“After spending a wonderful weekend with my husband in D.C., I drove to Charlottesville, Virginia where the artificial pancreas study is taking place at the University of Virginia.  Last night when I arrived, I received a crash course on the use of the Roche insulin pump.  I’ve never seen this particular type of insulin pump but they are using it for this study because it has great blue tooth capabilities.  The pump does have a very nice remote glucose meter which talks via Bluetooth to the pump.

The artificial pancreas system is comprised of an android phone which has no phone or other app capabilities, a dexcom g4, and the Roche pump.  In order to explain how the system works, I think it is best to provide a bit of education for those of you unfamiliar with type 1 diabetes.  In my normal life, I wear an insulin pump which is designed to give 2 different forms of insulin.  The first is basal insulin.  The purpose of basal insulin is to keep your blood sugar in a normal range when not eating.  The human body’s blood sugar constantly fluctuates based on stress hormones, growth hormones, and the liver sending out glucose.  The “normal” human body responds by releasing insulin from the pancreas.  I have figured out how much insulin I need (my basal rates) for the various times of day.  For example, I need more insulin when I wake up in the morning because the adrenaline and cortisol that my body produces causes my blood sugars to rise.  The current system is not perfect for diabetics because every day is not the same, some days I am more stressed than others, some days I have a small cold and other days I am perfectly healthy, all of which affect blood sugars.  The second form of insulin I receive is called bolus insulin.  That insulin is used to turn the glucose from the food I eat into energy and to lower any high blood sugars.  My bolus rates are different in the morning versus night because my body uses my food differently.

This particular system I am testing is designed to automatically dose the basal insulin.  You still need to bolus and tell the pump an approximate estimate of carbs but the system is smarter than humans and gives recommended doses based on where blood sugars are predicted to go over the next several hours and how much insulin is still left in the system.  I was hooked up to the system at about 9:30 pm last night and we pressed the go button at 11:00.  When the go button was pressed, the algorithm within the phone took over all basals.  My normal basal rates were not even considered, instead the very smart people here at the University of Virginia created these fantastic algorithms that will use information such as how much insulin I have on board and the direction in which my blood sugar is predicted to go over the next several hours to automatically adjust my basal rates.

For example, last night I was sitting at about 81 and slowly rose to low 90s.  However, the algorithm then predicted I was going to head low so it started to decrease the amount of insulin I was given and then eventually stopped giving me insulin for quite a while.  My blood sugar rose back up to the 150s from the lack of insulin and a bit of counter regulatory hormones from a low blood sugar at about 8:30 (again, this is experimental so they are learning from me and hope to improve the algorithm to avoid that small spike) but the algorithm brought me down to a nice 103 where I stayed for the rest of the night.  I woke up feeling fantastic and never went low during the night.  If I was at home, I would have gone low during the night and would have needed to scarf down some glucose tablets and woken up with a chalky mouth.  This system avoided that low.

The people here at the University of Virginia are very smart, friendly fantastic people.  I have learned a lot in the 12 hours that I have been here and look forward to sharing more information with you about how the system performs and where the folks here see this system heading over the next couple of years.”

It was surreal to hold the future of diabetes care in my hands last night and for the first time in 24 years I gave up control to a computer….

For more from Melissa on the functions of the artificial pancreas click HERE.

For more information on the artificial pancreas project, check out the following links:

https://www.jdrf.org/blog/2013/the-artificial-pancreas-does-its-homework

http://artificialpancreasproject.com

http://news.virginia.edu/content/uva-s-artificial-pancreas-project-receives-34-million-grant