Artificial Pancreas News: DIYP, Bigfoot and Medtronic

#WeAreNotWaiting has become very well know in the diabetes data space. As I read about it, the next steps are slowly starting to come tantalizingly into view. Some even have hastags and Facebook pages. Others come from the usual suspects.

#DIYPS

Do It Yourself Pancreas System the fascinating collaboration of Dana Lewis & Scott Leibrand. A lovely couple if there ever was one. Their story is outlined at Median.com (1).  What is clear is their DIYPS is doable. Some folks wonder why hack your diabetes? Dana's 2¢ is, "I have to make about 300 decisions per day on average. It’s really fatiguing." Brilliantly understated Dana.

Having had the great pleasure of talking with them over the past year, doable was never in doubt.  It was more about about when. So my big question after reading the Median piece was simply, are they moving up the wedding date? Read it and see why.

Another piece that makes the connections from Nightscout to AP in Wired. (2) It goes from Nightscout to #DIYPS and then on to tease about Bigfoot.

There is a Bigfoot?

Bigfootbiomedical (3) is on Facebook where former JDRF leader Jeffrey Brewer is listed as CEO.  Some other very interesting folks, who are less public about it, are said to be working there as well. I trust they will confirm those rumors in their own good time. In the meanwhile Jeffery is playing a fun game of cat and mouse with Bigfoot on his Facebook timeline today.

Medtronic

It isn't only the home brew and startup crowd that are making strides. Medtronic has launched a next step with the MiniMed 640G (4). This new device shuts off insulin predictively. While that is an incremental step, it is a step. OK step / stride? You say potato..., it is somewhere in there. What is significant to me is progress. Medtronic will be sharing more about their next step their Hybrid Closed Loop system soon (do two steps make a stride?) It will be presented at the upcoming Advanced Technologies and Treatments for Diabetes (ATTD) 8th Annual Meeting being held at CNIT Paris La Defense from February 18-21, 2015 (5) At the last #MedtronicDAF, they said they were going to speed up bringing things to market. Seems they are. 

YDMV

All these are great news IMHO. Before somebody starts complaining about FDA, lets remember FDA approved the Medtronic 530G under their Artificial Pancreas guidance. Lots of folks complained that it wasn't an AP. OK you AP may vary - but FDA approved it as AP and that tells me they are looking to do just that. Well, OK. Also FDA flat to say they are looking to approve innovations under AP guidance. It may be a tad short of them saying, "Bring it on!" - So maybe the 530G is, as the saying goes, proof in the pudding.

To me this all matters because of Eggs and Baskets (6) in which I wrote:

I believe that better is better and perfect should not be the enemy of good. 

So I am all for advances in type 1 diabetes care that may fit into individual's life styles in a Your Diabetes May Vary kind of way. AP may work for some while GRI works better for others. I am fairly sure none of it will make diabetes care easy but it may be less hard and that's better.  

I support a diversified approach to making life better. There is a fable about putting eggs in more than one basket that explains modern portfolio theory better than most finance professors. 

YDMV, so should your AP options.



In case the links break:
(1) https://medium.com/access-matters/do-it-yourself-diabetes-bd1ea1adf034
(2) http://www.wired.com/2014/12/diabetes-patients-hacking-together-diy-bionic-pancreases/
(3) https://www.facebook.com/bigfootbiomed
(4) https://www.medtronic-diabetes.com.au/insulin-pumps/640g
(5) http://newsroom.medtronic.com/phoenix.zhtml?c=251324&p=irol-newsArticle&ID=2017567
(6) http://www.ydmv.net/2011/10/artificial-pancreas-and-egg-baskets.html

Sexy new AP from Medtronic.

That get you attention? Good.

Medtronic is starting to roll out their next step to AP in Australia, and it's got a new look

What's new other than the good looks? Predictive suspend aka it stops delivery of insulin when thinks you are gonna go low. Very groovy. Medtronic calls this "SmartGuard™." I call it another step along the path to better care. 

When the 530G rolled out with Low Glucose Suspend, there was a lot of chatter about calling it AP. A Rose by another name is still progress in my book, and I am excited to see both a new pump form factor and another step to AP come to market. 

Speaking of Roses: Spare A Rose is coming up soon. We all need to join in and help kids around the world who need a hand. Show some love this Valentines Day. 

source: http://multimediacapsule.thomsonone.com/medtronic/medtronic-launches-minimed-640g-system--breakthrough-in-artificial-pancreas-technology-outside-the-us

The Bionic P With Katie C

In case you missed it, Katie Couric has a great story on Ed Damiano.

Enjoy!


 

Medtronic LGS Approved!

Just saw a press release that Medtronic has FDA clearance for the 530G Low Glucose Suspend (LGS) system. This is good news. It is the first step on the path to AP.

LGS uses a sensor to stop delivering insulin when the system detects a low. That seem only logical.

Regular YDM readers may have seen these posts on LGS

Approval is good news. It shows FDA has figured out how to allow an innovative step to better diabetes management. Before people start quibbling about sensors sensitivity and perfection, let's remember that diabetes perfection is not possible. Better is.

This is a significant step to better.

Your Diabetes May Vary

The Bionic Woman. An Inside Peek at and AP Trial

I love finding and sharing a good piece in the DOC. Here is one, well five. The real life experience of being in an AP trial. Anna Floreen shares her recent chaperoned real world experience with an artificial pancreas system. Real wold meaning she was out and about and chaperoned meaning a nurse with teh study was stalking her as she was out and about.

Here are her posts at Glu:
Day 1
Day 2
Day 3
Day 4
Day 5

An AP by Any Other Name: Animas HHM

Artificial Pancreas is in the news again. This time the press release is from Animas. Yesterday the news was of an article in the New England Journal of Medicine.

Everyone's favorite bard said, "A Rose by any other name would smell as sweet." Sorry Bill,  I am beginning to think you were wrong.  I think the first steps of AP smell sweeter with different names.

My experience talking with other parents is that the term Artificial Pancreas is all wrapped up expectations of it doing what they really, really want. That is magically managing diabetes so well they don't need to worry about it. Being reasonably smart people, who are regularly frustrated by their child's diabetes varying in inexplicable ways, the discrepancies of life, liberty to eat and CGMs, they conclude that the present technology can't deliver that magic.

No kidding. It can't.

There is a whole bit on this in Forbes by David Kliff, Stretching The Truth About An Artificial Pancreas to which others and I replied.

Here is what matters to me as a dad of T1D kids - the NEJM article says the first steps of AP can lessen the number of hypos and keep kids in range longer. This is where the Animas release kicks in, remember the Animas press release? This is a story about the Animas press release.

In the Animas release they don't call it AP. Go ahead go read it. Search it for the word Artificial. It ain't there.

The story is about, "a first-generation closed loop insulin delivery system." I will give you that AFGCLIDS is no rose. They got that.  They call it HHM for Hypoglycemia-Hyperglycemia Minimizer. I would call it Hypblurglycimic Minimizing System. Then I would go for a whole Gilbert and Sullivan operetta - HMS Pancreas.  But I digress.

Like LGS (Low Glucose Suspend) the idea isn't to manage precisely to target. The goal is to help minimize bad sh*t from happening. Preventing bad sh*t, is a good thing.

Progress happens incrementally. Regulators are gonna be more comfortable regulating incrementally and payers will probably be more likely to pay if academia (see NEJM above) can show incrementally better outcomes and hopefully incremental savings in the reduction of expensive hospital visits.

Staying in range more means better long term outcomes. That may not be actually magic but it is a nice parlor trick.


Oh and my apologizes to centuries of British culture.

AP, aka LGS in NEJM

Artificial Pancreas with kids at camp is the topic of  New England Journal of Medicine article just out called, Nocturnal Glucose Control with an Artificial Pancreas at a Diabetes Camp. It looks like they used the Medtronic Veo.

It is a report testing AP outside of the hospital. Reader digest version: Kids had fewer lows and better control with AP.

http://www.nejm.org/doi/full/10.1056/NEJMoa1206881

News on LGS

Medtronic Receives IDE Approval to Conduct Aspire In-Home Study of First Insulin Pump with Low Glucose Suspend for US Market