For the second time in a bit over a year I find myself living on an artificial pancreas in a trial at the University of Virginia…

It’s night time, and I’ve spent the whole day with the “team” — Boris (the system’s modeler), Marc (a systems engineer), and Stacey (my endocrinologist).  I haven’t pricked a finger or touched a pump since 2 p.m. — once again that odd feeling of elation permeates the room because I’m not thinking about my blood glucose .  I’m thinking about ways to rib JDRF’s Aaron Kowalski.

I first was introduced to my blood meter and lancet over six years ago.  There have been only two times that I’ve been able to put them aside, to walk away from the constant monitoring and action required by diabetes: the first time was the first trial on an artificial pancreas and now again in this second trial.  I ate dinner, I exercised and I haven’t had to test or pump.  Sigh – it really is a lovely feeling.

And as to how things are going…this trial is testing a similar system to what JDRF’s first industry partnership with Animas/Dexcom is pursuing – it is a hypoglycemia/hyperglycemia “minimizer.” And it has minimized the lows and highs – and when it comes into a target range it defaults to my typical basals.  It starts to put the brakes on if its forward prediction indicates I’ll fall below 112 from 45 minutes out…it almost worked perfectly.  At the very end of exercise I dropped to 69.  A one-point drop below the FDA threshold, so I had to take glucose tabs (ugh).  And after dinner I went over the upper limit of 180 (or it predicted I would) so it ramped up extra insulin.  I peaked at 200 and my blood glucoses have very nicely come back down to below 140.  In short – the minimizer is working fine.  It is more complicated – frankly – than the full control of the earlier trial.  But then putting a human into the mix guarantees more complexity…
I should note that this trial is designed to make a person go low to test the system – light lunch at 11 a.m., exercise at 4 p.m. (with no snack), and then dinner at 7 p.m. – whew.  It works – when I ran the show myself two weeks ago I went low EIGHT times – this time with the control program running things I’ve gone low THREE times and each time it was a “barely” low scenario (a 69 to say 65)…what I call a shallow low in that I was more drifting low than plummeting.  Like last time, the system used a lot less insulin than I did.  Amazing!  The purposeful design – aimed at going low – is meant to test the abilities of both patient and computer program.  There is a lot more complexity to all this than I’m including but I am in awe of the vision and brain power behind all this (thanks Aaron!).  This first system that comes to market will be like having my own personal coach in my pocket doing all it can to keep me safe and making suggestions when it can’t anymore and I need to step in…I don’t know why but the refrains from two songs keep going through my head: the Beach Boys: wouldn’t it be nice, and REM’s song (can’t remember the title…Country Feedback I think) where they sing: I need this…I NEED THIS.

Another thing worth noting is the advancements from the first time I did this.  Last time the engineers and Boris and my doctor had to be in the room with me.  Now it is remote telemetry and they are down the hall running the show and monitoring things.  Last time Stacey had to push the button on the Omnipod controller – now the computer program does it remotely and wirelessly – which means I don’t even know when it’s given me insulin.  The last time they had to have to jury-rigged boxes with the sensor receivers in them – this time the receiver is in a little pouch around my waist along with the wireless controller for the pump.  In short – essentially all the items for the artificial pancreas are now in a pouch on my body and it is ambulatory with me (clunky but truly mobile).  So what does this amount to…

We can tell our families, volunteers, and donors that their dollars have made a huge difference in just the past year in advancing the sophistication of this effort.  From big boxes and locked-in-place to everything in a pouch and mobile.  Step by step I am seeing this first generation system become a reality and it is because of the support of all our families!!!!  JDRF: progress you can trust!!!”