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Permalink Reply by MyBustedPancreas on March 2, 2012 at 11:33am

Very interesting. Thanks for sharing. I am still not sold on the whole artificial pancreas thing - I think it offers some promise for improved treatment definitely, but I don't think it's going to be the "cure" so many people hope for. 

My biggest concern about this study is that the range of what was considered a "normal" BG was 70-180 mg/dL.  If you stay in the 170s for several hours, that's not good.  I also have concerns about the accuracy of the CGMs.  They are still not terribly accurate and I would be worried that my CGM would signal that I'm low and shut off my pump when I'm really in range, and then I'd end up really high (if not in DKA). 

I guess I question some of these efforts when there are still so many other issues, like inaccurate home meters and T1s who aren't able to afford the current standard of care (pumps, for example).  Are we just creating another mode of treatment that will be out of reach for even more people? 

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Permalink Reply by LadyD on March 2, 2012 at 6:33pm

I'm a bit leary of the CGM myself at this point, though I haven't even started pumping yet. You make an excellent point about access and affordability that I hadn't considered.

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Permalink Reply by Gerri on March 4, 2012 at 12:42am

My concerns also. Afraid I don't have faith or trust in the AP. I've also thought of the increasing gap of what's affordable for most people & what the expense will be regarding insurance rates.

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Permalink Reply by Capin101 on March 2, 2012 at 11:43am

I think it is a reasonable first step to something (hopefully) better in the future. I am also not sold on low glucose suspend with sensor inaccuracies. I learned a few weeks ago that if the sensor comes out of my skin a good amount, then my pump will show a huge drop in my BG. Issues like this would cause my pump to suspend when in fact I am not hypo and would still require basal doses.

I also do not understand how a Low Glucose Suspend would not cause hypers later. It just sounds inevitable to me. With current technologies I would only be interested in LGS while asleep. That being said, you have to start somewhere and baby steps are likely the best way to achieve progress.

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Permalink Reply by Tom Goffe on March 3, 2012 at 6:54am

It is progress, but even when this technology becomes available in America (and it already is in use in Europe) it is but one step on a long road.

While it introduces an element of safety for CGM+pump users, it will not see it's full potential until even quicker acting insulins are in use. They are also in development. Also being tested are better CGM sensors based on the Minimed sensor also approved in Europe. It is smaller, more comfortable and around 10-15% more accurate. I think the utility of the suspend feature coupled with the new sensor will enhance safety, patient satisfaction and compliance once they are approved by the FDA. With luck I hope we can start using them sooner rather than later. Thankfully their widespread use in Europe should help get them to market faster rather than if they were starting from scratch here.

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Permalink Reply by LadyD on March 4, 2012 at 4:53pm

I also don't know if the 19% reduction in time spent below the low glucose threshold in patients using the MiniMed Paradigm System is a big enough improvement for me. I guess its better than nothing but as its been said this is a first step.

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