I guess it just dawned on me that the race is really on for the artificial pancreas. I listened to a webinar the other day about one group's work on it. Yesterday I was looking at a conference agenda, where another group's artificial pancreas will be discussed. And I just read an article about a artificial pancreas (scroll down to the third section) that is working on one as well. There are probably several more.
When I'm living in my little world, going about my business and taking my insulin, I don't really give a lot of thought to an artificial pancreas. All this information, though, makes it seem more real and maybe even possible (in my lifetime?).
Anyway, I was very impressed with the article I read today because they acknowledged that the artificial pancreas is not the complete answer and that it won't be perfect. Just as CGM - which has many wonderful benefits - is not perfect. I truly appreciate the honesty and the fact that this person stated, "I don't think any of us believe that these machine-based solutions and equations will ever be perfect," Levine said. "What we're trying to do is to close the gap between substantial imperfection and a better solution for real patients living in the real world."
I just want to say THANK YOU for that statement, and for all the work these and other scientists are doing to improve life for those of us with diabetes. It's good to know that while I'm not thinking about it, someone else is.
What are your thoughts on the artificial pancreas (closed-loop system)?
Even with the imperfections I hope it happens soon.When I got an insulin pump in 2003my A1C was 10 after adding new endoc its been 7 or slightly below. I had a 7.5 in Oct but this time back at 7%. I would love to join the 5 to 6 club but i have big time lows and highs. I think the only way Im goona get there is closed loop system.
Maggi, Congratulations on all the work you've done to bring your A1C down from 10 to 7. That is huge! Pumps are amazing, and I'm sure the closed-loop system will be too.
1. the FDA has ruled that no medical device is currently allowed to act as a closed-loop system. The current sensor technology is too unreliable to allow that. The systems are allowed to inform the user and to make a proposal like the pump wizard. There is no reason to critizise the FDA for this move. Every diabetic should wear these sensors for one week to get a feeling for the current limitations. Would I trust my life on that? I do not think so.
2. artificial pancreas is such a misleading term. The real pancreas has access to the portal vain thus the insulin released will quickly unfold its action. Based on the BG in this blood stream the pancreas can micro-manage the release of insulin. The algorithms would be very easy at that level. However with the artificial pancreas we have external insulin and a measurement for the blood glucose in the upper layers of the skin. Thus the blood glucose information is more than 15 minutes behind the portal blood. At this point the artificial algorithms have to be applied to compensate for the lack of information. But lack of information means interpolation and guestimation based on the past - a best practice approach. All that very smart to compensate for the informational deficit. However have you heard of a medical device that gets approval for his guestimation? Talking in big statistical numbers this device will save many diabtics from the dangers of bad control. At the same time it can likely kill some by mistake. Is the industry willing to take that risk?
3. the closed-loop systems will be forced to maintain an A1c of 7. I am pretty sure these system will not shoot for the level of a healthy human being. Is that enough?
However the working prototypes of closed-loop systems are putting pressure on the market to deliver better sensors - and this is finally a good thing.
All great points, Holger! Exactly why I commend the gentleman in the article for acknowledging the lack of perfection. Thanks for contributing to the discussion. Please post your thoughts on my blog later today (haven't posted yet) at www.janekdickinson.com about CGM...Thanks!
Yes, I think it is good that they admit to that. A machine can never really be perfect. And regardless if it's the AP or any other treatment, it is not our end goal - we should always be looking for something better, for something to really make a huge difference for diabetics - mainly, a type 1 cure.
