Treating T1 using mobile phone technology

day, July 9, 2011 08:24:00

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ELIZABETH JACKSON: An Australian hospital has come up with a revolutionary new way to treat type one diabetes using mobile phone technology. The new technique involves inserting a small sensor under the skin to monitor glucose levels that information is sent to a mobile phone which then tells a pump to give the right dose of insulin.

The hospital-based trials are in the very early stages but doctors say the method could make a radical difference to the management of diabetes in children and adults.

Dr Tim Jones is head of the diabetes department at Perth’s Princess Margaret Hospital. He’s speaking here to Emily Bourke.

TIM JONES: If you’ve got type one diabetes, your body can’t produce insulin, so your pancreas has stopped making insulin. Now normally, your pancreas is monitoring your blood glucose all the time and putting out insulin to keep it under control.

People with diabetes at the moment have to have injections and do blood tests very regularly. This is difficult, onerous and can be dangerous because people make mistakes.

The system itself has three components. It has a glucose sensor which is a little tick-like instrument that just has a little bit of metal that sticks under the skin and monitors your blood glucose level. And that radio beams and it wirelessly transmits the blood glucose level to a mini computer which is sort of situated inside a Blackberry. And the Blackberry tells the insulin pump which is the third component how much insulin to give the person with diabetes.

So it’s an attempt to try and copy the pancreas in an artificial way. So it’s called an artificial pancreas.

EMILY BOURKE: The trial at your hospital involved a young boy. I wonder what this has meant for the management of his diabetes, for his parents and carers.

TIM JONES: I mean all people, his parents, have to wake up two or three times a night to check blood glucose levels to make sure they’re not dangerously low and many parents with children with diabetes never have a good night’s sleep because they are forever testing overnight.

So if we can get a system that automatically controls it overnight, in a safe way, then it will allow parents of children with diabetes to have a sleep and to get a better quality of life.

EMILY BOURKE: Are there any drawbacks to this technology? Any safety concerns that you have already identified?

TIM JONES: The concept of allowing insulin to be controlled by a computer program, you have to safety mechanisms in there, you have to have systems in place that will pick up if something’s going wrong.

People with diabetes at the moment have severe episodes, do have dangerous episodes of low blood glucose in current treatment, and we have to compare the new technologies with what we have now and not with what’s perfect.

EMILY BOURKE: What are the obstacles to it being widely introduced?

TIM JONES: We need more trials, we need to do more research and there needs to be more trials and people and then take it out into the community and into the home.

ELIZABETH JACKSON: And that’s Dr Tim Jones from Perth’s Princess Margaret Hospital, speaking there to Emily Bourke.

It is very concerning that this technology is described as a safe way to deliver insulin. The problem of the artificial pancreas is the inability of the industry to deliver a reliable and cost balanced glucose sensor. In fact the sensors are that insecure that the FDA will not allow any direct automation or closed loop. So far the artificial pancreas systems have to propose a correction / dosage to the patient. Then the patient has to have the last word about it. Thus it is just wrong to state that the system can be a great relief for parents who have to test their children at night. The artificial pancreas projects are important to develop the software and algorithms just to have them ready for the time when the reliable sensors are ready. We need to see much more effords of the industry to improve the current sensor technology. I do not see closed loop readyness for the next 10 years or so.

Yes, the newspaper article says there is a lot more work to be done on this ‘artificial pancreas’. But Princess Margaret Hospital is at the very cutting edge worldwide with treating childhood cancer, and now it seems they are looking at diabetes in children.