needed, for example if the patient wants to go swimming.

The goal is to create a device that mimics the way a healthy body controls blood sugar level, so that the patient does not need to think about diabetes even when he or she is eating or exercising.

This ambitious project involves researchers in medicine, cybernetics, biosensor technology, electronics, product development and materials technology, as well as industry.

The project is led by the research group Artificial Pancreas Trondheim (APT) at NTNU, with St. Olav's Hospital as a research partner and Prediktor Medical AS as an industrial partner.

Project information

  • Category:
    Health
  • Duration:
    2016 - 2020
  • Funding:
    24,7 mill. kr
  • Institution:
    NTNU

Project lead

Sven Magnus Carlsen

E-mail: sven.carlsen@ntnu.no
Phone: 91769528

Profil

Partners

Artificial Pancreas Trondheim (APT), St. Olavs Hospital, Prediktor Medical AS

External resources
  • More about the project
  • Activity
  • Events
  • Publications
  • Participants

Mimics the body's pancreas

In the project Double Intraperitoneal Artificial Pancreas, the researchers will develop a robust artificial pancreas with fully automatic control of insulin delivery for patients with diabetes type 1. It will give them a better and longer life.

In 1922, insulin was administered to humans for the first time. It stands as one of the great breakthroughs in the history of medicine. Patients with type 1 diabetes who had previously faced a certain death, could now live a long life, but not without complications. Today, these patients still have 10 years’ shorter life expectancy than healthy persons.

One reason for this increased mortality is the difficulty to control the level of glucose (sugar) in patients with type 1 diabetes using current methods. In a healthy body the pancreas produces extra insulin as soon as blood sugar levels begin to rise. In patients with type 1 diabetes, the beta cells that produce insulin are destroyed by autoimmune disease.

Without cells to produce insulin, these patients are dependent on external insulin supply. This can be achieved by injecting insulin into the subcutaneous tissue by a syringe or an insulin pump. Yet, it is very difficult to accurately control the glucose levels in the blood by this manner, and the patient may become hypo- or hyperglycaemic, which in the long-term is harmful to the body.

It has long been a dream to create an artificial pancreas, but no such device is currently able to work fully automatically. Now researchers in Trondheim aim at developing technology to control the supply of insulin automatically around the clock.

Current methods are not accurate enough

The artificial pancreas which today is about to come on the market, consists of a glucose sensor in a needle inserted under the skin, and an insulin pump that infuses insulin under the skin.

This technology will never be accurate enough. Firstly, there is a time lag between when a glucose change occurs in blood until the detection of said change. The delay may be 8 to 20 minutes. Secondly, it takes about 45 minutes from the insulin is pumped under the skin until its level in the blood reaches the top. However, full effect on glucose metabolism is not reached until one and a half to two hours after insulin was delivered.

Another disadvantage with the current approach is that the sensor must be replaced after a few days, and that it must be calibrated a few times a day by the patient using small blood samples.

The researchers in Trondheim will develop technology that closer mimics glucose metabolism in healthy subjects. They place both glucose sensors and insulin delivery inside the abdominal cavity; the fluid-filled space between the intestines. Measurements show that the glucose level is more in line with blood glucose levels. The time delay from the change happens to detection by the glucose sensor, thus becomes small.

More importantly for the response time is that insulin is absorbed much faster in the abdomen than in the skin, and that very much insulin enters the portal vein and then goes directly to the liver. According to preliminary simulations performed by these researchers, this method makes it possible to normalise the level of blood glucose in type 1 diabetes patients.

A small hole in the abdominal wall

An important part of the project is to construct the port to be placed in the abdominal wall. This port must be small, and the goal is that the outside diameter shall not exceed 1 cm. The optical fibre of the glucose sensor and the tubing for administration of insulin must be correspondingly small with a diameter below 4-5 mm.

The port will have a quick release so that the patient can disconnect the equipment when swimming or doing other activities where an insulin pump is a hindrance.

Another important part of the project is to develop technology for continuous measurement of glucose in the abdominal cavity. Here the industrial partner Prediktor Medical in Fredrikstad has an important role.

A third important part is to figure out how the insulin pump must be programmed to automatically give the correct dose of insulin, after the patient eats and glucose levels rise rapidly in the blood. Researchers will find data on the relationship between glucose readings and how supplied insulin in the abdomen affects glucose levels in the blood.

Interdisciplinary

The project brings together researchers from NTNU and St. Olav's Hospital within the disciplines of cybernetics, mathematical modelling, biosensor technology, biotechnology, biochemistry, optical spectroscopy, veterinary medicine and the medical specialties of endocrinology, anaesthesia, intensive care medicine and pharmacology.

Engineers may think completely differently than physicians and attack the issues in a more systematic way. However, it is not always that the doctors realise what the engineers are talking about and vice versa. The project is designed in such a way that researchers from the different disciplines meet each other with an open mind.

Professors, doctoral students and postdocs have meetings every fortnight where there is discussion at the intersection of medicine and technology. Industry partner Prediktor Medical joins the meetings through Skype.

Three PhD students, two postdocs, two scientists and an engineer are working on the project, in addition to the permanent staff at NTNU.

Socially responsible research and innovation

Two of the researchers in the project have diabetes themselves. They have a good understanding of how the treatment of diabetes is at present.


The project will follow national regulations for research on animals and humans. All experiments on animals are approved by the Mattilsynet (the Norwegian animal research authority). All human studies are reviewed by the regional ethics committee before they can be implemented.

Innovation

If researchers succeed in this project, it will be very important for the treatment of patients with diabetes type 1. Around 26,000 people in Norway have this disease. Globally, there are millions. The market for the new solution is large.

NTNU and St. Olav's Hospital have therefore secured the intellectual property rights of the new technologies being developed, but they will not commercialize innovations themselves. This may be done by industrial partners at the forefront of medical technology, such as Prediktor Medical. The project management of Artificial Pancreas Trondheim (APT) has consciously chosen to work with a Norwegian company rather than major international partners in order to keep the rights and commercialisation in Norway.

Activity

Events

Past events:

Publications


All results in the CRIStin-database

Participants

  • Sven Magnus Carlsen

    Sven Magnus Carlsen

    Professor in clinical research (NTNU) + Head of Unit for Clinical Research (NTNU) + Consultant in endocrinology, Dept. of Cancer Research and Molecular Medicine (NTNU), Unit for Clinical Research (NTNU), Dept. of Endocrinology (St. Olavs Hospital)

    Head of the Artificial Pancreas Trondheim (APT) research group and the DLN project Double Intraperitoneal Artificial Pancreas (DIAP). Supervisor for several PhD and master students in the medical part of APT.

    Profile

  • Reinold Ellingsen

    Reinold Ellingsen

    Senior Advisor, Dept. of Electronic Systems

    Member of APT's steering group. Sharing responsibility with APT members on sensor technology and development, including IP. Co-supervisor of PhD and post.doc within optical sensor technology.

    Profile

  • Øyvind Stavdahl

    Øyvind Stavdahl

    Associate Professor, Dept. of Engineering Cybernetics

    Member of APT's steering group with main responsibility for modelling and control engineering activities.

    Profile

  • Anders Lyngvi Fougner

    Anders Lyngvi Fougner

    Postdoc, Dept. of Engineering Cybernetics

    Member of APT's steering group, secretary of APT. Focusing on modelling, system identification and simulation. Currently funded by Samarbeidsorganet (the Liaison Committee between the Central Norway Regional Health Authority and NTNU). From May 2017 funded by NRC.

    Profile

  • Astrid Aksnes

    Astrid Aksnes

    Professor, Dept. of Electronic Systems

    Supervisor for PhD students and postdocs doing research on optical spectroscopy (Raman and mid-IR) of peritoneal fluid. Project leader for the DLN project 'Lab-on-a-chip biophotonic sensor platform for diagnostics'.

    Profile

  • Dag Roar Hjelme

    Dag Roar Hjelme

    Professor, Dept. of Electronic Systems

    Supervisor for PhD students doing research on optical spectroscopy of peritoneal fluid.

    Profile

  • Petter Aadahl

    Petter Aadahl

    Professor (NTNU), Research Director (St. Olavs Hospital), Consultant (St. Olavs Hospital)., Department of Circulation and Medical Imaging (NTNU), Department of Anesthesia and Intensive Care Medicine (St. Olavs Hospital)

    TBC

    Profile

  • Stig William Omholt

    Stig William Omholt

    Research Director, Research Professor

    Head of NTNU Biotechnology - the Confluence of Life Sciences, Mathematical Sciences and Engineering (Enabling technology programme 2013-2020).

    Profile

  • Harald Aagaard Martens

    Harald Aagaard Martens

    Adjunct professor, Dept. of Engineering Cybernetics

    Consultant/advisor in multivariate data modelling.

    Profile

  • Olav Spigset

    Olav Spigset

    Professor of Clinical Pharmacology (NTNU), Senior Consultant (St. Olavs Hospital), Department of Laboratory Medicine, Children's and Women's Health (NTNU), Department of Clinical Pharmacology (St. Olavs Hospital)

    Consultant/advisor in pharmacology and measurement of hormones.

    Profile

  • Nils Kristian Skjærvold

    Nils Kristian Skjærvold

    Postdoc, Dept. of Circulation and Medical Imaging (NTNU), Department of Anesthesia and Intensive Care Medicine (St. Olavs Hospital)

    Since January 2015 he is a postdoctoral research fellow on a topic related to APT (Personalized care of critically-ill patients with time-series analysis of oscillating physiology). Currently funded by Samarbeidsorganet (the Liaison Committee between the Central Norway Regional Health Authority and NTNU).

    Profile

  • Sverre Christian Christiansen

    Sverre Christian Christiansen

    Researcher (50%), consultant in endocrinology (50%), Dept. of Cancer Research and Molecular Medicine (NTNU), Dept. of Endocrinology (St. Olavs Hospital)

    TBC

    Profile

  • Konstanze Kölle

    Konstanze Kölle

    PhD candidate, Dept. of Engineering Cybernetics

    Has worked for APT as a PhD candidate since May 2014. Her research topic is "Development of control algorithms and safety mechanisms for closed-loop glucose control in patients with diabetes mellitus type 1 and 2 and in intensive-care patients." Co-supervisor for several MSc students. Currently funded by Samarbeidsorganet (the Liaison Committee between the Central Norway Regional Health Authority and NTNU).

    Profile

  • Marte Kierulf  Åm

    Marte Kierulf Åm

    PhD candidate, Dept. of Cancer Research and Molecular Medicine

    PhD candidate in APT since January 2016. She will primarily focus on glucose sensing in the peritoneal cavity. Funded by Samarbeidsorganet (the Liaison Committee between the Central Norway Regional Health Authority and NTNU).

    Profile

  • Ilze Dirnena-Fusini

    Ilze Dirnena-Fusini

    PhD candidate, Dept. of Cancer Research and Molecular Medicine

    PhD candidate in APT since February 2016. She will primarily focus on insulin absorption in the peritoneal cavity.

    Profile

  • Patrick Bösch

    Patrick Bösch

    Staff Engineer / Development Engineer, Dept. of Engineering Cybernetics

    Patrick worked with APT for 8 weeks in summer 2015 during an IAESTE internship. Since February 2016 he works for APT as a Staff engineer in the function of a Development Engineer. He is primarily focused on design and prototyping of novel instrumentation based on optical spectroscopy and other relevant sensing modalities for the measurement of glucose in peritoneal fluid, as well as the associated insulin infusion mechanism and related components and systems.

    Profile

  • Ine Larsen Jernelv

    Ine Larsen Jernelv

    PhD candidate, Dept. of Electronic Systems

    PhD candidate in APT since May 2016. She will focus on investigating optical spectroscopy of peritoneal fluid for glucose sensing, both in vitro and in vivo.

    Profile

  • Karolina Milenko

    Karolina Milenko

    Postdoc, Dept. of Electronic Systems

    Employed as a postdoc in Artificial Pancreas Trondheim since June 2016, she focuses on design and development of novel sensing devices for intraperitoneal glucose levels, based on optical spectroscopy methods.​

    Profile

  • Sajeetha (Gita) Nagarajah

    Sajeetha (Gita) Nagarajah

    Master student in pharmacology, Dept. of Laboratory Medicine, Children's and Women's Health

    Pursued her MSc in Pharmacy during Fall 2016 and Spring 2017. In an animal model she investigated how intraabdominal administration of glucagon affects circulating glucose level. Supervised by Sven M. Carlsen.

    Profile

  • Roar Nøstbakken

    Roar Nøstbakken

    MSc student, Dept. of Engineering Cybernetics

    Pursued his MSc degree during Spring 2017, on a topic related to APT. Roar studied the possibilities for using additional sensor modalities to identify and suppress motion artefacts in non-invasive glucose measurements. Supervised by Øyvind Stavdahl.

    Profile

  • Karl Arthur Unstad

    Karl Arthur Unstad

    MSc student, Dept. of Engineering Cybernetics

    Pursues his term project and master thesis during Spring 2017 and Fall 2017, respectively, on a topic related to APT and fault detection. Supervised by Konstanze Kölle, Anders Fougner and Øyvind Stavdahl.

  • Albert Danielsen

    Albert Danielsen

    BSc student, Dept. of Engineering Cybernetics

    Pursued his BSc degree at Department of Engineering Cybernetics during spring 2017, on a topic related to APT and glucose sensor calibration rig. Supervised by Patrick Bösch and Pål Gisvold.

  • Anders Nilsen

    Anders Nilsen

    BSc student, Dept. of Engineering Cybernetics

    Pursued his BSc degree at Department of Engineering Cybernetics during spring 2017, on a topic related to APT and glucose sensor calibration rig. Supervised by Patrick Bösch and Pål Gisvold.

  • Axel Hansen Grøvdal

    Axel Hansen Grøvdal

    BSc student, Dept. of Engineering Cybernetics

    Pursued his BSc degree at Department of Engineering Cybernetics during spring 2017, on a topic related to APT and glucose sensor calibration rig. Supervised by Patrick Bösch and Pål Gisvold.

  • Silje Skeide Fuglerud

    Silje Skeide Fuglerud

    PhD candidate, Dept. of Electronic Systems

    PhD candidate in APT since June 2017. She will work with methods for optical spectroscopy and sensor fusion.

    Profile