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Will improved glucagon help the artificial pancreas?
July 17th, 2012
Recently I was quoted in an article in The Oregonian about a method developed at the Oregon Health & Science University to improve the artificial pancreas (an insulin pump regulated by a glucose sensor). Here is a link.
The basic problem the researchers addressed is a serious one, and they made a substantial improvement. I used to keep glucagon in my refrigerator, right next to the insulin. I used it once. It came freeze-dried and had to be reconstituted by adding saline water. Once reconstituted it is unstable, losing its efficacy in hours. And this is that the OHSU lactate idea solves (see the article for details).
But although clever, it does not address the core issue, which I have discussed before. In summary, when you combine the sensor delay, sensor unreliability, and the slow activity of even the most rapid insulin, the artificial pancreas device can never keep up with any patient who eats. And that’s almost all of us.
Adding glucagon to save yourself if the artificial pancreas overdoses the insulin is a Rube Goldberg solution. I just don’t buy that it will significantly help many people.
I think we need to go with Islet Sheet implants or a radically reimagined artificial pancreas.
Mr. King I agree with you. I just do not see the AP as a practical solution. I to believe the islet sheet is the closes thing we will get a to solution. Working in IT I see how many times machines fail. Also the human element is still there as I would constantly be worried about the numbers being correct from both the CGM and if the AP giving the correct amount of insulin. I would not like my daughter have an AP but islet sheet yes. Worse case scenario the sheet stops working you will know pretty soon as I am assuming the symptom of diabetes would manifest itself again. But with the AP who know what will happen with a malfunction.
I am anxiously looking forward to the animal studies having been completed and human trials starting in 2013. Our girl has had Type 1 for 7.5 years now, dx’d at 8. I am keeping an eye on LCT, Sernova Corp. and your technology. LCT’s data seems encouraging but does not seem as if it will lead to a cure, just aid in euglycemia. I am wondering if that is because LCT uses less islets than you will be using or a problem with the delivery system, using alginate as coating for the islets, which breaks down easily. I have great hopes for Sernova and would have even greater hopes if Dr. Valdes was part of the Sernova team (they are building on his research, or copying it, just seem to be changing the implantation device). Because of the large number of islets used, if the sheet is viable, I believe you have great chance of success. I am hoping for, but do not really believe, there will be no obstacles and the islet sheet will work well the first time. There are always obstacles that crop up that you don’t expect. Having Type 1 yourself for so many years, I know that you will press on, no matter what setbacks you encounter. This is the cure I have been praying for; I cannot trust her life to some machine that could malfunctiion…. the artificial pancreas would have to allow more human input for me to trust it completely.