Friday, July 13, 2012

The Artificial Pancreas Project

I had an incredible opportunity the other night.  Our local chapter of JDRF held a Research Progress Summit at the Medtronic World Headquarters.  I couldn't pass up the opportunity to go and see what they had to say.  And I have to say, I was not disappointed by what I heard!  Not only did I get to meet a very funny d-blogger (Scott from Scott's Diabetes), but I also heard a great deal that I want to share here.

The first portion of the talk was given by Dr. Marlon Pragnell.  I'm not sure how well-known he is or even what his general place is in the research, but he gave a great talk about the Artificial Pancreas Project (APP).  He even went so far as to break down the the research for us and tell us about the six stages that are going to be pursued and how the artificial pancreas will evolve into three generations of devices over that span of stages.  The first stage is already Europe, anyway.  It's the Medtronic Veo pump, which automatically suspends for two hours if a low is detected.  The next step is what they're working on now....figuring out how to turn the pump down/suspend when a low is predicted, instead of just when it's detected.  The third stage is adding in an increase in basal or an automated bolus when a high is detected.  How awesome would that be?  To have an insulin pump bring your blood sugar back down before it's even become elevated?  The next two stages after that are more complicated....they require new insulins to be developed and possibly new infusion options.  In order for the artificial pancreas to deliver insulin for meals, automatically and quickly enough, the insulin needs to affect the body quicker and the sensors need to sense the rise in blood sugar quicker.  One of the infusion options that the doctor brought up, which I have to admit scares me just a bit, is the idea of the infusion site being a "port" like what they use for cancer.  For me, fine.  For my daughter....not so sure I want her to have to undergo surgery to have a port put in!

Final stage and where the 3rd generation of artificial pancreas comes in.....a dual chamber pump that will inject both insulin and glucagon, as needed.  There's quite a bit of research and development that has to be done before any of that can happen.  We're all familiar with the glucagon kit.  The tiny vial with a powdery white pill and the big-ass needle with clear liquid that has to be mixed with the pill before injection.  Obviously, this part is going to be complicated.  An easier to use, more stable form of glucagon has to be developed first. I wrote all of the above about three weeks ago and then saved it as a draft.  I'd intended to move on to the second part of the summit and tell you all about the "cure" stuff too.  But, I'm having a hard time sitting down and writing about all of that.  I have some major misgivings about the "cure" portion of the research.  When I was first diagnosed, it was thought that being diabetic meant that you had a bad pancreas. Further research changed that and said your pancreas wasn't bad, just your beta cells.  Diabetes is much bigger than just the beta cells though.  Research is looking into how the beta cells can be regrown and protected, which is great....but.....the real problem isn't just the beta cells, it's what they need to be protected from.  The immune system.  I don't want to get too far into it, so I'll just say that in my mind, I wonder what messing with the beta cells will do to the immune system.  Would it then go attack something else in your body?  Because, honestly, I can deal with diabetes.  That's okay.  But I really, really, really don't want to have to learn to deal with Crohns or Celiacs or something tremendously worse than what I deal with already.

I'm going to give a quick update on my fitness stuff too.  I've been doing better.  I've been making it to the gym.  I've been exercising again.  And my bone spur isn't causing me any more problems.  I think a big part of my problem was that I was concentrating on the weight....I'd forgotten about the fitness aspect and just saw a lack of change in my body and my weight and I got discouraged.  Nothing changed for the last year.  I got frustrated.  I met with a new endo at the beginning of March and she promptly started me on Metformin, which is a medication for insulin resistance.  She's thinking that I won't lose any more weight until we break down my body's resistance to insulin.  It's a vicious cycle....the more you weigh, the more insulin you have to take.  The more insulin you take, the more your body thinks it needs to store up as much fat as it possibly can.  The more fat you store, the more insulin you need to take.  Round and round it goes.  I've been on the new med for a few weeks now, at full dose for the last week.  Time will tell if it will work.  In the meantime, I'm going to keep on exercising, keep on being healthier and more active, and I'm going to put some more effort into reading Ginger Viera's book, Your Diabetes Science Experiment.  She's a personal trainer/fitness coach with Type I.  I'm hoping for some new info and a new direction to take myself in!