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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. lynn

    lynn Approved members

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    Nathan's pediatrician is his endo's brother. When I brought Nathan for his check-up last May we talked diabetes and his opinion is that the closed-loop system will be THE cure. He doesn't believe there will be a cure that we will see--just better mechanical means of treatment.

    Sorta depressing.:(
     
  2. AlisonKS

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    so if this comes about, I wonder if there will be less focus on finding a real cure? People will brush off the whole diabetes thing cause "oh, it's easy you got that", kinda like now how people think it's all good since there are pumps.
    I dunno, I'd love a closed-loop system in the meantime....
     
  3. Sarah Maddie's Mom

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  4. ecs1516

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    That is depressing. Hope he is wrong.
     
  5. Flutterby

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    This is EXACTLY why I am refocusing my money. If JDRF believes the close looped system is a 'cure'. Then they don't have MY child's best interest at heart so my fundraising will be will focused else where.
     
  6. Sarah Maddie's Mom

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    Well, I'm beginning to feel that some forces in the community are redefining the notion of what a "cure" will be and that perhaps, we as parents of CWDs are only now getting wind of it.
     
  7. Marcia

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    So, I just did a site change on Ab and it was a sensitive skin area and she cried a little. We don't do cgm yet, I imagine that would require EMLA most of the time. Hmmm, every 2 or 3 days needles and tears-calibrating-double checking-alarms-doesn't sound like a cure to me. Maybe better A1c's, but not a cure. I want a cure.
     
  8. TheFormerLantusFiend

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    Would it absolutely prevent complications of diabetes? Then it would be good enough for me (though not exactly a cure).

    The thing is though, I get awful reactions to the adhesive. I just went in for an EEG and MRI, and after just twenty minutes of having an IV taped to my arm, my arm was swollen! The sensors they put on my chest during the EEG also caused my skin to peel in that area.

    Although I would like to go back on a CGMS, it did awful things to my skin and I am not sure I could tolerate wearing it full time, particularly not if I had to wear both a CGMS and a pump.
     
  9. Seans Mom

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    Seans endo talks about the artificial pancreas like it's a cure also. :(
    She's a great endo and person but I'm glad she's not on a research team. I want a real cure. :cool:
     
  10. Barbzzz

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    I will continue to hold out hope for a real cure, because the truth is even if the closed loop pump/cgm comes to fruition and gets FDA backing, it will not help Alexandra and thousands of other T1 children in developing countries who won't have access to it nor money or insurance to obtain it. :( We need a cure. :(
     
  11. Danielle2008

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    I guess it depends on how you define a cure.

    If I look at a cure as having a completely normal functioning pancreas...then no, it is not a cure.

    If I look at a cure as something that regulates my BG to perfect levels, without much thought on my end....then yes.

    Personally, I am much more excited about technology advancements then the other options.
     
  12. Toni

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    I would prefer a less invasive cure, such as islet transplantation without use of immunosuppressants to the AP, even acknowledging that you would most likely have to repeat the procedure every few years. I doubt Researchers are not still actively looking for a cure for Type 1 but if the AP is advertised as such Federal funding could dry up, effectively making finding the real cure more difficult.
     
  13. Sarah Maddie's Mom

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    Monica, I think the vast majority (95%) of the people responding to this thread would probably agree with you.
     
  14. hawkeyegirl

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    Monica, I ask the following with absolutely no snark intended, but genuine curiosity:

    What do you know that all of these famous doctors and researchers and huge corporations don't? Why do MDs/PhDs who speak at CWD events speak of the AP with such confidence? Why are Medtronic, Dexcom, and Abbott all pouring huge sums of money into working with JDRF on this?

    I don't think of the AP as a cure, but I've heard you say before that the AP itself will never happen, and I don't understand how you can simply discount all of these people and corporations who are working on it who claim that it is indeed very, very viable.
     
  15. Darryl

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    Monica is correct - it is impossible for a closed loop CGM system to work using any sensor and insulin technology that is available today. The requirements for a closed loop control system are:

    1) The sensor (in this case, the CGM) and control method (in this case the pump and the Insulin) must be 6 times faster than the fastest rate of change of blood sugar to maintain loop stability.

    2) The control method must have 6x response sped both in the upward and downward directions.

    3) The sensor and control method must be 100% reliable, and at least 90% numerically accurate.

    These are fundamental requirements of any closed loop system. An example is the cruise controls in our cars: The sensor (speedometer) is reliable and accurate, and the control method (acceleration and braking) can change the car's speed in a matter of seconds.

    There are unrelated factors with a AP that have not been addressed; namely that regulation of insulin alone is not sufficient to address pre-bolusing for meals (which will remain necessary as long as external insulin is slower than internal insulin), correcting low BG's, exercise, illness, etc. These ALL require human intervention and judgement, and before-the-fact knowlege of what's going on. A closed loop system can not know that you are about to eat, or that you are feeling sick, or have ketones, or are swimming, unless you intervene with that information.

    Current investments in AP are in my opinion a waste of time and money. If the AP is to be feasible, the first order of business is to invest in the development of sensors and insulins that are sufficiently fast and reliable to trust with one's life to. When those goals are reached, the closed loop system may be feasible - but even then, we don't fly airplanes on autopilot or drive cars on cruise control without constant human monitoring and intervention - and we never will manage T1 with any closed loop system without constant human intervention and monitoring.
     
  16. OSUMom

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    I was very interested in reading what some of the thoughts were by the young adults or adults living with type 1 diabetes. I'm perceiving it that improving technology (and supplies for sensitive skin) and working towards a closed loop system is still a goal worth pursuing though not necessarily calling it "the cure". I think putting money towards improving the lives now of people living with type 1 is still very important.

    Now that being said, I believe in an absolute cure for type 1 and soon. I believe we must *see* it or have a vision it's out there to achieve it. I really do. Call me crazy. :)
     
  17. hawkeyegirl

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    Well, with all due respect, that's kind of obvious. But I'll ask you what I asked Monica: What do you know that all the people working on the AP don't? Do you think doctors like Dr. Buckingham are lying when they say that this is real and feasible?
     
  18. Christopher

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    I think using words like "it will never work" or "impossible" stifle creativity, hope and are just negative in general. No offense to those who use them, just that many things that were previously thought to be impossible or would never work have come to fruition.
     
    Last edited: Jan 7, 2010
  19. Jacob'sDad

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    I didn't read everything, but I think you can always follow the money.

    It may be that our expectations of what would constitute a successful AP and what the people working on it expect, are two different things. Just getting level BGs overnight is a major success and that alone would likely sell the product. If you then start adding things like shutting down the basal when BG gets too low, it becomes more appealing to those who might buy it.

    Maybe they have to dangle the carrot out there of what an AP might be SOMEDAY, maybe several generations off, in order to get people to get excited about what the FIRST generation may be able to do for them.

    For example, anyone with a CGM knows what they would really like it to do for them, but if you're going to use what is available today, you have to accept the current shortcomings.
     
  20. Mikker

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    Amen! While an AP would help lower the learning curve for newly dx'd T1's, I also see it as mathematically impossible to develop a reliable AP system with any existing technologies. I can see where improvements in meter and sensor technologies would be of an immediate benefit, but I don't really want a better band-aid. IMHO, the resources are much better spent on developing a cure.
     

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