Wednesday, March 10, 2010

Diabetic Ken and the Artificial Pancreas


I know it's distracting, but if you try really hard I bet you can manage to take your eyes off this amazing, slightly-creepy Diabetic Ken doll picture for just one second to talk about the gear he's sporting. (It's similar to mine, in fact, although I'm currently hitched to a Dexcom CGM. And I don't have his svelte abs.) The CGM and the pump are incredibly useful tools in disease management - I love/hate my gear, and rely on that technology to keep me alive. But as any T1 knows, our disease is unpredictable (Kiss My Variables!) and the tech is imperfect. So I've been a little freaked out about the artificial pancreas project (diaTribe has an excellent summary piece that you can read here).

This new partnership between the JDRF and Animas/Johnson & Johnson has a stated goal of "automating how people with diabetes manage their blood sugar." It's a good goal, and one I could totally get behind - after all, I miss my pancreas and it did automatic management quite well for 15 years! But like most PWDs, I'm a bit of a control freak about my health management. I am in charge of myself, and nobody else is the boss of me.

The idea of making something that runs on batteries the project manager for my life gives me the heebie jeebies, and those HJs are only made worse when you consider the Dexcom/CGM issue. I simply cannot rely on anything the Dex says. It provides a steady stream of invaluable data, but I would never in a million years allow that trending data to dictate what insulin my pump is providing:

The pump would house a sophisticated computer program that will address safety concerns during the day and night, by helping prevent hypoglycemia and extreme hyperglycemia. It would slow or stop insulin delivery if it detected blood sugar was going too low and would increase insulin delivery if blood sugar was too high.

If I can't trust my CGM to provide 100% accurate data, how am I supposed to trust it with my insulin dosing - and my life? I realize this is a project, i.e. they're working on it, it's not finalized, and that actual implementation is likely years and years down the road. I know that there have been awesome studies and everyone is all super-jazzed about the outcomes of said studies. Whooptidoo. What I want is for the JDRF and J&J to say "Hey, T1s!
  1. We know that the existing tech from which we'll pull a lot of our artificial pancreas stuff is kind of meh right now. We promise we'll have some PERFECT CGMs out there - we're talkin' fingerstick-free levels of awesome CGM - ages before this whole thing goes live, so you have some time to play around with it and learn to trust in its awesomeness.
  2. We know that we make it sound like it'll be this fabulous invention where you don't have to do anything anymore but that won't be the truth. You'll still be monkeying with sets, playing with insulin bubbles, stabbing yourself, and spending oodles on equipment and supplies...not to mention your time and effort.
  3. We know this is a lot for you guys after years and years of caring for yourselves. So we're going to ask for your thoughts and feelings, talk to your patient advocates, and make sure we have your support as this project progresses.
  4. We promise to remember that "Insulin Isn't a Cure," because it is NOT. We're just trying to make your lives better and healthier while we still plow gobs of money and time into finding that cure."
I won't hold my breath, obviously, but a girl can dream....

2 comments:

  1. I dream of Ken.....oh wait. Never mind.
    Is the research a step in the right direction? Maybe. Does it freak me out? Oh yes.

    KMV! I don't think any technology can cover all the variables that mess with us.

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  2. Yeah, as my CGM alarm has been blaring all morning reporting readings in the 40s while I've actually been hovering in the 70s, I can imagine it will be quite a while until we see the fabled artificial pancreas. But if it comes with svelte abs too, I'll be really excited!!

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