The Pushback Against the Artificial Pancreas

There has been some pushback against labeling the Medtronic 670G an “artificial pancreas”. Even Jeffrey Brewer, the current president and CEO of Bigfoot Biomedical and the former president and CEO of JDRF, has soured on the term. In an October 6th, 2016 Facebook post, he wrote why Bigfoot Biomedical won’t be calling their coming automated pump system an artificial pancreas:

“In retrospect, those of us who came together in 2005 to drive development of automated insulin delivery systems shouldn’t have embraced the term ‘artificial pancreas.’ That label is misleading in so many ways. The human pancreas is an amazingly important and multifaceted organ that makes many hormones, not just insulin, and supports human digestion and metabolism through a variety of mechanisms. Furthermore, insulin is just one of a number of important hormones regulating glucose and cell metabolism. Even adding glucagon doesn’t begin to cover what the pancreas does to control blood sugar. So from now on, you won’t hear me use the terms ‘artificial’ or ‘bionic’ pancreas.’ I’ll simply say ‘automated insulin delivery’,” Brewer wrote.

Readers who weighed in on the Medtronic 670G on Insulin Nation’s Facebook page were divided as to whether the term was appropriate for this system:

“I am sort of offended that they refer to it as an artificial pancreas. The pancreas releases insulin and glucagon, hormones that control blood sugar.; an artificial pancreas should release both. An artificial heart is differentiated from other assistive cardiac devices because it replaces the function of the heart; this pump is a great step in the right direction, but it does not replace the function of the pancreas. It does a disservice to this awesome device and the researchers who have contributed to its development, as well as the researchers diligently working away at a true artificial pancreas when we don’t accurately describe (the Medtronic 670G).”
-Kristin J.

“Medtronic calls it a closed loop. JDRF and the media are the ones who call it an AP. Leave it to the media to sensationalize something. 🙄”
-Kelly E.

“They can call it whatever they want if my wife and I can sleep with more confidence that our daughter’s resting safely, and if we can do our jobs without simultaneously managing multiple highs/lows each school-day.”
-Aaron K.

“The pancreas has several functions, but two hormones specifically for blood sugar control – both insulin and glucagon. If this pump does not deliver both of those automatically, it is not an artificial pancreas, but more an advanced insulin pump. I detest this announcement and the claim that it’s an artificial pancreas.”
-John S.

“I’m appalled that people are complaining about a name being used rather than being incredibly grateful for the technology. Too many people are missing the point here.”
-Emily D.

“No it’s not an artificial pancreas, but it’s easy to ignore that hype. What it does better than what’s out there is automatically adjust its basal rates, and it seems to prevent lows much better than other pump systems. They are the first, and more will follow; each hopefully will be progressively better, but it’s progress.”
-Bart S.

Language is always evolving, and sometimes language changes rapidly. At Insulin Nation, we will keep monitoring discussion to look for whether consensus can be achieved on what is and what isn’t an artificial pancreas.

Comments may have been slightly edited for clarity.

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Craig Idlebrook is a past editor for Insulin Nation, Type 2 Nation, and Información Sobre Diabetes. He is now the community engagement and content manager for T1D Exchange.

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