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Is a "closed-loop" CGM and Pump a Cure?

Discussion in 'Stickies' started by Sarah Maddie's Mom, Jan 6, 2010.

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Is a "closed-loop" system a cure?

Poll closed May 6, 2010.
  1. Yes

    4 vote(s)
    1.7%
  2. No

    224 vote(s)
    96.1%
  3. I don't know

    5 vote(s)
    2.1%
  1. Toni

    Toni Banned

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    Minimed already has a pump that will turn off when the blood sugar hits 50. It is already on the market. That is very different from a pump where basals are automated based on reading from the current Dexcom sensor. Aside from ??? a good part of the night, Dex has been WAY off... and at times when the sensor had been working reliably. Drifting. Recalibration fixes it. But the pump would deliver insulin based on the faulty readings. Since I believe a computer could figure out basals much better than I can and in real time, the only real drawback for us is the reliability of the sensor readings. If there is any way to get around this, either by frequent testing (not good enough), or if they came out with tiny multiple sensors using the microneedles so it would not be invasive, I think we would try it. But even if the pump worked most of the time, only one large erroneous reading could be dangerous. The pump with a separate chamber for glucagon.... that is not the pump they are talking about marketing in four years. Yes, I would feel so much safer with a pump with dual chambers, one for glucagon and one for insulin.
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    I was really listening to get a better understanding of the "bridge to a cure" concept and to hear more of the issues hinted at by Dr Kowalski in his first posts on CWD regarding the notion that the research indicates that excellent glycemic control is a necessary component in the cure research trajectory of JDRF.

    I came away with a better understanding of the time horizon of the AP project.

    It sounds to me that it will be:

    1. Generation 1 AP to provide, "treat to range" assistance in glycemic control

    2. Next phase advanced AP - a true, "closed-loop"- to restore glucose control via mechanical solution

    3. Glucose responsive insulin

    4. What Kowalski called, "bio mechanical cure"

    5. Then, at long last a totally biological, "walk away from D" cure.

    This makes me pretty blue. I'd love to know what the true time projections are for steps 1 and 2. Four years to step 1, then what? 2 years? 8 years to step 2? :(

    And I'd really like to hear more about this research that indicates that excellent glycemic control will be a necessary precursor to a biological cure.
     
  3. Toni

    Toni Banned

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    I do not understand that. With something like islet transplantation (which is a therapy but not the biological cure he must be talking about) the islets, once transplanted will provide the excellent glycemic control, for a few years after transplantation at least. Are they talking about Diamyd? He did not mention which drugs he was referring to. Yes, if they can force limited regeneration of some beta cells, glycemic control would have to be maintained in that instance because they can only force regeneration of a limited amount of beta cells, not all of them or most of them. As far as the "treat to target or range only" with first generation AP that is still a big problem. Because a reading of 126 on the Dexcom and 36 fingerstick (and such a low reading has only occurred in past two years when trusting Dex), AP would not turn off, AP would do nothing. The sensors themselves need to be more accurate even to trust the first generation AP. P.S. That is what also intrigues me about Faustman. Total cure for some, but for others, even limited regeneration would most likely enhance glycemic control; much less hypoglycemia, etc.
     
    Last edited: Jan 28, 2010
  4. Pavlos

    Pavlos Approved members

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    The results to this poll are pretty unanimous.

    Food for thought for all parties engaged in funding reserch...
     
  5. Erin Grace's Mom

    Erin Grace's Mom Approved members

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    Sarah - I was looking for the "heck no" option. Thanks for the poll!
     
  6. twodoor2

    twodoor2 Approved members

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    As long as my daugher relies on synthetic insulin to survive, I don't consider that a cure. A working pancreas is a cure, and IMO, I don't think much can compete with that. A mechanical cure just cannot compete with the complexity and response of the human body itself. While I applaud the doctors and scientists working on the closed loop system, and I am hopeful for it in my daughter's lifetime, I much rather she had a working pancreas. This is not to discount their tireless efforts on this device, but I'm sure they would agree as well.
     
  7. OSUMom

    OSUMom Approved members

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    I agree. Will we get back-ups for all these devices? If something breaks, it could be days before our kids are "cured" again. ;):cwds::cwds:
     
  8. maha

    maha Approved members

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    The feedback could be immediate too, that won't be straighforward but if there's no direct feedback, what the point ?

    There will still be failure and there's something outside connected

    It just will be more easy - to not have to think about what dose to do with calculations that are often wrong, with less hypo or hyper.

    I'm not seeing that as a cure, the cure won't be for the next year, seeing the last research report on type 1 so could be a nice solution in waiting, not to have to think about what dose to do, when ...
     
  9. PatriciaMidwest

    PatriciaMidwest Approved members

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    I don't think it's a "cure". But hey, let's forget about the semantics, because if the closed loop system is safe and gets results..I'll be the first in line for it.
     
  10. Tuff

    Tuff Approved members

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    Not a cure

    Nope not a cure - but still would be great until a cure is found!
     
  11. Kim3

    Kim3 Approved members

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    No not a cure by any means...we all would still be living with diabetes...well said "Jus a band-aide for now". My little boy would still have diabetes.
     
  12. diabetesgurl

    diabetesgurl Approved members

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    Nope.

    Read James S. Hirsch's "Cheating Destiny: Living with Diabetes, America's Biggest Epidemic" and you'll be as convinced as I am.
    Insulin is and never will be a cure, unfortunatly. As much as in 1922 it was thought to be a cure, and to this day - some still believe - insulin is not a cure.
    What stinks is the technological and human error(s).
    That's what scares me the most when people talk about the "closed loop" system. I've been on the pump since 1998, but I haven't taken the leap to the sensor. I'm 24, not only do I not want another needle to deal with - as well as the possibility of more infection, but I don't want the hassle and the cost to deal with either.
    Trusting this stuff, is a stretch. I plan on waiting it out a good 5 years after it's release... then you know it's tested through and through and they'll be more companies out there with competing techonology.

    Until then, it's more pricking and more sticking. :cwds:
     
  13. Ronin1966

    Ronin1966 Approved members

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    Hello Sarah Maddie's Mom:

    Nothing short of a COMPLETE cure will ever be enough, period! They can pretend anything they wish... it is a lie. They never lie, or bend the truth about anything do they....

    No never :rolleyes::eek:
     

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