Glucose Control: Artificial Pancreas

JDRF led efforts to bring the artificial pancreas systems to market. There is one system on the market now, and this is only the beginning. Future systems will be smaller, more automated and bring about tighter control, and we continue to develop faster insulins and better infusion sets to make the artificial pancreas systems even better and more user friendly.

The Leona M. and Harry B. Helmsley Charitable Trust and JDRF have announced a collaborative grant agreement to provide Tidepool, a California nonprofit software organization, with the initial funding it needs to begin developing Tidepool Loop, a hybrid closed loop automated insulin delivery app, for the iOS App Store as an FDA-regulated mobile application. Tidepool intends to deliver Tidepool Loop as an FDA-regulated app in the iOS App Store. Tidepool Loop is intended to work with multiple insulin pumps and continuous glucose monitoring devices.

The JDRF open protocol initiative was introduced in October 2017. This initiative will work to allow people with T1D to connect their preferred devices, even if made by different manufacturers. Now, there are nearly 10 organizations that are pursuing open protocol approaches. We are thrilled to see manufacturers moving to allow communications between different diabetes devices, which will provide people with diabetes more options, accelerate innovation and, most importantly, improve diabetes outcomes. And that the FDA is supporting this change as well. In early 2019, the FDA authorized the first interoperable insulin pump that can digitally interact with devices made by other manufacturers. The pump—the t:slim X2™ insulin pump by Tandem Diabetes Care, based in California. The FDA also created a new category for insulin pumps: alternate controller enabled (ACE) infusion pumps, and established criteria, called special controls, that outline requirements for future ACE insulin pumps to follow. Importantly, the new category of pumps will allow for more efficient patient access to such pumps in the future.

Glucose Control: Smart Insulin

Glucose-responsive insulins could be called a drug-based closed-loop system. These insulins will circulate through the bloodstream, turning on when they are needed and turning off when they are not. A rise in blood sugar will act as a biological trigger for the insulin to activate and as that blood sugar drops back into range, the insulin will deactivate. This will prevent highs and lows in blood sugar and significantly reduce the burden of daily management. A once daily shot would provide the necessary insulin and the need for glucose testing would be eliminated.

Ultra-Rapid insulins will be “fast-on, fast-off”, lowering blood sugar immediately after administration and not lingering in the body for hours. They will reduce meal-time blood sugar excursions and delayed post-meal hypoglycemia, and allow us to “close the loop” in artificial pancreas devices.

Complications

Many people also do not realize that T1D can have a lasting impact on the human body, leading to complications that include kidney and eyesight problems. We are working to preserve kidney function and eyesight with early intervention through: research to discover biomarkers that indicate the early stages of complications; by identifying T1D genes so that people at risk can take steps to intervene early in the disease process — and prevent complications; and by including people with T1D in clinical trials so that promising type 2 diabetes treatments extend to T1D.

Visit our blog next week to read our 2019 Mission Update Recap – Part 5: Research Update: Advocacy