So my "mole" who attended the Diabetes Technology Society meeting in Maryland last week got back to me, and the news was kind of disappointing. On the whole, it doesn't sound like there's anything particularly new under the sun for us PWDs at the moment; it's all about more baby steps in research and development.
But Aaron Kowalski, Research Director of the JDRF, might disagree with me there. He delivered a keynote address entitled "Accelerating the Availability of an Artificial Pancreas." (He even offered me a peek at this slideset, although he asked me not to publish them here because he's working on a paper about this topic right now.)
The upshot of his talk is summarized in a JDRF press release HERE.
He's essentially explaining that the Artificial Pancreas Project is proceeding on three different tracks:
1) The extensive JDRF Continuous Glucose Monitoring clinical trials, which are providing the necessary scientific evidence that CGM does in fact significantly improve diabetes control. (Trial participants who used the devices regularly — six days per week or more — saw a reduction in A1c levels, without an increase in hypoglycemia.)
2) JDRF's Artificial Pancreas Consortium, which is working to bring together scientists from multiple disciplines "to safely and effectively link blood sugar sensors with insulin delivery systems, using a sophisticated algorithm to ensure the device accurately mimics how a human pancreas does." That means the device should be able to sense glucose and deliver just the right amount of insulin, taking into account all the relevant variables including insulin sensitivity, exercise, stress levels, meal types and others.
3) JDRF's campaign to create partnerships with industry companies "to build artificial pancreas technologies and create a robust, competitive marketplace for them."
OK, No. 1 is great news. No. 2 sounds like a gargantuan challenge. And No. 3 — well, that'll be a slow incremental process that will depend a lot on further development in Numbers 1 and 2.
I know that we have come a long way in the last 10 years or so with diabetes technology, but people have been forecasting the closed-loop system for too long and there are too many obstacles to get too excited about "acceleration" just now, if you ask me.
Meanwhile, my mole tells me that there was a great deal of detailed discussion at the conference about the possibility of including glucagon in the closed-loop / artificial pancreas system: i.e. how to overcome the complexity of delivery? (Ooh, this is going to take a while.)
But what was new this year, my mole says, was the apparent consensus that "CGM technology is here to stay" — which was apparently not a foregone conclusion last year's event. Hmmm...
I also learned that Dr. David Klonoff, who heads the Diabetes Technology Society, gave another talk calling into question the value of self-monitoring of blood glucose (SMBG) for Type 2 diabetics. His take was apparently a little different, however. He states that the "human factors" of self-testing haven't been studied enough to give us a good overview of what's happening out there. There should be more focus on the behavior of both patients and caregivers, he claims. That I would have to agree with! The "behavior" side of things (otherwise known as "real life with diabetes") has been summarily ignored by conventional medicine for far too long.
So are we on the fast track to major changes in the way most people's diabetes is treated in this country? Probably not. But again, all progress is good, so stay tuned.