On Tuesday, June 2nd, British press had a story that caught my eye. It was an announcement for the product called the Medtronic Veo. The Veo is an insulin pump with a continuous blood glucose sensor, but the catch is this: when a low is detected, it shuts down the flow of insulin.
Juvenile Diabetes Research Foundation’s pet project, the artificial pancreas, is a promising technology for many who require insulin injections. The artificial pancreas is a “closed loop” device (insulin pump, continuous glucose monitor with an algorithm that regulates glucose levels by continuously measuring the level of glucose and dispensing doses of insulin based on those measurements. If approved by the FDA this device would almost guarantee stable control of the disease and drastically decrease complications of diabetes, such as kidney disease, heart attack and stroke, amputations, blindness and death from severe hypoglycemia.
But this Medtronic Veo is only part of the artificial pancreas project; it appears to lack the ability to add insulin when needed. Still, it is a very impressive statement that Medtronic sees the manufacturing of the artificial pancreas as the next step for them! With the full algorithm in place, the device would sense both highs and lows, thus automatically dispensing more insulin for the highs, and shutting down delivery of insulin when a low is detected through the sensor.
For those who have found the pump a bit problematic, like me, check out SmartInsulin! I’m a huge fan and feel that SmartInsulin will be a breakthrough technology for those living with diabetes that don’t do as well with an external device, or for those who have skin sensitivity to the adhesives, or …
couple of questions:
the glucose sensor and pump are still two separate things right?
and i knew that it would have automatic shut off for low, but where did you read it would dispense insulin for highs?
The artificial pancreas is one device, but you wear a sensor and infusion set like a CGM. the algorithm will detect both and from what I know it will adjust insulin flows accordingly. Heres’ the link to the story from UK.
This is not the Artificial Pancreas b/c JDRF would have sent that out in a PR blitz as would Medtronic.
This is not even close to an artificial pancreas, for a number of reasons. Firstly, infusing insulin under the skin as we do is not how the body secretes it. That is why it takes so long for it to start working and why it sticks around doing its thing for much longer relative to insulin in a non-diabetic human that is secreted by the beta cells. Second, the Medtronic CGMS is nice, but it does not measure whole blood glucose like a pancreas’ beta cells do. It is not adequate for determining insulin dosages all on its own. Finally, it lacks the ability to infuse glucagon to raise blood glucose, and amylin to control appetite and modulate digestion- both of these hormones are products of the beta cells and we Type 1s lack endogenous production of them, along with insulin of course.
SmartInsulin looks extremely promising, as does the Diabecell product by Living Cell Technologies. My money is on LCT coming through first though, considering they have cured two Type 1s in their trials so far.
I agree with Jason that we’re still a long way from a complete artificial pancreas (and if I’m feeling really cynical I question wheher will will make it to a fully artificial pancreas as I agree with Jason’s summary of the issues we face) but I’m interested in progress and it’s certainly that. For me, the availability of a pump and CGMS in the same device was a huge leap forward, the Paradigm Veo shutting off when the user fails to respond to low alarms is another step in the right direction.
I don’t believe there’s one answer to diabetes, I think the answer lies in incremental improvements across the board that give us a fabulous selection of top class treatments to choose from - incremental improvements to pumps, CGMS and associated algorithms plus Smart Insulin are the ones I’ve got my eye on at the moment. A bit of non invasive glucose monitoring wouldn’t go a miss either.
Emily,
I am introducing Dr. Todd Zion, Ceo of SmartCells, next week here in DC. Smart Insulin is being reviewed by the FDA right now to go to human trials, so it is absolutely an up and coming research. Here’s the link to SmartInsulin: http://www.smartinsulin.com/
On another note, I’m wondering if you might have an answer to a question about the VEO. In all the info I have read, nothing says if the low blood glucose shut off has a turn on once the blood sugar is up to a certain level. Can you share any info on this?
Emily! Thank you for the follow up. We are very curious about the low feature and whether it is auto if it turns back on. An alarm would be good if you achieve a level that is sufficient to handle the insulin coming back on. I assume there is something to will happen. My concern was what if you forget to turn the pump back on.
Very exciting indeed!
I read your blog section about the smart insulin, amazing concept. How long you thinking it would take for data, trials, bla bla etc etc. What’s your thoughts on it. Have u seen any new articles on it?
Hi Jim,
I have talked with research people at JDRF to ask where, in the process of getting to human trial, is SmartInsulin? It’s still in animal trials and appears to be about 5 years away from hitting human trials. There are now similar polymer insulin being developed in other countries. It is very exciting indeed!
