Keeping the Big Picture in Sight

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I’ve put more trust into the closed-loop artificial pancreas (AP) system. I typically have a low carb diet and am not a huge dessert eater. This week, it seems I have consistently picked the most carb-filled item on the menu on top of dessert and a sugary beverage at almost every meal. The fourth day of my trial I had a beef brisket sandwich for lunch… the brisket was layered between TWO grilled cheeses!!! Why did I do this? Because I could!! During those five days, I never tired of watching my sugar levels stay in a straight line around 120–145, both during and hours after my gluttonous meals! My final dinner while on the CGM consisted of Italian cheeses and prosciutto, pasta carbonara (and I typically don’t “do pasta”), and apple cinnamon sugar donuts with a vanilla bean sauce. I also strategically had my mom order the ice cream Sunday so that I could get some of that, too! Go big or go home!

At the end of the trial, I participated in a focus group about the study. I was asked questions about what I liked, didn’t like and wanted to tweak about the closed-loop system. At one point I was asked, “If you could take the system with you today, would you?” For some reason that caught me off guard; I was so busy critiquing the device during the trial and trying to come up with good feedback for the team that I lost sight of the “big picture.”

photo-kady-icecreamFlash forward to being at work on Monday morning… I was back on my usual CGM and pump regimen. It was around 11:30 a.m. when it dawned on me that I needed to check my CGM and my sugar levels and decide whether I needed insulin or not. After five days on the system, I needed to actively get back in the habit of micromanaging my diabetes—and it was frustrating!!

I was expecting some huge life-altering experience of feeling like I had no diabetes during the trial. Once I started it and saw that I still went over 160 with the system, I got discouraged and immediately ignored my pre-trial expectations. It wasn’t until I was without the AP system that I understood what a mental burden had been lifted. It was such a treat to have something monitoring my sugar levels every five minutes and reacting to it. I only really had to focus on T1D at mealtimes. I knew that in between my meals the AP system was doing the work for me and keeping me in range. Sure, I still have a CGM that tells me my sugar levels, but I can’t check that every five minutes and make miniscule adjustments. The AP system gave me back time during the day and took away my worry about the “diabetes rollercoaster” of highs and lows.

Do I think this system is safe? 100 percent. It was frustrating how sometimes I would get kicked out of closed loop (the machine would sound an alarm and automatically put me back on my regular basal rate) if the sensor reading was off from my actual blood glucose. If I could change anything, I wanted the system to be allowed to give me MORE insulin! I never had one low, not one time below 70 during my trial. I am used to having to restock my purse with gummies or juice boxes, and it was noticeable that I didn’t have to during the trial. I loved it because I was cutting out roughly 200 needless calories a day from treating lows.

I am so looking forward to having this technology in the market and in MY hands!!! It was encouraging to see how far the system has come since I participated in “in-hospital” closed-loop studies years ago. I know it can be frustrating to wait for FDA approval, but the algorithms that make this device so smart are still being perfected, and I wouldn’t want something that wasn’t the best it could be on the market yet. I also know that when this is available that the sensor technology will be more accurate, and pump sites and sensor sites will become better and last longer. Even more exciting is that the next round of this trial won’t have the cellphone and transmitter— all of that information will be present in the pump—so there will be only one device instead of keeping track of three. There are many pieces to this puzzle, and I couldn’t have been happier to be a part of pushing the research forward!

Clinical Trials Connection is an online service that allows you to “opt-in” to get information about trials, and access to them. It contains information about all currently active diabetes trials in the U.S and U.K. Based on the criteria you choose, the connection provides you with information about selected trials and how to contact the researchers conducting them. You can also choose to receive regular updates so that you’ll know when new trials that meet your criteria become available. If you find a trial that interests you, you can discuss it with your doctor and also contact the trial’s primary investigator with any questions or concerns.

Read Kady’s previous blog post

By Kady Helme