Mr. Tom Brobson is the guy everyone wants to hear talk these days about diabetes technology.
As the JDRF's national director of research investment opportunities, Tom's one of the most sought-after speakers at the moment because he's able to not only give an overview of the latest exciting D-tech, but also share his own personal experiences as one of the first people ever to wear an Artificial Pancreas system over a prolonged period of time.
Yes, this 54-year-old from Virginia is a fellow PWD (person with diabetes) diagnosed a decade ago in his mid-40s, and he's an OmniPod and Dexcom G4 user. Over the past several years, Tom's been participating in various Artificial Pancreas Project clinical trials at the University of Virginia -- from the very first studies in 2007 and 2009 to his latest in December 2012.
Tom's been touring the country since then and has visited 50+ of the JDRF's 100+ chapters since early 2013, on the move almost non-stop to tell his story and get PWDs, families and potential donors excited about the state of AP affairs and related research projects. We've unofficially dubbed this effort "The Artificial Pancreas Roadshow."
Last week, I had the chance to see Tom when he visited the JDRF Indiana chapter to address about 80 people about his AP trials and what he's been up to since our January 2012 Q&A interview with him here at the 'Mine.
One of the biggest changes is taking on the new role of national investment opp director beginning in April 2012. But he says that in reality, his "big task is mostly the same" since joining the JDRF in 2005: working to translate the organization's research and scientific updates into language the D-Community can understand.
"Real-person-speak is one of my bugaboos," he says. "It's tough for 99.9% of folks to understand the complexities of what JDRF is doing, and... I've always been interested in helping all of us with type 1 understand. JDRF hasn't always been good at that, because it's easier to communicate about research and science in ways that people don't connect with. So that's where I come in. There are no initials or letters after my name; I'm just a T1D, and that's all I need."
Through the wonders of blogs and online videos, Tom's been able to share his story far and wide. But hearing him talk in person and chatting face-to-face was a treat, especially seeing his face light up when talking about all the cool advancements in the works.
Of course, the main attraction for many is hearing Tom talk about his first-hand views of these developing AP projects. As noted, he's been involved in three AP trials, all at the University of Virginia where his endo, Dr. Stacey Anderson, is based. That particular AP project includes modified Android smartphones that are wirelessly connected to Dexcom CGMs and the OmniPod, and is led by Dr. Bruce Buckingham of Stanford and UVA's Drs. Anderson and Sue Brown. Since Tom began in the project about seven years ago, he says there have been a lot of changes -- the most significant being the fact that they've moved out of the clinical setting and into the real world.
"We've come a long way, even in just the past two years. I was told the other day that they've made the (combination) device more snazzy, so what I've been using and carrying around in demo mode will go into the AP museum soon," he said.
I found it interesting during his Indy talk about how Tom sees this AP development as one of the many chapters in the book of Diabetes Treatment history, starting back with the discovery of insulin in the 1920s. He thinks we're at the halfway point now, and with all the powerful technology, mobile health tools and connectivity available now, it really comes down to how quickly we will move forward.
Check out Tom sharing his story about the last trial he participated in during Dec. 2012:
This widely-popular video has garnered more than 18,000 views, and Tom tells bits and pieces about that same experience during his talks on the road, including one of the most-shared nuggets of how he was able to go to a Five Guys burger joint and eat a cheeseburger and fries -- along with an ice cream sundae -- without worry, and not hit above 155 mg/dL after that meal! And I had to smile at the quip Tom shared: even with the AP on him, he couldn't bring himself to eat all the fries because "I just couldn't do that to my blood sugars." :)
Of course, the whole audience "wowed" (as did I) when Tom said the night after eating that meal, he stayed level overnight and woke up to the same 100 mg/dL he'd gone to bed with. Something all of us PWDs long for!
While Tom's no longer actively connected to the AP smartphone device, he carries it around in demo mode and shows it during his talks -- and sometimes has to remind PWDs and D-Parents that the beeping for low blood sugars isn't actually happening in real-time, so there's no need for anyone to fetch him glucose tabs or juice.
Tom pointed out that when he's on the road talking about the AP, young kids are often most excited about how they'd get a smartphone if the AP was available. He laughs and often responds, "Yeah, but you can't play 'Angry Birds' on it."
Tom's a great showman because, as he did in Indy, he never uses a scripted speech but rather lets the audience ask questions from the start and thus dictate where they want to go with the discussion.
"I run through much of what we see from the JDRF now, and the researchers voices run through a lot of what I say," he said. "The big thing for people to know is what the advances are, and to see that it's changeable and real, and that their investments in the long haul are what's driving all of this."
Right. We have to keep in mind that along with all the PWD insight and firsthand experience that's totally exciting, there's a marketing side to all of this; Tom does work for the JDRF, after all, and he's focused on donors and investments.
In just the past two years, Tom says he's seen a lot more adult PWDs take an interest in JDRF since the organization has phased out the word "juvenile" from its name and made it clear that kids aren't their only focus -- and that better treatment and options for the here and now are a part of the JDRF's focus, on the way to a cure.
"I've noticed a huge shift in responses from people, recognizing that this is about all of us and... seeing progress that we can actually touch and hold in our hands," he said. "People are coming out of their skins and looking for news about real activity, and I get my energy from that."
FDA & Commercialization
Also of note in just the past year or so: the FDA issuing final guidance on the AP in late 2012, more talk about that technology at the ADA's Scientific Sessions in 2013, and the FDA approval last fall of the Medtronic 530G that has automatic insulin shutoff and is a first step on the path to an Artificial Pancreas. All of those have fueled interest from the broader D-Community as well as donors.
Tom encourages PWDs to get involved in the many feeder trials happening now -- small trials of 3 days and 2 nights, all leading up to a longer two-month trial and the eventual "pivotal" studies that will involve several hundred patients for at least six months. There's no timeline on when that will begin, but if the FDA moves quickly, it could materialize by sometime in early 2015.
Meanwhile, a lot of questions remain about how the commercialization side of the AP will materialize as these various systems are being developed. Especially with multiple D-device companies that don't always play well with each other when it comes to integration and data connectivity.
"The FDA's worst nightmare would be to have 300 versions of the Artificial Pancreas," Tom said.
As regulators explore interoperability standards and the D-device industry navigates that world, Tom is looking forward to seeing what comes from that for PWDs.
"There's nothing simple about this coming to fruition in commercialization," he said. "There are so many things that haven't been done before."
Of course, when he's on the road, Tom also has to keep in mind that some people are wary of the JDRF's focus on these tech-heavy studies. "The AP isn't a cure, but it gave me a glimpse of what the cure would be like," he said. "For me, that's not thinking about diabetes anymore!"
Being able to witness this "Artificial Pancreas Roadshow" gave me personally a lot of hope as to how far treatment for our D-Community has come, and where it's going, on this open road.