We often hear about diabetes in terms of the growing health epidemic in the US?as the US population becomes more obese and less physically active, more adults are diagnosed with type 2 diabetes every year. However, type 1 diabetes?which accounts for about 5% of all diagnosed cases of diabetes?tends to get less attention. After all, there is currently no way of preventing the onset of type 1 diabetes and it affects a much smaller number of individuals.
Despite innovations that now allow diabetics to live long and happy lives, the management of diabetes, particularly type 1 diabetes, can be extraordinarily cumbersome, however, involving significant caution and manual effort. Currently, type 1 diabetes patients must regularly monitor their glucose levels through either a continuous glucose monitoring (CGM) device or traditional self-monitoring blood glucose (SMBG) device?most use the latter, which involves multiple pin-pricks a day to collect blood samples. Moreover, diabetics must ensure that they get sufficient dosages of insulin through various insulin delivery devices such as syringes, pens, and pumps. In addition, many things beside insulin can affect a patient's glucose levels, requiring extreme diligence on a daily basis.
Given the difficulties and risks associated with managing type 1 diabetes, the development of an artificial pancreas has long been hailed as the holy grail of diabetes care research. In concept, an artificial pancreas device or system would actively monitor a diabetic patient's glucose levels and provide timely dosages of insulin as needed without any manual effort from the patient. In essence, such a system would allow someone with type 1 diabetes to live as close to a normal life as possible.
An effective artificial pancreas system would have to replicate the two primary components of diabetes management ? glucose monitoring and insulin delivery ? within one integrated system. There have already been significant advancements in each of these two components, creating optimism that a first-generation artificial pancreas is within sight.  For example, Medtronic has already developed a system that allows communication between a patient's CGM device and their insulin pump ? the MiniMed Paradigm REAL-Time REVEL System. In this system, the insulin pump alerts the patient when an insulin dose is required. To become truly a ?closed loop? artificial pancreas system, however, insulin delivery will have to be automatic. Medtronic, along with several other manufacturers, are continuing to enhance their systems to bring diabetes care closer to this reality.
Besides the obvious benefits for diabetics, an artificial pancreas system could significantly benefit the health care system in the US. One recent study showed that improved glucose control as a result of an artificial pancreas system could save Medicare about $1 billion over 25 years after the introduction of the system. These savings would be triggered by reduced expenditures on treating diabetes complications as well as lower payments for traditional diabetes management disposable devices such as SMBG test strips, lancing devices, syringes etc.

For manufacturers, the market could reach a value of about $400 million within a year of introduction with significant potential for growth, assuming that pricing for such a system would reflect the individual prices of CGM and insulin pump components and an ?integration premium? for bringing the two components together, and that 10% of type 1 diabetics will adopt the system. As with other advanced product markets, first-mover advantage could be significant, and the first competitors to enter the fray could not only recuperate R&D costs quickly but also secure large and stable profits for the foreseeable future.

As with the holy grail of lore itself, the artificial pancreas holds the promise of good fortune for many and could usher in a new era of diabetes care. This much is certain: the lives of millions of diabetics the world over could be dramatically improved in the coming years if this particular quest does come to fruition.

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