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We already have automated continuous insulin injection pumps that work well. It's a big improvement over shots every few hours. But they still need manual setti

We already have automated continuous insulin injection pumps that work well. It's a big improvement over shots every few hours. But they still need manual setting of pump rate, based on manual periodic measurements. A noninvasive sensor that measures blood glucose accurately, even just once a minute, would give you the ability to close the feedback loop and remove all human input from the system. No "oh shit I forgot to measure and adjust". Especially for kids it would be a big breakthrough. In essence, you'd have an almost-perfect artificial pancreas.

jcims 10y ago
Medtronic released the first closed loop pump this year.
- zaroth 10y ago
  I'd say closed loop ish system. It uses the CGM data to make temp-basal adjustments. It's not like a full autopilot or anything. Since modern fast acting insulin still takes time to kick in, you need to dose to cover carbs about 15 minutes before eating. So there will always be some level of involvement of you want to avoid actually going high and then coming back down (proactive vs reactive). Don't get me wrong, it's great to know you're going to wake up at your target even if you screwed up your dinner-time bolus a bit. That is, assuming the CGM is functioning properly. My experience with the Dexcom G4 with my kids was much less than stellar. Lots of '???' readings or having it off by over 50 points, extremely painful insertions and being mostly useless the first 24 hours and then sensors failing long before 7 days was the norm and ultimately we abandoned it. Anxiously waiting for the auto-inserting CGM to come out of trials.
  - coldpie 10y ago
    That's too bad. I got my Dexcom about 18 months ago and while it's not perfect and very expensive, I really do miss it if I have to go a week without it. I can imagine having to use it on children would be pretty nasty, though. Putting the sensor in is not a fun time for a grown adult. You have multiple kids with T1D? That's a stroke of bad luck :(
  - zippergz 10y ago
    I wonder if kids are harder on the dexcom sensor or something? I have a family member with the G5, and it works well. Not perfect by any means, but a lot better than what you're describing.

jcims 10y ago

Medtronic released the first closed loop pump this year.

zaroth 10y ago
I'd say closed loop ish system. It uses the CGM data to make temp-basal adjustments. It's not like a full autopilot or anything. Since modern fast acting insulin still takes time to kick in, you need to dose to cover carbs about 15 minutes before eating. So there will always be some level of involvement of you want to avoid actually going high and then coming back down (proactive vs reactive). Don't get me wrong, it's great to know you're going to wake up at your target even if you screwed up your dinner-time bolus a bit. That is, assuming the CGM is functioning properly. My experience with the Dexcom G4 with my kids was much less than stellar. Lots of '???' readings or having it off by over 50 points, extremely painful insertions and being mostly useless the first 24 hours and then sensors failing long before 7 days was the norm and ultimately we abandoned it. Anxiously waiting for the auto-inserting CGM to come out of trials.
- coldpie 10y ago
  That's too bad. I got my Dexcom about 18 months ago and while it's not perfect and very expensive, I really do miss it if I have to go a week without it. I can imagine having to use it on children would be pretty nasty, though. Putting the sensor in is not a fun time for a grown adult. You have multiple kids with T1D? That's a stroke of bad luck :(
- zippergz 10y ago
  I wonder if kids are harder on the dexcom sensor or something? I have a family member with the G5, and it works well. Not perfect by any means, but a lot better than what you're describing.