ELI5, is it possible for insulin pumps to be designed to bring up sugar instead of just bringing it down?

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I know someone with an insulin pump and it only gives insulin to bring sugar down. He does not always want to eat or drink something to bring up his sugar when he is low. I was wondering if it was possible to have a pump that could administer glucose to bring up sugar, or just keep it from dropping below a set point? I’m sure more qualified people have already thought of this and maybe there is a reason it does not exist but I would like to know.

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Anonymous 0 Comments

I suppose it could be possible – it would have to use the other hormone secreted from the pancreas, glucagon.

Both insulin and glucagon are secreted from the pancreas in response to blood sugar levels. Insulin helps cells absorb sugar from the blood (lowering sugar levels) and glucagon stimulates the liver to make/release sugar into the blood (raising blood sugar levels).

There already are glucagon injections (kinda like an epipen for low sugar), and pumps with both hormones in them are currently being studied for use

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589308/

Edit: adjusted link

Anonymous 0 Comments

In emergencies or severe hypoglycemia where someone can’t eat or drink, glucagon is the hormone that opposes insulin to increase blood sugar, and it can be given by injection or nasal spray. There’s been research on developing a pump that can deliver both insulin and glucagon based on current blood glucose levels, furthering mimicking a healthy pancreas. Doing this in a safe/perfectly reliable/effective/small enough to wear on your belt way has apparently been hard.

For now, glucose is a pretty great medication, because it’s food. It’s cheap, available everywhere, is safe and effective across a wide dose range, very well-tolerated, no one’s allergic… Yes, there are long-term issues with eating too much glucose, and they all pale in comparison to the right-now effects of hypoglycemia. Giving juice to someone who seems hypoglycemic is one of the few life-saving interventions so easy that kids learn to do it. (By comparison, insulin is a deadly poison with finicky dosing and large interpersonal variation, to the point that even seasoned pros routinely miss the mark.) If someone can drink a soda, treating low blood sugar with sugar is a solid case of “if it ain’t broke, don’t fix it.”