Tides of Change

 Artificial Pancreas approved by FDA”  Sounds great doesn’t it? Its sadly right up there with “Scientists find way to cure diabetes”…in mice.  Well, its not quite that bad but it is media hype that does not quite match the reality of the innovation.
The Medtronic Veo insulin pump has been available in Canada for quite some time.  For a change, we were able to avail of a new technology before the US market. In this case, it means availing of a technology that shuts down your insulin pump if your CGM tells the pump that you are low and dropping. This is a pretty great feature but does not for many equate to a true “artificial pancreas”.
A number of people in the diabetes community feel that a true artificial pancreas is more in keeping with Dr. Ed Damiano’s Bionic Pancreas project rather than these smarter pumps. His pro-type has been used on adults and children with Type 1 diabetes in real world settings. A bulky model at that moment, but it has given people with Type 1 diabetes a freedom that they have not experienced since prior to their diagnosis.
Dr. Damiano’s approach combines the use of insulin, glucagon, a CGM, a smart insulin pump, and finally an iPhone.  With all of this, he is able to create a pancreas for people like his son who live with Type 1.  Those who have listened to his presentation (like myself) walk away amazed and inspired. Those who have used the system talk of an experience like nothing that they have ever imagined before.  They were able to enjoy meals without carb counting. They had nights without testing.  They experienced relatively stable bg levels. It is truly amazing.
This research is not funded by an insulin pump company. This researched is fueled by a father’s desire to keep his son safe.  David Damiano was diagnosed with Type 1 diabetes at the age of 11 months. This amazing project has given my own son hope where he didn’t have a lot before.
There are many great changes in the wind for people living with diabetes. Whether we are looking at a bionic pancreas, an artificial pancreas, or simply the improved accuracy of Continuous Glucose Monitoring systems.  Diabetes care has moved forward a lot since our journey began over 13 years ago. I am excited to see it move forward much further in the next 13! The next challenge will be to ensure that people living with diabetes will have the ability to access these improved technologies.

My Take on the Hub-bub About the Bio Hub

Yesterday there was a huge buzz in the diabetes community about the release of something that would bring a cure for diabetes within our reach.  People were excited, nervous and anxious.  Could we really see a world without testing and injecting? 

Late last night or sometime this morning (I only saw it this morning), the story broke. The Diabetes Research Institute announced that they were pursuing the concept of a “mini-organ”  that they were calling the BioHub

I have read a bit about it.  I have heard people complain that other groups are already investigating this idea.  Others asked, until we find the underlying cause, how can we “cure” anyone?  Finally there are those who say that another 5-10 years is the same line that they were told at diagnosis 5 years ago. 

I respect all of these opinions.  Personally, I am becoming more optimistic that a cure or something that will see my son live a life without testing and injecting may well happen in his lifetime.  That is something that I would not have said five years ago. 

This month marks 13 years that we have lived with diabetes.  We were never promised a cure.  We were promised a better life.  I believe that we have seen that in a lot of respects. 

When my son was first diagnosed, we had a meter that took 30+ seconds to count down and required me to cover his small finger completely with blood to have enough for a reading. The process was painful on many levels.  When we were first given a Freestyle Mini meter, I thought we had died and gone to Heaven.  The glucometer used very little blood and gave me a reading in five seconds! I would instantly know if my child was high or low.  I was so excited! 

Today we have all sorts of meters that don’t just read quickly or use a small sample size–they now show us trends, send readings to phones and other devices.  They can be downloaded without all of the cords and such we once had to order.  Even pen and paper people like me are finding it easier to upload a meter and see what it has to say. 

Insulins have also changed.  We no longer are reliant on NPH or regular insulin that require specific schedules and meal planning.  My son was lucky in that we started out on the relatively new “humalog” and I learned how to be more flexible with it and our NPH.  Today we have three rapid acting insulin choices as well as a variety of long lasting “peak-less” insulins. 

Insulin pumps have become “smarter”  and now “talk” to Continuous Glucose Monitors.  When I first heard of a CGM, it was a blinded device that was cumbersome and only available through your doctor.  You wore it with no idea if it was actually working or what it had to say.  The machine had to be returned to your diabetes clinic to be reviewed and interpreted.  13 years later, CGMs are commonly used devices that work in conjunction with some pumps. 

I have no idea if we will have a cure in 5-10 years. My best guess is that the Hub will change.  The artificial pancreas projects will be altered but we will see something amazing.   We have seen amazing changes already.  100 years ago, my son would not be living with diabetes it would have killed him.  50 years ago he would not have been using home blood glucose and ketone meters.  20 years ago he would not have been carrying around a tiny insulin pump to keep him alive.  20 years from now that pump may be sitting on his fireplace in a glass case with a sign that says “Remember when…”

Today there is more hope than we have had in previous years.  We are making progress. Slow and steady, I finally believe that we will win the race.