I was thinking recently about what was the one thing that should be achievable in diabetic treatment that would most make a difference in my life. Setting aside the obvious – the cure or the perfect closed loop system, or chocolate cheese cake that tastes great, has no calories or carbs – what would make the most difference in how you take care of yourself, and why?
For me, it would be faster acting insulins that more closely match the effectiveness of insulin in non-diabetics. It takes so long to bring a high back down that a single high can throw the average off in a big way. Novolog and Humalog are good, and Apidra may be better, but I would like to see something even faster.
A faster Insulin called VIAject will be available in 2009. I am patient at the Institute for Diabetes Research in Münster and they were able to verify that VIAject is acting faster than analogs: http://www.biodel.com/pipeline/viaject.htm
I think that all this talk of artificial pancreases and closed loop systems essentially mean nothing if we can’t get the insulin action time to match the speed of glucose conversion. If I had a closed loop system, it would detect a blood sugar problem and choose a response (insulin, glucagon perhaps), but if the delay in that due to interstitial reading delay and the delay of insulin action time keeps my blood sugars spiking and spiraling as they try to achieve balance, I’d much rather have the control back in my hands so I can make choices about my insulin needs ahead of the machinery. I admit I’m skeptical of closed loop systems for that reason.
The other advancement we must have is in better, smaller, more efficient batteries. We will not and cannot have smaller pumps and/or cgms receiver/transmitters until our battery technology advances. The size of many devices is dependent on the lifespan and housing needed for current batteries.
