Diabetes Self-Management Blog

We’ve previously reported on efforts to create an “artificial pancreas,” a device consisting of a continuous glucose monitor and an insulin pump that work together to prevent high or low blood glucose without requiring input from the user. JDRF (formerly the Juvenile Diabetes Research Foundation) is funding artificial pancreas trials at 13 sites around the world, and several other studies are being funded by medical device manufacturers. This week, we’d like to give you an update regarding two milestones reached in the development of an artificial pancreas.

Successful Inpatient Trial in Adolescent
The first update concerns Elle Shaheen, a 12-year-old girl with Type 1 diabetes, who was chosen to take part in a trial of an artificial pancreas at Massachusetts General Hospital. For three days she stayed in the hospital, where she was outfitted with an artificial pancreas hooked up to a laptop that monitored her blood glucose levels and responded accordingly. According to researcher Steven Russell, MD, PhD, “For three days, the device did the work Elle’s pancreas can no longer do. It went very smoothly — her blood sugar control was really very, very good, and we were really very pleased by what we saw with Elle.”

For the duration of the trial, Elle did not have to check her blood glucose levels, and she was able to eat more carbohydrate than usual at each meal. “We’re extraordinarily impatient for access to the device. I think it will revolutionize the way she lives,” her mother noted.

Russell and his research partner Edward Damiano, PhD, recently visited the offices of the Food and Drug Administration to present their prototype for an artificial pancreas, which consists of two tiny pieces that go under the skin — one to measure glucose levels and the other to administer insulin or glucagon (a drug that can raise glucose levels) — and a small device that can be carried in a pocket or clipped to a belt. The investigators are hoping to have permission for trial participants to walk the grounds of the hospital while wearing the device by the fall and to give the artificial pancreas to children attending a summer camp by the summer of 2013.

FDA Approves Artificial Pancreas for Outpatient Trial
The second update regards the Food and Drug Administration’s approval of outpatient trials for another artificial pancreas, this one developed at the University of Virginia School of Medicine. The handheld device, which was created by reconfiguring a smart phone, monitors blood glucose levels and administers insulin as needed. Previous inpatient trials of this artificial pancreas, conducted in both France and the University of Virginia, along with an outpatient trial under way in Italy and France, have shown good results; the first eight people involved in the outpatient trial were able to keep their blood glucose levels in a safe range using the device during a night outside the hospital.

“Conducting the first US tests of a portable artificial pancreas running on a cell phone in a real-world setting is an important step toward evaluating its effectiveness and how it may impact treatment for Type 1 diabetes patients in the United States,” notes lead researcher Boris Kovatchev, PhD.

For more information about Elle’s experience with the artificial pancreas, see the article “Artificial Pancreas Gives Girl a Vacation From Diabetes.” And to learn more about the FDA’s approval of outpatient testing of the device, read “Type 1 Diabetes: Artificial Pancreas Approved for Outpatient Testing.”

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Comments
  1. This is great work but in my mind as type 2 this is a type one cure that some folks hope solves T2.

    I also hope that might help but all my experience as a 64+ old with 30 years as t2 and extensive work in last 4 years after stroke and nearly rotting out and getting mess controlled along with extensive reading suggests to me that T2’s will not see any major gains here.

    I truly wish we had a research effort targeted to T2 problems and a practical cure.

    There will always be benefits from work done on T1 but it is in T2 where the number of cases is exploding world wide and we do not in my honest opinion making a dent in that.

    Worst yet, the only agreement we have is that carbs control-diet and exercise clearly are two key items that work somehow and then the rest are a contending mish mash of theories each having a corner of the schmoo diagram and its supporters attempting to stretch/expand and stretch that over the whole picture/schmoo as a complete holy grail answer.

    Lastly, the only current noise/controversy is with curious results nobody can properly explain is bariatric surgery, extreme (starvation diets 600 to 1200) that seem to show that pancreas function and control mysteriously returns along with unexplained better sugar control well before any serious weight loss in place and some of those results have shown by MRI spectography that pancreas function has in fact restarted after being shutdown for a long time.

    So in summary, congratulations on this progress and hope it helps us all.

    Posted by jim snell |
  2. Jim,

    While I see your point, Type 1 is a MUCH harder disease to control than Type 2. Many of the problems (I stated many, not all) with type 2 can be controlled with diet and exercise, additional issues can usually be controlled why medicine not as vital to life as insulin.

    Type 1 can ONLY be controlled with insulin because the pancreas is such down. Type 2’s still have insulin production. Most T2’s can increase their sensitivity by exercising and eating well.

    Another point.
    There is a lot more money to be made in T1 than T2 for medical companies. (The answer to this is simple, T1’s as a whole take better care of themselves than T2. I’m not trying to be mean, that’s reality, look at the numbers.) So why would they research T2 when more is to be made in T1?

    It sickens me that you have to write a complaint under an article that gives hope to so many.

    Posted by Johnny J |
  3. As a person with type 2 diabetes, I am happy to see that the children are being given this opportunity to have access to this new technology. I will never begrudge them this.

    We have a lot of work to do before type 2’s will have access to this as the next people that should have access are the type 1 hypoglycemia unaware and next those that have “don’t like the term” brittle diabetes.

    Even being on insulin myself, I don’t expect to see this for me in my lifetime. I will continue to follow the research being done in the rest of the world with porcine cells and having humans be able to use these without immunosuppressants unlike the research at the U of MN where immunosuppressants are required. This I feel has more potential.

    Posted by Bob Fenton |
  4. As a type II since 1994, I have discovered that for me, I am my worst enemy sometimes, while at other times, I am definitely my own best friend. Just look at the labels. If it has sugar in it, any kind of sugar, ask yourself, do I really need this? If not, that’s my friend talking to me. Carbs are just sugars waiting to happen. Eat protein, fiber, lots of green vegetables, try to stick to a sub-2000 calorie intake daily, get a little moderate exercise, and you should see positive results. It may not work for everyone out there, but dump dairy products, take a good calcium supplement, almond milk, for example, and you may notice two things start to happen: your glucose levels will come down, and you just may lose weight while you’re at it. If I avoid ice cream, etc, I can do this diet for life without feeling deprived, and it works for me.

    Posted by Gene |
  5. I am so happy to hear about the new technoligy! I am a Type-1 for 50 years and I’m 53.I can remember as a child, going to the hospital lab every morning to have blood drawn by 6AM,and waiting for glucose results so I could or couldn’t eat breakfast before 9:00.(no BG monitor before the age of 12,and then it was the size ofan old hand crank adding machine! No disposable syringes,(they were glass) or alcohol swabs.I was referred to as a “Brittle Diabetic”.Took 9 mths of hospitals before regulated on U-100 P ure Pork Insulin, which was experimental at that time.There was no bolusing in those days! You injected in the morning, after BG results.I became a “pumper” as soon as possible. Probably the reason I’m alive today! NEW TECH IS FANTASTIC!!!

    Posted by marina |
  6. This article brought tears to my eyes! I never dreamed I would live to see anything this close to a cure! A 65-year-old with 53 years as a t1, I wonder what my parents would say. While there are more t2 diagnosed people, t1 is often difficult to control. It is a minute-by-minute struggle that doesn’t always respond as expected. I give many thanks to all who have worked to make this happen, especially those willing to use the initial technology. My prayer is for easier control for the young people who are just beginning their journey with diabetes.

    Posted by Trudi Peters |
  7. Regarding Johnny J’s comments which seemed he was loading the blunderbus and firing all directions.

    I was not in any way making light of the excellent work and success on the artificial pancreas as described by Dianne Fennell in an excellent article and description. Others have provided excellent comment on the meaning and benefit of this progress.

    Neither type 1 and/or type 2 are easy to control and I for one am not interested in subtracting from Dianne’s article by starting-continuing a type 1 versus type 2 battle royal.

    Numbers today suggest that 85 per cent of all diabetics are type 2. Type 2 does a faint in its early stages whereby carbs control and sufficient proper exercise help alleviate the symptons. It does not stay that way for long and ends up progressing to far worse stages requiring all the skill, knowledge, discipline of a type 1 to reign back in without rotting out. I am now on cgms, metformin and small amounts of insulin as my pancreas did come back to work after 30 years on the so called oral pills (pre-metformin) that were supposed to help.

    I apologize my comments set you off. My intent was not to put you into orbit as it apparently did. Have a great day.

    Posted by jim snell |
  8. As a T1 of nearly 47 years (I am 48), I have heard there would be a cure within 10 years all of my life, and I remember those glass syringes mentioned a few posts up! My parents were told i’d likely only live about a decade or I’d at least be a vegetable before the end of adolescence. (I love proving them wrong!)

    I got the first model for home glucose testing when that rolled out. I got a CGMS when that technology rolled out. My eyes, nerves & skin have been hit, but praise God, my heart & kidneys remain intact! But the Hypoglycemic Unawareness has gotten dow-right scary. The artificial pancreas sounds promising, but I can’t keep waiting. Because I found the CGMS expensive but unreliable & inaccurate, I will be partnering with a Diabetic Alert Service Dog through Warren Retrievers. As they say, until there’s a cure, rhere’s a dog.

    Posted by Patricia Kasper |
  9. As a type 1 for 55.5 yrs., I also remember the glass syringes, the insulins from beef and pork, the urine testing for glucose, and sitting in the lab waiting to get my blood sugar results. My parents were also told the same thing as Patricia’s.
    I am so grateful for the insulin pump although I still have my spells of highs & more than a few lows. I’ve been on the pump since shortly after it first came out.
    Good luck, Patricia, with your diabetic alert service dog. I was so blessed with our first dog, Blackie (a lab/collie mix) when she taught herself to alert me every time my glucose dropped to 67. She was so valuable to me by doing that.

    Posted by Connie Stuart |
  10. Lets pretend that T1 is Aids or another more socially “interesting” disease to the media active celebrity world–we would likely get more attention and $$. Instead, for the 23 years I have had the disease there are only Promises that a cure is around the corner, or a solution is near and more BS. I challenge anyone to post an example of a disease that is this Big an industry that has been cured. No more test strips, variety of devices, I don’t think so. Any institutionally-led cure will be shelved away. My hope is someone like Dr Faustman or another scientist working alone in a lab will have a breakthru. But the Diabetes establishment, please these are well paid bureaucrats who would have to find another gig if a cure is found.

    Posted by Bob |
  11. It is amazingly heartening to hear some of your stories–the idea that many of you have lived through so much with a start of so little hope and technology gives me hope. As a 29 year old who has had type 1 diabetes for twenty years, I try to think about how fortunate I am to see the technology that constantly arises (despite the also constant promises of a cure in five years), but I also sometimes forget where we really came from in my frustration over the long wait and seeming limitations. To think that I had started to lose real hope when you have all come through so much for so much longer than I had ever imagined possible given the times you started in. Thank you for helping me regain perspective, thank you for your bravery, and thank you for sharing your stories. Best wishes!

    Posted by Amanda |
  12. I agree with Jim Snell, T2’s will never see any benefit from research. I have HAD gastric bypass in order to control this diabetes and to no avail, no improvement whatsoever, still totally insulin dependent, and now using Victoza on top of it beccuase my brittleness could not be controlled with diet and exercise. So I most definitely am NOT my own worst enemy. I’d love to see the medical profession change our diagnosis to T1 when we get to this point of progression with this disease. A person gets tired of all the disparaging remarks made when you know you are doing everything possible to keep it under control.

    Posted by Pat Weiser |
  13. Where do I sign up for the trial.
    I have had diabetes for 43 years . I have an average A1C of 6.3 I want to make my diabetes count for something . A trial to help research
    a new device would be FANTASTIC.
    PS I was 5 when diagnosed
    Lor
    w

    Posted by Lora Edwards |

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