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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. hypercarmona

    hypercarmona Approved members

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    Because they are interested in receiving "huge sums of money" from a captive target market who would jump at the chance of having just a little bit more of the burden of diabetes lifted off their shoulders. It just makes sense that they would push for technology that would keep us in sets and tubing, or whatever technology would be able to accomplish the closed-loop goal, instead of a real cure that wouldn't require purchasing these things.
     
  2. Christopher

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    So you believe it is a waste of time to try and develop better technologies that may one day make this a reality? You would rather keep your old dirty band aid than a clean one that works better than the old one? hmmm... :confused:
     
  3. tom_ethansdad

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    Absolutely not a cure, but I'd be happy to have one until a cure is discovered, assuming it could really work.
     
  4. Toni

    Toni Banned

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    This is the most I could hope for with the AP. And we are interested because she will be 18 in six years. D management, as it currently exists is too much of a burden for an older teen or young adult. If the AP could turn off the pump for a few hours (and I would like that to happen at 60, not 50) to prevent severe problems from night time hypoglycemia that, alone, would be worth it to me. Minimed already has such a pump out in the U.K. I'm sure a computer could mathematically figure out proper basal adjustments in the absence of food far better than my feeble brain! But what if the apparatus malfunctions? So I am thinking AP plus alert dog (to wake her if low and call 911) if she is out on her own. :D

    P.S. A cure is many years away, I would think ten or more. AP should be ready in some form in five.
     
    Last edited: Jan 7, 2010
  5. Mikker

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    We were talking specifically about AP's.

    I'm all for improvements in meter accuracy, CGMS reliability, etc etc. AP's are intriguing, but diverting millions of dollars from research to develop a system that will, at it's best, still be behind the curve on bg levels, still require constant monitoring and human intervention (much like existing systems), will still be prone to mechanical, site, and sensor failures, and may take a decade or more to develop... then yes. IMHO, it's a waste of resources.

    I don't know about anyone else, but I plan on seeing my son T1 free long before a reliable AP is ready for the open market. Heck... his c-peptide levels have increased slightly over the past 9 months, and a woman we ran across recently that participated in the same study 7 years ago still has detectable c-peptide levels 5 years after the fact. We might be closer than we think. :cwds:
     
  6. Christopher

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    Sometimes in the process of developing one piece of technology, improvements and breakthroughs are made in other areas. I don't believe any legitimate research is a "waste of reasources".

    You stated that an AP may take a decade or more to develop and that you plan on seeing a cure long before that. So you are thinking a cure will happen in the next 5 or so years? Interesting.....
     
  7. hawkeyegirl

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    So you agree with me that an AP is feasible? Because otherwise why would these major companies all be pursuing it?

    Well a true AP would do more than take "just a little bit" of the burden of diabetes away. If all I had to do was to change my son's site and sensor and do infrequent finger pokes, that would lift about 98% of the diabetes burden off of my shoulders.

    I mean, even a partial AP that could control BG reasonably well at night would be an absolute godsend. I'd be dancing in the streets. Dr. Buckingham says the technology is there. It's just a matter of developing the product and getting it through the FDA - a rather Herculean task, but it's coming according to him.

    Working toward a cure and an AP aren't mutually exclusive, and the money that is going to AP work is not necessarily being diverted from cure research.
     
  8. StillMamamia

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    A cure is doing away with the disease altogether.
    A closed-loop system won't do that. It would just make "management" "easier" , IMO.
     
  9. Sarah Maddie's Mom

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    I think this gets right to the heart of the matter. If private corporations, who stand to gain from our purchase (or our insurance companies purchase) of this technology and the supporting supplies, want to do the R&D and bring it to market then I too would be thrilled. BUT, I'm not so thrilled with the money I ask my friends and neighbors to give in support of JDRF and finding a CURE should be spent to advance this research.

    I realize that this is a contentious issue, but I think I'm not alone if feeling somewhat miffed that JDRF is devoting energy and $$ to the AP cause and since they appear to be doing just that, it does in fact take donated money away from the stated goal of finding a cure.
     
  10. Christopher

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    Then don't give them money?



    (Great thread, btw :cwds:)
     
  11. Toni

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    I am very happy for those whose kids have participated in a clinical trial and not gotten the placebo. But most of our kids are not in the same boat. We can't wait it out. DN's C-Peptides are low to none, I believe. An AP that will keep her safe overnight is not a diversion. Five year cure for those out of honeymoon with low or undetectable levels of CPeptide? Do you know of any promising ones, other than Faustman's (and, 45 percent cure rate would still be my best estimation despite refutations on other post)? Or encapsulated islets? Which, also, is not a cure, but a therapy?
     
  12. Mikker

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    I doesn't bother me if the pump companies want to foot the full bill for the RnD. Heaven knows their profit margin isn't hurting. I'm just not too fond of JDRF funds going into the pot.
     
  13. Mikker

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    Kind of hijacked the thread.. sorry...

    Even those with no detectable levels of C-Peptides are capable of regrowing their own beta cells if the autoimmune attack is halted. I guess I consider therapies that obviate the need for "life support" a "cure".
     
  14. Toni

    Toni Banned

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    Yes, I do too. I was asking if you knew of any possible therapies that fit this description that might be available in a five year time period? VERY interested!
     
  15. Sarah Maddie's Mom

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    Toni - why do you persist in throwing around that 45% rate? If I may, a quote from you in another thread from about a week ago...

     
  16. Toni

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    Because endo has explained to me why a 45 percent rate was a good, probable guess (and refutations on other post address CD3 antibodies which is NOT what endo was talking about re the CD8 T cell regulators) and 75 to 100 percent cure during Phase III could be hoped for but was unlikely. It is not right to promise such a high rate of cure in Phase III. Endo did not think Faustman herself is claiming 75 to 100 rate cure in her Phase III trials. It is the parents who are jumping to that conclusion. Need more than the article given in the link and am researching. But any understanding will have to be filtered through the endo because the scientific studies are just... so.... complicated. Will then take endo's very pertinent questions to researchers. It is irresponsible for anyone to claim such a high possible rate of cure. And as to the question: "Will people support a possible therapy that has a 45 percent cure rate for Type 1 Diabetics of long standing, out of honeymoon phase?" You betcha! And Sis will have to understand what the therapy is, in detail, before volunteering DN for it. Investigate all the risks. The papers given... not enough. Have high speed printer at work and will be able to print a lot of the studies out which must be on the web.
     
  17. Sarah Maddie's Mom

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    Toni, I really don't see how you can think it's reasonable to post this in a thread about AP. No one, NO ONE but you, has mentioned any other cure by any other researcher and yet you not only had to repeat a dubious figure of your own invention (one which you agreed not to keep repeating) but then launch an incoherent slam directed at god only knows who. I honestly don't know what to make of your conduct. It really incomprehensible.
     
  18. Toni

    Toni Banned

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    Yes, this is getting off topic. All for the AP and only really aware of two or three possible therapies, Faustman and Elliot's islet transplants without immunosuppression, Synovia a bit behind Elliot and I have seen one or two more, not yet investigated. All possible therapies would have to be investigated in depth before possible participation. Sorry I have made you angry. I do not get angry if a parent claims 75 to 100 percent success rate, just skeptical.
     
  19. buggle

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    The reality of the physiology of our bodies and physics and chemistry show it can't work. They'd have to be able to inject the insulin directly into someone's bloodstream and measure the glucose in blood for a closed-loop system to work. The lag time is just too long for the insulin to travel through the fluids under our skin into the blood stream. You need realtime feedback, so no algorithm will ever be able to perfect it as long as we keep using pumps and CGMs in their current incarnation. And imagine what it'd take to deliver insulin into the bloodstream.

    And really... all of us who have kids on pumps and CGMs know that calling this a cure is total propaganda. As I said upthread, filling a cartridge and puncturing your kids' skin with an infusion set and sensors and worrying about occlusions and equipment failure and tissue issues form insulin injection, etc, etc, etc. How is that a cure? If you can't get your insulin for some reason, you die. It's just a fancier version of what we have now. And I can guess it will be incredibly expensive. Just pumps alone today are already $6K.

    Why is everyone working on this? Well, the companies are driving it. You get grants for it and you can employ your students and postdocs with it. And companies wouldn't be driving it if their business analyses didn't show massive profits. They're getting money from foundations (from parents) and from granting agencies and from Congress. So their business plans must show that it's a winner -- for their investors.

    It's been so hyped that I imagine people are becoming true believers. And this *product development* is being called research at the expense of research that might uncover something that could actually lead to a cure.
     
  20. hawkeyegirl

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    I guess I'm a bet-hedger. I'm supportive of AP efforts and of cure efforts. As for JDRF working on the AP, I think it just depends on on literally one wants to hold them to being Juvenile Diabetes RESEARCH Foundation. I'm sure they do a lot of things that are not directly related to finding a cure (advocacy, etc.) Frankly, I'm a lot less concerned about the money that they are using to support the AP project than I am about the research they are actually choosing to fund. I'm no scientist, but a lot of what I read about sounds worthless to me.
     

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