This, for me, was one of the first realizations I had as I concluded living on the artificial pancreas in one of JDRF’s human clinical trials of a closed-loop system at the University of Virginia last year. Of course the goal of an artificial pancreas system is to deliver significantly enhanced blood glucose control, avoiding both highs and lows – so why was this one of my first thoughts?

A bit of background may help – my name is Tom Brobson and I have type 1 diabetes.  I’m also ones of those crazy people who work hard to keep their blood glucose as close to normal as possible.  My A1Cs are consistently below 6 which, as we all know is great, but that number comes with a high price.  As my endocrinologist always reminds me it means I am always on thin ice – always at risk of experiencing a severe low.  And over the years I’ve had my share of them – the big change for me came with the arrival of continuous glucose monitoring (CGM).  With CGM I’ve been able to push my A1Cs down without having a low blood glucose episode creep up and ambush me.    That isn’t to say I don’t head low – I do – far too often – but with the CGM alarm I know its coming and head it off at the pass.  The other tough part of trying to have a good A1C is the amount of time and energy required day in and day out, 365 days a year; the constant testing, the judicious tweaking with .05 or .10 units of insulin (for example), and so on.  The burden of a never ending commitment to monitor what I eat, how I exercise, and how I take insulin…as we all know…its exhausting.

So as I prepared to participate in the artificial pancreas trial at the University of Virginia one of my big fears was: “What if the system doesn’t provide as good a control as I deliver for myself?”  This thought wasn’t far from the minds of some of my friends.  One very good friend who is also a type 1 kidded me that I would be the only person to see their A1C go up a tad while on a closed-loop system.

And then came the trial – you can see my blood traces below.  When I ran the show I went low 6 times with one high…the trace of my control looks like a roller coaster ride.  When the closed-loop system took over the difference was dramatic: a wonderful, calm, “normal” looking blood glucose trace.  The difference between the two was even more apparent in how I felt – I woke up on the closed-loop system feeling like I’d not only slept but that for the first time in years I hadn’t had to maintain hyper-vigilance – I was not only rested…I felt more free than I could remember being in a very long time.  In short – the whole experience was fantastic!!!

So often our work toward finding the cure seems to become an intellectual exercise in patience and future visions – something we are working for that will happen “some day.”  Participating in this trial brought home to me that with the artificial pancreas, the proverbial “some day” is today.  Even in its most primitive form, using off-the-shelf technologies, a first-generation closed loop system will vastly improve my ability to live and thrive with type 1 diabetes, ensuring that one day I will be able to fully benefit from the biological cure that JDRF is working to achieve.  The hours I spent on the artificial pancreas during the study allowed me, however briefly, to glimpse what actually experiencing the cure will be like: for me the cure will mean not having to think about my type 1.  With all of you, I look forward to that day’s arrival.