Al did not invent the insulin pump but rather perfected it at MiniMed which became the first commercial pump. At the time most companies gave up their pump development activities after a number of deaths during trials. Minimed was then sold to Medtronic.
Al was trying to develop the first artificial pancreas at MiniMed and inventing the CGM was the first step. Yes, Al invented the CGM. Kevin Sayer who is now the CEO of Dexcom was Al’s accountant at MiniMed.
Al came to realize the artificial pancreas was limited by the speed of action of the insulin and knew the AP limitation was not the algorithms but rather the insulin. In search for a faster insulin he worked with Sol Steiner to invent afrezza. We see it today where the best control with the APs is to bolus with afrezza.
Once he had afrezza he saw little need for the AP. He believed T1s would transition to a simple patch pump and afrezza at meal time. However, with the CGM he started to really understand early onset T2 and believed if T2s started using afrezza as step 1 and not go through the current SoC “treat to fail” protocol of metformin, TZDs, SGLT2s, etc. T2 progression could be stopped and in some cases reversed.
I am really excited to see companies like Nutrisense starting to pop up using CGMs in the diet space for the reasons demonstrated in the podcast. As Nutrisense mentions on their website a big limitation right now is the cost of CGMs.
By now I was hoping guys like Tim Cook had a non-invasive CGM integrated into something like the Apple watch. When that happens and the average Joe can see whats going on at meals, when taking metformin, SGLT2s etc maybe Al’s afrezza will get a second look by the medical community. As the lady said in the podcast “data over dogma”.
BTW - some of those body builders who are using insulin as a dietary supplement have discovered the speed of action of afrezza and its benefits.