the New England Journal of Medicine is reporting great progress with the use of an artificial pancreas. Far better at reducing hypoglycemia that pump and CGM.
DOES ANYONE KNOW HOW WE COULD GET AN ARTIFICIAL PANCREAS?
In this multinational, randomized, crossover trial, we assessed the short-term safety and efficacy of an artificial pancreas system for control of nocturnal glucose levels in patients with type 1 diabetes ...
Artificial pancrei are still in the clinical research trial phase. There are no FDA approved artifical pancrei available in the USA. If you are interested in trying one out you can try to enter a research study. I would ask you endo if they know of any in your area and browse clinicaltrials.gov. A quick search found a few actively recruiting studies: http://clinicaltrials.gov/ct2/results?term=artificial+pancreas
Thanks. Very helpful and I admire your knowledge of the Latin plural!
I'm also impatient to get the AP. Trying it out for a couple of days is not good enough. In this interview, one researcher reluctantly estimates that it will be available in Europe by 2016 and the US by 2018:
http://www.medscape.com/viewarticle/766148
Not fast enough for me, but the options are limited. The frustrating part is that all of the pieces have been available for years. The clinical trials are using real working equipment. The only things slowing it down are regulation and fear of litigation. They are more worried about a few people dying from overdosing on insulin than they are worried about millions of people dying early from complications. I say let me make that risk decision for myself.
I'm interested in the artificial pancreas but not all that optimistic about it. I think that you can learn or perhaps engage yourself might be a better word, useful things about insulin and your body that one might miss out on, or at least take a lot longer, with the AP. Then again, I've been taking insulin for 27 years so perhaps that is a pretty long time in itself. I got serious about 5 years ago and things have fallen in line but I always have my eye on things and would be very leery of unplugging my brain. I also sort of doubt the potential for tight control given the propensity of doctors to "settle" for goals that may be less than mine.
I agree with AR. I think the AP is a neat idea, but not that reasonable with current technology. A CGM that is on a 15 minute lag and insulin that takes 2 hours to peak in activity are too slow to make an AP that effective. This doesn't even include a faulty or off or dying CGM which could cause major problems. I believe if you put me up against researchers leading AP that I would win everytime! The technology just is not fast enough right now.
Thank you both for your thoughtful comments. 45 years since my T1 diagnosis. I was hopeful about CGM but found the Medtronic product useless in preventing lows. As for "unplugging my brain", I have to do that to sleep and find that those hours are the most challenging.
The cure we were promised in 1968 is elusive and quality of life leaves a lot to be desired.
It would be nice if patients were allowed to make medical decisions. But given the various levels of patient knowledge and sophistication when it comes to their own medical issues and the complexities attendant to them, it is no wonder whey the FDA, insurers and medical care providers have assumed that power. As frustrating as it is, that is why progress seems so glacial in bring new treatments out of the labs and into the hands of patients. Simply put, for the general good the goal is to ensure that the philosophy of "first, do no harm" are not just words from the Hippocratic oath but the way things work in the real world.
Hey Tom, great post. It's very practical and grounded in reality. I am concerned that these groups are taking the Hippocratic oath too literally. They are doing great on "do no harm" but don't seem to grasp the implications of "allow great harm." In other words, the attitude is that it is of lesser importance if people are harmed from inaction than from action. That mathematical inequality is unethical.