How far way are we from an "all in one unit" that measures BSL as well as pumps the correspondingly correct insulin?

This would be such a lifeaving/extending device. Does anyone have any update/gossip on this?

Very well thought through reply. It answers my question. Much appreciated.

One of the reasons to keep BG’s as close to " normal " , so we may benifit, instead of pushing up the daisies :slight_smile: …actually I did not answer your question .

Yeah I am hoping for a bolt on pancreas too. lol

Closest yet is the Minimed’s Veo which is for sale everywhere except the US.
http://www.medtronic-diabetes.co.uk/product-information/paradigm-veo/index.html

Check out the Juvenile Diabetes Research Foundation (JDRF) Artificial Pancreas Project. The JDRF works to compress the time when an insulin pump will be successfully married to a glucose sensor using sophisticated software to negotiate appropriate insulin delivery.

If you haven’t visited this web site yet it is well worth the time. There are interesting videos and loads of information on the state of the art in “closing the loop.”

This is not the ultimate fix but will tremendously improve the lives of T1s.

Stephen,

The JDRF Artificial Pancreas Project (APP) that I write about below mentions this tactic that MiniMed’s VEO uses to halt insulin when hypoglycemia is detected. The APP also sees automatic delivery of corrective insulin delivery when blood glucose is very high as another transition application before a fully closed loop system emerges.

Good info Terry. I should have passed it on.

Dave, if you could look at some of the info and results that have come out of the APP you may be surprised to find that the algorithms that have been developed to run the pumps in the APP are extremely accurate and have been able to keep BGs tight with all kinds of foods and situations. Some patients in the study when pregnant have regained their islets and have been able to go off insulin. So there is a lot more to the development of the AP that what we might think. We are closer than ever before, there are now tools and technology that are in the testing phase now that make the AP a tangible reality…hopefully sooner than later. Who cares if it is like an old DC player hung around your neck, no D would be worth carrying it around.

Terry has pointed out something great, the support of the JDRF in the APP, without their support it would not be where it is today. BTW…if you are able to see the CGM charts of someone on an AP you would be shocked, it looks like a normal person. There is new sensor, insulin and software coming out of the project that may come before the actual AP. Keep dreaming and supporting Ds and the D organizations that can get us there!

Dave,

I understand your skepticism. I started following news about a continuous blood glucose sensor about 15 years ago. Every article seemed to imply a working system within a year or two. When Minimed brought out its first CGM about five years ago, I couldn’t gain access since my insurance company (and most others) would not cover it for me.

The JDRF studies on CGMs in 2008 (part of the Artificial Pancreas Project, APP), however, lent sufficient weight so that my and many other insurance companies started to cover CGMs in early 2009.

The movement toward effective diabetes T1 tools is slow but with the push of the JDRF things are moving. I believe that without the JDRF and the APP I would not be wearing the Dexcom 7+ today. That technology has lowered my A1c from 7.2 to 6.5 in 60 days.

The push of the dependable artificial pancreas will yield fruit before it fully matures. Stopping insulin delivery during nightime hypos would be a significant step forward.

I support the JDRF push for the artificial pancreas. We will gain benefits before a complete APP success.

The Accu-Check Combo looks very promising…

Although I like the look of the Accu-chek combo as well, I don’t think that it has an integrated CGMS (perhaps I am wrong about this). I think that it just has a meter that communicates with the pump and a bolus manager that can be used through the remote/ meter.

I just like the bluetooth capability! all my laptops have built in bluetooth!

True! It’s a good step :slight_smile: And hopefully will be integrated with an accurate CGMS soon :slight_smile:

quick, everyone from TU flood them with letters!

What I found interesting is that the closed loop in a healthy body does not only involve BG measurements and insulin production. Japanese scientists revealed that the hormone Orexin is emitted when high carbohydrate intake is about to happen. This hormone orders the muscles to consume glucose and this compensates for the slower response of the insulin producing cells. Here the body has invented a mechnism to manage the fact that the insulin is coming slower as needed.

My speculation: Maybe this mechanism can be used to expand the capabilities of todays pumps by injecting a small dosage of Orexin to compensate for the time that is needed to absorb the insulin from the regions of the upper skin. It really depends on how fast the homone can become active. If Orexin is smaller and less complex than insulin then there may be a chance that Orexin can prepare the muscles before the insulin reaches the blood stream. But these speculations were not part of the research of Minokoshi.

Researcher: Yasuhiku Minokoshi
Institute: National Institute for Physiological Sciences in Osaka
Magazine: Cell Metabolism

I forgot to mention that faster insulin has the advantage that the total amount can be reduced. Less active insulin has benefits for potential closed loop systems.

I have heard that c-peptide was part of the old pork insulin. The claim is that c-peptide will protect from long term effects of diabetes. This connection is interesting and worth to investigate. I look at it this way: todays insulin manufacturers desperatly need new inventions to separate their products from their competitors. India is now a very big player with regular insulin and only the worldwide patents for analog insulin protect the current manufacturers from this competition. If c-peptide is really that benefitial we would already see insulins that make us of that (in trials etc). This has not happened so far and I have heard rumours that c-peptite can have negative side-effects too. Maybe the manufacturers are stuck here: scientifically the benefits stand on a weak statistical basis and the potential risks need much more research to be done. Situations like these will slow down the progress that we all would like to see.