When I hear the word “bionic,” I can’t help but have the opening theme of the 70s TV show “The Six Million Dollar Man” pop into my head. Then I come back to the 21st century, and ponder the exciting innovations of the bionic pancreas project.
A collaborative effort between Boston University and Massachusetts General Hospital, the bionic pancreas consists of a Dexcom G4 continuous glucose monitor, an iPhone, and two Tandem t:slim pumps. The G4 streams blood glucose data to the iPhone, which in turn uses a mathematical algorhythm to make decisions every five minutes about dosing of insulin and glucagon from the two pumps. An app in the iPhone sends dosing instructions via Bluetooth to the pumps, which have separate infusion sets. Pre-adolescent and adolescent summer camps are the laboratory in which the studies are conducted in children, while adults are monitored in Boston. Half the study time is on the artificial pancreas, and half on usual care. Visit http://sites.bu.edu/bionicpancreas/ for more details.
The improvement in blood glucose control is amazing, with levels being maintained—and consistent– in near-normal range. What they achieve is automated glucose control, taking the constant decision making out of the hands of the person with Type1. What freedom that provides! It’s not a cure, but what a difference in quality of life that would make. Sure, there’s more equipment to contend with, but I think it would be worth it.
There are other innovations towards a cure. Researchers at Harvard have been able to generate insulin producing beta cells from stem cells, and in mice have cured Type1 because these cells are able to produce insulin for several months. The cells do need to be protected from an assault from the immune system. Encapsulation of new beta cells in a permeable, protected barrier allows them to produce insulin for up to 24 months when implanted into the human body, protected from attack by the immune system. This is in early clinical trials. It is a much better option than an islet cell transplant, which necessitates high doses of immuno-suppressive drugs. More information is available at http://jdrf.org/encapsulation/.
Until such treatments are available to all who could benefit, it’s important to do the best possible job with the management tools that you have at your disposal. If you’d like to have a tune-up, give us a call! We’d be happy to help.
I don’t know what the future will hold. Perhaps these things will not be available to all Type 1s in my lifetime, but I love that this research is being done, and that advances are being made. Hope can keep you going; it’s something to hold on to. And that’s worth a lot.