Even my A1C would improve on the artificial pancreas!
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.
Carol Ann Narozniak says:
January 14th, 2010 at 12:19 pm
I was surprised to read your blog on Type I and find out that you actually participated in the closed loop system trials. Your comments are very hopeful to all of us with Type I.
I’ve been on insulin for 56 years. I have a pump and a CGM. It’s better than taking four injections daily, but not perfect. I, too, test my BG 15+ times daily and walk the tight rope of the possibility of lows. I have no complications so far.
Please keep all of us informed. Best of luck to you.
teresa jensen says:
January 14th, 2010 at 4:11 pm
just wandered why does a person go about getting this ? My daughter has this disease and it sounds like something that she would benefit from?
teresa jensen says:
January 14th, 2010 at 4:13 pm
was wandering how to get this? my daughter has diabets type 1 and i thnk she could benefit from this> Please help>>
Heather Worboys says:
January 26th, 2010 at 12:19 am
As a Registered Nurse with Type 1 diabetes, I understand the vigilance of trying to maintain ‘normal glycemic control’. Working in the healthcare field, I see first hand the effects of poor control. I also struggle with lows in my efforts to establish good control. I agree, the artificial pancreas is the beginning of a new era for Type 1’s. I have wore a pump for approxiamately 10 years and the technology is ever increasing. I am so excited about this, every time I read more information I fill with emotion. It was great to hear about your experience.
Thanks for sharing,
Heather
Kathleen says:
February 2nd, 2010 at 11:43 pm
I have lived 42 of the 44 years of my life with a diabetic. First was my mother. I remember her having to boil her glass syringes to sterilze them. Then in 1982, I think, she was put on one of the first insulin pumps. Wow, what a difference. My mother was a very brittle diabetic with many other autoimmune illnesses that only complicated her diabetes. She passed away in 2005 at 63. In 2007, my older daughter, then 10, was diagnosed by me with type 1. She had been ill and was vomiting and complained of feeling shakey. I automatically went for my mom’s glucometer and checked her blood sugar. It was 465. I was in disbelief, so I checked mine. It was normal. I checked her again and it registered “high”. I did a control test. It was fine. I checked her again at it was 453. I called her pediatrician and headed for the hospital. I had her put on her pump 6 months after diagnosis. We have lived a nightmare. She too is a brittle diabetic and has also been diagnosed with cyclical vomiting syndrome and chronic acute migraine. I can hardly wait until the artifical pancrease is available. As soon as it is available, we will be one of the first in line for it. Thank you to all who have dedicated their lives to making life better for diabetics and for searching for cures.
bandsxbands says:
February 6th, 2010 at 4:45 am
My friend and I were recently discussing about the prevalence of technology in our day to day lives. Reading this post makes me think back to that debate we had, and just how inseparable from electronics we have all become.
I don’t mean this in a bad way, of course! Societal concerns aside… I just hope that as technology further develops, the possibility of transferring our memories onto a digital medium becomes a true reality. It’s a fantasy that I dream about every once in a while.
(Posted on Nintendo DS running R4 SDHC DS qqPost)
StephanJade says:
February 11th, 2010 at 8:04 pm
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February 12th, 2010 at 8:15 am
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Fran DIckinson says:
March 3rd, 2010 at 4:44 pm
I have a medtronic paradym insulin pump that links to their CGM. While it is good, I find it is sometimes way off from the readings I get from my glucometer. This is especially true when blood sugars are rising or falling quickly. How does this relate to your experience in the closed loop system research you participated in? Anyone else with similar or different experiences?
Ruth Ann Johnson says:
March 21st, 2010 at 5:15 am
Yes…this is amazing and so very exciting. My son has type 1 diabetes and is about to turn 18. He was diagnosed at age 12. He is wanting to go into the aviation field of flying drones. This would be an answer to prayer…what a miracle this would be. Is there anyway to allow him to be apart of this study and receive this close loop system? Also, is there a way to invest in this new system?
jdrfadmin says:
March 22nd, 2010 at 1:53 pm
Hi Ruth Ann – you can find out about clinical trials by registering at http://www.trials.jdrf.org.
James Stewart says:
June 27th, 2010 at 10:11 pm
I am 71, have a Ph.D. in engineering, and have had diabetes for 25 years. I use the medtronics pump. I have tried the Medtronics continous monitering system but found it was adjusting insulin differently from my pump. I am able to maintain a 6.5 A1C but find my current meter readings to be consistantly at about 150-250 and autmatically adjust Basel and Bolis for delivery through the pump system.
In the past, I have severe fluctuations resulting in falls, periods of blackout, and hosbital visits. But these seem to be adjusted for.
I am still very weak and can not take extended walks or gardening.
I am quite capable of understing the requirements of testing protocal and wonder if the pancreas research might be appropiant in my health regimen.
James Stewart, PhD
Professor Emeritus
Northern Illinois University