Artificial pancreas

[twodoor2]

What is the artificial pancreas and the various projects surrounding it? I always hear about it, but my guess is that it's a smart pump that can "talk" to the CGMS to obtain short term BG predictions. Is my description accurate, or is it something else, or much more complex than that?

[Flutterby]

from what I've hear (and I couldn't be wrong, it happens LOL) is that its the same as the 'closed loop' system that MM is working on.. the pump and cgms will eventually communicate with each other, the pump with have both insuln and glucagon in it.. WE won't have to do anything, it will work like a pancreas SHOULD work.. but I'm guessing thats years away..

[saxmaniac]

Originally Posted by twodoor2

What is the artificial pancreas and the various projects surrounding it? I always hear about it, but my guess is that it's a smart pump that can "talk" to the CGMS to obtain short term BG predictions. Is my description accurate, or is it something else, or much more complex than that?

There's a JDRF talk soon about it here in Boston, the guy developing it has a T1 kid. See here. Last I read, they were experimenting with 2 pumps hooked up together, one with insulin and the other with glucagon. I don't think they were doing CGMS yet, but still using blood pricks. They were feeding those into the two pumps, and concentrating more on the counter regulation.

[frizzyrazzy]

Here's my question - what would it take to trust this sort of system?? i'd be scared out of my mind.

[twodoor2]

Originally Posted by frizzyrazzy

Here's my question - what would it take to trust this sort of system?? i'd be scared out of my mind.

I know, I was thinking that myself, I think I'd be more inclined to trust porcine beta cells.

[dqmomof3]

This is exactly why my endo thinks that system will never come to market. Too many variables to account for, especially in children, like growth hormones!

[vettechmomof2]

Originally Posted by twodoor2

I know, I was thinking that myself, I think I'd be more inclined to trust porcine beta cells.

I was reading this quickly and thought that you said porcupine cells.
Allene

[vettechmomof2]

Originally Posted by twodoor2

I know, I was thinking that myself, I think I'd be more inclined to trust porcine beta cells.

Also marsha, what reasons do you have for trusting the pig more? THanks,
Allene

[Twinklet]

http://www.jdrf.org/index.cfm?page_id=106675

Marsha, the Artificial Pancreas project is a huge clinical study that has many, many different facets. Last year, Yale university, in combination with Medtronic actually did a test-run on a closed-loop system. http://www.ynhh.org/press/2008/pancreas.html

We had the opportunity to hear a lecture from a CA physician whose son participated in this Yale study. He brought slides of his son's BG data while on the device and it was astonishing. I don't think he was out-of-range much, if at all. He told us that the device has a ways to go before it can be available to the general public, but he was very encouraged.

Last year at camp we heard another speaker discuss the closed-loop system. Apparently there are prototypes of dual-cartridge pumps, and they are being tested with insulin and glucagon.

The part of the study my daughter is participating in doesn't have anything to do with a closed-loop system. I'll type part of the "Purpose of Research" from the consent form:

"You are invited to participate in a research study entitled A Randomized Clinical Trial to Assess the Efficacy of Real-Time Continuous Glucose Monitorint in the Management of Type 1 Diabetes. <snip> This study is being done to find out if use of a CGMS that gives glucose readings in real time can improve blood sugar control and help prevent low blood sugar events. In addition, we are evaluating the cost-effectiveness of real time continuous glucose monitoring. <snip> We also want to learn how using a CGMS affects daily life with diabetes. We also want to find out if there are any drawbacks to using a CGMS."

The very small leg of this study Emily is participating in is to assess whether wearing a CGMS will prevent lows in children with A1C's in a certain range; the other leg assess whether using a CGMS will reduce the A1C of those with higher levels.

They hope to provide data to insurance companies so that reimbursement of CGM systems will become more widespread.

The main reason we're doing it is for the free CGMS! Our insurance won't pay for one and I really wanted to see if we thought it would be worth it before we forked over a ton of dough. (Right now we're all thinking it IS worth it so we'll probably pay out-of-pocket when the study is over).

Anyway, just wanted to share that info with you!

[twodoor2]

Thanks Andie, please keep us posted on your daughter's progress. I read the link you sent, and I was particularly interested in this

The device, about as big as a pager, was developed by Medtronic, a Minnesota-based company. It is an automatic "closed-loop" system made of three interacting synchronized parts: a sensor inserted just under the skin to monitor sugar levels continuously, an insulin infusion pump with a catheter to infuse insulin under the skin, and a computer algorithm that regulates the delivery of insulin based on information from the sensor.

I would be very interested in how they do this. I'm sure you have to provide settings like the pump to determine insulin sensitivity, carb ratios, etc. . . but how in the heck does it know how to automatically regulate insulin (if that's what it's doing)? Even with a brain, it's difficult to sometimes make these predictions with 100% fullproof safety, especially in young children. I would love to know more about it in detail. Perhaps it's nothing more than prebolusing a specific period of time and looking at BG relative to DIA. I also wonder if they came up with a more accurate continuous function for IOB vs the discrete one that the pumps currently use today. I would also assume some of the settings are more varied and dynamic than they currently are on today's smart pumps.