Carolyn N. Kinder
The demand for better diabetes care products did not increase exceptionally until the results of the Diabetes Control and Complications Trial (DCCT were released in 1993.
6
This was a trial that showed tightly controlled insulin therapy delays the onset and progression of long-term complications, such as nerve damage and kidney failure, in individuals with type 1 diabetes.
7
As a result of the DCCT and other reports, diabetes care technology advanced rapidly throughout the 1990s. This included further advancements in insulin pump therapies, available types of insulin, and glucose monitoring systems.
8
New technologies have improved everyday life for people with type1 diabetes. Before modern insulin pumps, glucose meters and better forms of insulin were introduced, life was tremendously stressful for people with type 1diabetes. New technology has brought greater flexibility to what and how a person with Type1 diabetes can live. Today, advances in diabetes technology are responding to the hope for a life in which people with Type1diabetes don't have to constantly check blood glucose levels and give themselves insulin.
The most recently released glucose monitoring system, Medtronic MiniMed's Guardian RT, has a subcutaneous sensor to take readings from interstitial fluids.
9
The sensor sends readings to the monitor every five minutes--up to 228 a day--and these generate a continuous report of a patient's glucose levels. Instead of getting isolated readings a few times a day, people with diabetes can now view a continuous reading of their glucose levels, which allows them to intervene earlier and more effectively to prevent high and low emergencies.10
This latest advance in technology has scientists thinking about developing an artificial pancreas. An Artificial pancreas would combine two tasks: glucose sensing and insulin delivery through a closed loop system, thereby taking up the function of a human pancreas. A closed loop system has an implantable sensor, which is coupled to an implanted pump, which would deliver insulin in response to the monitor signal. A system, which combines an implantable glucose monitor with an implantable pump and associated controls, would be in effect, an artificial pancreas with potential for a dramatic impact on the health of diabetics, both Type 1 and those 40% of Type 2 who requires insulin injections.
11
The three interacting elements of a closed loop implantable artificial pancreas are: a glucose monitor which has a long life, a miniature pump which deliver precise quantities of insulin in response to the signal from the glucose monitor and a power supply and controller which provides the interface between the monitor and pump and also provide telemetered diagnostics of the system performances.
12
To date no implantable glucose monitor has been demonstrated with long life. This has been the principal obstacle to the development of an artificial pancreas.
13
Developing an artificial pancreas for people with type1diabetes would stop the constant pressure of worrying about controlling their glucose throughout the day. It would allow the freedom and flexibility for people to do anything they set out to accomplish because they can monitor themselves and control their blood sugar levels.
There are many insulin delivery devices. For example, insulin pumps are not the only way for diabetic to get the insulin into the body, insulin pens, continuous subcutaneous glucose sensors; new finger stick devices are convenient methods of insulin administration. The next section of this unit will address types of insulin delivery devices.