International Diabetes Center Celebrates 50 Years

Research journey leads to artificial pancreas

International Diabetes Center (IDC) is celebrating 50 years of helping people live well with diabetes. For 34 of those years, Richard Bergenstal, MD, has been an integral part of the center. He joined as medical director in 1983 and was named executive director in 1996. Throughout his career, Bergenstal has been principal investigator on National Institutes of Health (NIH)-funded studies evaluating the importance of glucose control in type 1 and type 2 diabetes, studies on novel diabetes medications and technology, and new models of diabetes care.

One of these NIH trials, the Diabetes Control and Complications Trial (DCCT) showed that good glucose control could dramatically reduce complications in type 1 diabetes (T1D). IDC embarked on studies to find a way to safely achieve good glucose control using advanced technology. The center published articles in the New England Journal of Medicine in 2010 and 2013 showing an insulin pump and continuous glucose monitor used together moved a step closer to good control.

In 2015, IDC was selected as one of 10 sites in the world to study the Medtronic 670G hybrid closed-loop system. The system uses a sensor that checks glucose every five minutes, day and night. Results are sent wirelessly to an insulin pump with a built-in program that determines how much insulin to deliver to keep glucose as normal as possible. IDC published study results in JAMA in September 2016, and a few weeks later the U.S. Food and Drug Administration approved the first-ever hybrid closed-loop system, often called the first generation artificial pancreas.

While patients must still interact with the system every day, the study showed they improved their overall glucose control, reduced their low glucose levels and felt some of the burden of living with diabetes was lifted.

The first generation artificial pancreas is now being prescribed by a few diabetes centers in the U.S. including the pediatric and adult endocrinology clinics at Park Nicollet and the adult endocrinology clinic at HealthPartners.

IDC was eager to explore the elements needed for an effective next generation system. Early in 2017, the National Institute of Diabetes and Digestive and Kidney Disease (part of the NIH) awarded IDC and Schneider Children’s Medical Center in Israel a $6.94 million grant to continue their groundbreaking work in artificial pancreas research. IDC and Institute researchers will study if a new system can improve glucose control even more than the currently approved system, particularly around meal times. The study will begin in late 2017 and enroll 100 youth age 14 to 30 years old.