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Monday, May 10, 2010

How An Artificial Pancreas Works

Jeffrey Brewer is a former dot-com entrepreneur who is now on a mission to have an artificial pancreas built. He believes it would help his son, Sean, and others with Type 1 or juvenile diabetes.

Unlike Type 2 diabetes, which is brought on by diet or lifestyle, Type 1 can never be cured – only treated; it requires endless blood sugar tests and insulin injections.

(Juvenile Diabetes Research Foundation)

The artificial pancreas has three parts: a continuous glucose sensor/monitor (CGM), a computer (noted as the control-algorithm on the diagram) and an insulin pump.

The CGM monitors blood sugar levels, then relays that information to a computer, which calculates how much insulin a person needs using complex algorithms.  The computer then instructs an insulin pump attached to the person’s body.

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  • Bill Welter

    I use the pump and it is a wonderful thing except for 1 drawback. You have to change sites every 3-4days. If you wear the glucose monitor also that is 2 sites every 3 to 4 days. Can they not blend the 2 sites?

  • Agnes Rayome

    Thank you Robin for being so knowledgeable about the difference between Type 1 and Type 2 diabetes, and the challenges of living with Type 1.

    My 11 year old daughter was diagnosed almost 3 years ago, and wears a pump and a continuous glucose monitor. We hope for a medical cure, but wholly support the JDRF’s efforts to develop an artificial pancreas. We are aware there will be challenges – living with life sustaining technology is time consuming and adds another layer of anxiety to managing the disease. But the advantages are many, they allow for as close an approximation to “normal” living as possible while maintaining optimal glucose control.

    Let’s close the loop and set our children free.

  • A Hamilton

    Thank you and Mr.Jeffrey Brewer for discussing Diabetes,Type I and Type II and the need for an artificial pancreas. I thank Mr.Brewer for his much needed and generous donation. I know how horrible it is when you are caring for a loved one that has had a multitude of too low and too high blood sugar episodes since the age of 5. The resulting mental and physical damage is permanant also. I just want to add that like computers, pumps depend upon the operator properly programming and prepping the unit so that it does what you want it to do. An endless supply of glucose at a slow, constant drip will not prevent the low and high episodes either unless the user has fuel to convert into energy. Sleeping poses more likelihood for these episodes occurring with my experience. So, Kudos to Mr.Brewer, seems as if he is on the right track for a CGM,monitor/pump that may eliminate not only the worry but lessen the damages resulting from Type I diabetes. I hope his son, Sean, is better and thank you for your consideration, time and efforts toward another miracle!!!Mr.Brewer. Thank you Robin for the show!

  • Ellie Feddersen

    Thank you so much for a fabulous report! Your intro was a stellar and precise presentation on the difference between type 1 and type 2. As a diabetes nurse educator for the past 20 years a “closed loop sytem” would probably put me out of a job. But the sooner we can develop this technology the better. My patients who struggle daily “trying to be chemists” with imprecise tools and an inexact science deserve relief from this complex and sometimes brutal disease. I would only add that the “auto off” feature of almost all insulin pumps could have protected his son from such a severe low blood sugar.
    Good luck with R & D. I am eager for a cure.
    Ellie Feddersen, RN, CDE Evanston/Skokie , IL

  • Shannon Westrup

    I beg to differ with your statement that type 2 diabetes is caused by diet and/or lifestyle. Type 2 patients may have risk factors which are exacerbated by bad eating habits and other lifestyle choices, but the notion that type 2 patients brought it all on themselves is the worst kind of fallacious thinking. Please stop spreading misinformation about type 2 diabetes.

  • Chris Schuch

    I belong to several diabetic forums every week we get people who join the forum, their first and only post is “I just found out I am type 2 diabetic, what is the cure”

    They get this from listening to shows like yours.

    As a type 2 Diabetic I take great offence to the information you give and imply on T2 diabetics.

    I understand this was not a show on T2s, that does not mean you should give out wrong and misleading info on T2s.

    You did acknowledge that T2 is “a terrible thing for children to go through” However you give the distinct impression that unlike T1, T2 is curable, it is not!

    Unlike what you lead the listener to believe, T2 has no cure. Just like Sean, we T2s are going to spend the rest of our life, trying to manage our diabetes. When first becoming diabetic, if caught early enough it is manageable by “life style” changes. Unfortunately, most T2 are not diagnosed early enough and “life style” changes are insufficient to control their diabetes.

    T2 is progressive, meaning once you get it, it only gets worse and eventually most T2s end up on insulin. If diagnosed early some T2 can control it with “life style” changes for a while eventually most of them will end up on insulin too.

    I did not ask for this disease, I was not obese, it runs in my family my grand mother died from T2 in the 1950s. T2 has a very strong genetic component.

    Like a T1 I test my blood throughout the day to adjust my insulin. I count my carbs and take insulin based on the carbs, my activity level and other factors. Just like Sean I too “will suffer the consequences of not doing it well” (insulin).

    Many T2s are on insulin, we cannot be cured, many of us cannot manage it with “life style changes”. We too will die if our Blood Glucose Levels (BGL) go too low. We too can die from ketoacidosis. We too will suffer complications from high blood sugar. Diet, exercise, illness and stress all affect T2s BGL just like T1s.

    T1 Diabetics are not the only diabetics that have these problems. Listening to your show certainly gives the impression they are, and being T2 is our fault, all we have to do is a simple lifestyle change.

    You did a very big disservice to your listeners, who turn and judge us T2s as curable and controllable with “life style changes”.

    I expect better from Robin Young and NPR affiliated radio station than I do from FOX news. You let me down.

  • Marie

    I wonder if Chris, the commenter above, might have been happier if the report said something like “Many Type 2 diabetics can control their disease with
    lifestyle changes. Type 1 diabetics do not have this option.”
    I agree with many of the early comments, always appreciate a report that attempts to explain the difference between Type 1 and Type 2 diabetes. I wish they had two different names altogether, the diseases (and treatments) are so different from one another.

  • Chris Schuch

    You are correct they are very different diseases, I don’t think comparing them really helps.

    That is a much better statement, but, I think that is still misleading. I and many T2s can not control our diabetes with Lifestyle changes. We are on insulin and will die without it, further most T2 will end up on insulin.

    If Robin is going to compare T1 and T2 it is important to note that T2 is not curable, Lifestyle changes work for some but not all T2s most T2s will end up on insulin.

    Why is this important? I run into people all the time that think its my fault I am diabetic, that its curable and non fatal.

  • Jason Taylor

    This is not an artificial pancreas! This is an insulin pump controlled by a CGM. Whats new about this?? By saying type 2 diabetes is caused by diet and lifestyle, do you mean type 2 diabetes is “fat peoples disease”?

  • Aneel

    Is there any transplant of pancreas in the body which help the patient to move in normal life.

  • William-fleming

    type 2 diabetes can also be inherited 

  • Tracy Ann

    My son is type 1 and also wears the pump. We love it and it definately changed our life with diabetes. The leash didn’t fall off but definately got longer.. The idea of combining the two would be wonderful but I do have to say that going from 3-6 shots a day PLUS checking glucose levels down to checking glucose levels less often due to less frequent highs and lows and changing sites ever 3-4 days is sooooo much better! I think back about how many times my baby had to poke himself ( Average of 63 times a week!!!!!) and how often he has to with the insulin pump (Average of 37 times a week!)The difference is AMAZING (26 FEWER pokes!!!! Praise God!!! ). I would recomend the pump to anyone new to living with diabetes! I am super excited about the new developments because even with the new added sticks with a seperate monitor (if it is every 3-4 days as well) we will still be far better off with the 39 pokes versus the 63 pokes a week. It only gets better! Wouldn’t this mean fewer checks with the regular meter? I am just now reading about all of this and super excited! Last I heard they were still “talking” and had not tried it on human subjects yet. LOVE IT! :)

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Robin Young and Jeremy Hobson host Here & Now, a live two-hour production of NPR and WBUR Boston.

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