5 ms·

Wearable device senses blood glucose and administers insulin accordingly

63 points by sohkamyung 5y ago

labster 5y ago
News story, 2028: Insulin implant users get painfully hot arm as hackers mine cryptocurrency
Quatih 5y ago
I'd recommend anyone with type 1 diabetes (or type 2) to read Dr. Bernstein’s Diabetes Solution. http://www.diabetes-book.com/ http://www.diabetes-book.com/
ohiovr 5y ago
It doesn't make insulin. Not a replacement for the pancreas yet. Insulin is a fantastically complicated molecule and costly to life to make. Cells in the pancreas have to be doubly sensitive to glucose. They have to make insulin from sensing glucose, and they are more easily damaged by glucose. https://en.wikipedia.org/wiki/Insulin_(medication) https://en.wikipedia.org/wiki/Insulin_(medication) For now it takes the sacrifice of many animals to satisfy a diabetic. What is needed is barley bread. And other famine foods.
- triclops200 5y ago
  We don't generally use harvested insulin anymore. The vast majority of insulin uses recombinant production (modify yeast and bacteria to produce insulin). So, no, it doesn't "take the sacrifice of many animals to satisfy the diabetic." Also, as a personal note who's spouse has both types of diabetes, "famine food" does not work for all diabetics, and is considered dangerous quakery by a lot of people.
- guywhocodes 5y ago
  Insulin from animals have not been used for human injections in like 4 decades. We use synthetic insulin-like proteins these days. And they are produced typically by modified e-coli. This product does not produce insulin, like other insulin pumps it contains a reservoir of it.
  - GekkePrutser 5y ago
    Lol I had heard it was made by bacteria but not that that was e. coli :) It's weird to know that something we inject to save lives comes from poop :P And a bacteria that can actually cause severe illness itself! I wonder why they picked that specific bacteria? Maybe because it's one of the first known to man and as a result we know so much about it?
    - guywhocodes 5y ago
      I don't think the process was developed specifically for insulin production but rather arbitrary protein synthesis. And we just applied existing technology to insulin production. Anyway this was like mid 70s so there probably were no options. Edit: I don't know anything about the benefits or issues with using e-coli specifically.
    - mattkrause 5y ago
      E. coli is a very common model organism for molecular biology and a really popular tool for generating synthetic proteins. (Yeast too). Bacteria have a neat feature where, in addition to their "main" chromosomal DNA, they also have small circular "loops" of DNA called plasmids that can be copied independently. In 1973, Cohen and Boyer demonstrated that one could "cut" a piece of DNA from one source, insert it into an E. coli plasmid, and then coax the cells into producing the protein coded for by the edited gene. This trick lets you generate "heterologous proteins" by purifying them from the cells or can change how the cell behaves. E coli. can't make every kind of proteins, but they can make a lot of them. It's also cheap and easy to grow, so it's often the "default" approach.
- ohiovr 5y ago
  Okay. Then why does it cost a fortune to get in the USA? Its just as simple as brewing wine is it? Well. I have my doubts.
  - triclops200 5y ago
    Pharmaceutical monopolies over the best production methods and the laborious process of getting production approval by the government makes upfront cost of new competition incredibly high. Thus, a couple companies control the entire supply and can choose price. It genuinely costs almost nothing to produce and there are hacker communities around doing it at home, because it's genuinely that easy.
  - UnpossibleJim 5y ago
    |Okay. Then why does it cost a fortune to get in the USA? Its just as simple as brewing wine is it? Well. I have my doubts.| Genetically modifying yeast to produce insulin is a little more difficult than brewing wine. Seriously, what are you on about? They haven't harvested insulin from animals since 1998. That's the last you could get it. They started using it in 1978... all that was a 2 minute Google search.
  - happy_path 5y ago
    The question could be why does it cost a fortune to get in the USA while it is paid by taxes in other countries?
idontwantthis 5y ago
“Artificial pancreas” = “Full Self Driving”? It offers guidance on insulin injection amounts. It doesn’t make insulin and doesn’t do any of the many other critical functions of the pancreas.
- guywhocodes 5y ago
  Yeah sadly that is what the marketing term means. Personally my bar would be fully automatic and insulin and glucagon at a a minimum.
  - jaggederest 5y ago
    Interesting, I didn't know that Type 1 diabetes involved impaired glucagon regulation as well - the beta cells only really produce insulin and amylin, but from reading the wiki briefly there are knock-on effects in other areas. Cool stuff, hopefully the technology continues to improve and produce something resembling a true artificial pancreas soon, or maybe beta cell regeneration therapies.
    - porknubbins 5y ago
      I believe diabetics can mostly only raise their blood sugar by eating, or accidentally by other mechanisms such as high intensity exercise causing adrenaline spikes. Type 1 diabetes would be a much less serious disease if you didn’t have to maintain a narrow range of blood sugar between the Scylla and Caribdis of unconsciousness due to lows and organ damage due to highs.
    - guywhocodes 5y ago
      My understanding is that it's not as total as insulin deficiency and of course that the function is not as critical has caused it to go largely unnoticed.
      - jaggederest 5y ago
        Yeah for sure, I certainly didn't know about it, and I've been an interested observer of the technology around diabetes for a while.
whyage 5y ago
While the article is thorough and covers the topic well, these devices have been available to diabetes patients for years. Not sure what makes it newsworthy.
gabroo 5y ago
I'm a type 1 diabetic. None of the examples mentioned truly replace the endocrine functions of the pancreas lost in the disease progression. They do, however, use a sensor that measures blood glucose (fairly accurately) and a controller that estimates how much insulin to give (very crudely). Maybe this seems unintuitive, but the bottleneck of these systems is not the hardware or the control algorithm, but rather the time it takes for the insulin to start "working" once injected. In a normal situation, the pancreas secretes insulin directly into the hepatic portal vein and reaches peak concentration within minutes. When you inject insulin, depending on how good ($$$) it is, it can take anywhere from 2-4 hours to peak [1]. In technical terms, you have a closed loop controller with a very slow actuator, which severely limits how tight the control can be. There is ongoing work to make faster insulins. But personally, I think the "cure" for type 1 diabetes will come from restoring the insulin-producing capabilities of pancreatic islets, or synthetically adding such capabilities to other highly vascularized tissues. Also worth checking out is Tidepool, an organization trying to take an open source closed loop controller through FDA submission. https://www.tidepool.org/automated-insulin-dosing https://www.tidepool.org/automated-insulin-dosing [1] https://images.squarespace-cdn.com/content/v1/5b7c64af620b85f7900691ed/1536679717267-QERDYTZUVY6IL7PGCKHE/blog3+4.png https://images.squarespace-cdn.com/content/v1/5b7c64af620b85...
- andreareina 5y ago
  Do we know approximately why synthetic insulin is that slow, e.g. is it the delivery mechanism or is it the formulation?
  - micro_cam 5y ago
    Delivery I believe, it takes a while to get absorbed from where you inject it and spread around. You can speed this up by exercising the area it was injected into or even a hot shower to increase blood flow. There is also a new faster acting inhaled insulin, afrezza, but that won't work with the pumps discussed here.
- sgt101 5y ago
  My daughter has the cambridge (CamAPS) one : https://camdiab.com/ https://camdiab.com/ My understanding is that it has a predictive algorithm based on what it's learned about the response of the user. Also we work out carbs and put them into the device 20 minutes before meals so that it can pre-dose. Another advantage is the minute to minute monitoring providing data that allows us to understand how well she is doing and what we need to do to improve her levels.
jimrandomh 5y ago
I'm a type 1 diabetic; I use OpenAPS, an open-source DIY system that does this, and have made some code contributions to it. So what this article is talking about is, basically, taking the thing DIYers are already doing, and making a more foolproof, FDA-approval-grade version. And I'm sure they're massively better in terms of how fiddly they are to set up and get working, but the end result is actually worse; they wind up not including features like autotune (which auto-adjusts basals and carb ratio based on historical data), because there's less risk of liability if they make doctors do the tuning, even if the doctor is only looking at the patient's data once every six months and is doing a poor by-eye approximation of what the algorithm does.
rStar 5y ago
i can’t wait till people start getting their internal organs hacked. and they still don’t care about privacy and operational security, and they are still buying their kids iot devices for christmas.

63 points by sohkamyung 5y ago

News story, 2028: Insulin implant users get painfully hot arm as hackers mine cryptocurrency

I'd recommend anyone with type 1 diabetes (or type 2) to read Dr. Bernstein’s Diabetes Solution. http://www.diabetes-book.com/ http://www.diabetes-book.com/

ohiovr 5y ago

It doesn't make insulin. Not a replacement for the pancreas yet. Insulin is a fantastically complicated molecule and costly to life to make. Cells in the pancreas have to be doubly sensitive to glucose. They have to make insulin from sensing glucose, and they are more easily damaged by glucose. https://en.wikipedia.org/wiki/Insulin_(medication) https://en.wikipedia.org/wiki/Insulin_(medication) For now it takes the sacrifice of many animals to satisfy a diabetic. What is needed is barley bread. And other famine foods.

triclops200 5y ago
We don't generally use harvested insulin anymore. The vast majority of insulin uses recombinant production (modify yeast and bacteria to produce insulin). So, no, it doesn't "take the sacrifice of many animals to satisfy the diabetic." Also, as a personal note who's spouse has both types of diabetes, "famine food" does not work for all diabetics, and is considered dangerous quakery by a lot of people.
guywhocodes 5y ago
Insulin from animals have not been used for human injections in like 4 decades. We use synthetic insulin-like proteins these days. And they are produced typically by modified e-coli. This product does not produce insulin, like other insulin pumps it contains a reservoir of it.
- GekkePrutser 5y ago
  Lol I had heard it was made by bacteria but not that that was e. coli :) It's weird to know that something we inject to save lives comes from poop :P And a bacteria that can actually cause severe illness itself! I wonder why they picked that specific bacteria? Maybe because it's one of the first known to man and as a result we know so much about it?
  - guywhocodes 5y ago
    I don't think the process was developed specifically for insulin production but rather arbitrary protein synthesis. And we just applied existing technology to insulin production. Anyway this was like mid 70s so there probably were no options. Edit: I don't know anything about the benefits or issues with using e-coli specifically.
  - mattkrause 5y ago
    E. coli is a very common model organism for molecular biology and a really popular tool for generating synthetic proteins. (Yeast too). Bacteria have a neat feature where, in addition to their "main" chromosomal DNA, they also have small circular "loops" of DNA called plasmids that can be copied independently. In 1973, Cohen and Boyer demonstrated that one could "cut" a piece of DNA from one source, insert it into an E. coli plasmid, and then coax the cells into producing the protein coded for by the edited gene. This trick lets you generate "heterologous proteins" by purifying them from the cells or can change how the cell behaves. E coli. can't make every kind of proteins, but they can make a lot of them. It's also cheap and easy to grow, so it's often the "default" approach.
ohiovr 5y ago
Okay. Then why does it cost a fortune to get in the USA? Its just as simple as brewing wine is it? Well. I have my doubts.
- triclops200 5y ago
  Pharmaceutical monopolies over the best production methods and the laborious process of getting production approval by the government makes upfront cost of new competition incredibly high. Thus, a couple companies control the entire supply and can choose price. It genuinely costs almost nothing to produce and there are hacker communities around doing it at home, because it's genuinely that easy.
- UnpossibleJim 5y ago
  |Okay. Then why does it cost a fortune to get in the USA? Its just as simple as brewing wine is it? Well. I have my doubts.| Genetically modifying yeast to produce insulin is a little more difficult than brewing wine. Seriously, what are you on about? They haven't harvested insulin from animals since 1998. That's the last you could get it. They started using it in 1978... all that was a 2 minute Google search.
- happy_path 5y ago
  The question could be why does it cost a fortune to get in the USA while it is paid by taxes in other countries?

idontwantthis 5y ago

“Artificial pancreas” = “Full Self Driving”? It offers guidance on insulin injection amounts. It doesn’t make insulin and doesn’t do any of the many other critical functions of the pancreas.

guywhocodes 5y ago
Yeah sadly that is what the marketing term means. Personally my bar would be fully automatic and insulin and glucagon at a a minimum.
- jaggederest 5y ago
  Interesting, I didn't know that Type 1 diabetes involved impaired glucagon regulation as well - the beta cells only really produce insulin and amylin, but from reading the wiki briefly there are knock-on effects in other areas. Cool stuff, hopefully the technology continues to improve and produce something resembling a true artificial pancreas soon, or maybe beta cell regeneration therapies.
  - porknubbins 5y ago
    I believe diabetics can mostly only raise their blood sugar by eating, or accidentally by other mechanisms such as high intensity exercise causing adrenaline spikes. Type 1 diabetes would be a much less serious disease if you didn’t have to maintain a narrow range of blood sugar between the Scylla and Caribdis of unconsciousness due to lows and organ damage due to highs.
  - guywhocodes 5y ago
    My understanding is that it's not as total as insulin deficiency and of course that the function is not as critical has caused it to go largely unnoticed.
    - jaggederest 5y ago
      Yeah for sure, I certainly didn't know about it, and I've been an interested observer of the technology around diabetes for a while.

whyage 5y ago

While the article is thorough and covers the topic well, these devices have been available to diabetes patients for years. Not sure what makes it newsworthy.

gabroo 5y ago

I'm a type 1 diabetic. None of the examples mentioned truly replace the endocrine functions of the pancreas lost in the disease progression. They do, however, use a sensor that measures blood glucose (fairly accurately) and a controller that estimates how much insulin to give (very crudely). Maybe this seems unintuitive, but the bottleneck of these systems is not the hardware or the control algorithm, but rather the time it takes for the insulin to start "working" once injected. In a normal situation, the pancreas secretes insulin directly into the hepatic portal vein and reaches peak concentration within minutes. When you inject insulin, depending on how good ($$$) it is, it can take anywhere from 2-4 hours to peak [1]. In technical terms, you have a closed loop controller with a very slow actuator, which severely limits how tight the control can be. There is ongoing work to make faster insulins. But personally, I think the "cure" for type 1 diabetes will come from restoring the insulin-producing capabilities of pancreatic islets, or synthetically adding such capabilities to other highly vascularized tissues. Also worth checking out is Tidepool, an organization trying to take an open source closed loop controller through FDA submission. https://www.tidepool.org/automated-insulin-dosing https://www.tidepool.org/automated-insulin-dosing [1] https://images.squarespace-cdn.com/content/v1/5b7c64af620b85f7900691ed/1536679717267-QERDYTZUVY6IL7PGCKHE/blog3+4.png https://images.squarespace-cdn.com/content/v1/5b7c64af620b85...

andreareina 5y ago
Do we know approximately why synthetic insulin is that slow, e.g. is it the delivery mechanism or is it the formulation?
- micro_cam 5y ago
  Delivery I believe, it takes a while to get absorbed from where you inject it and spread around. You can speed this up by exercising the area it was injected into or even a hot shower to increase blood flow. There is also a new faster acting inhaled insulin, afrezza, but that won't work with the pumps discussed here.
sgt101 5y ago
My daughter has the cambridge (CamAPS) one : https://camdiab.com/ https://camdiab.com/ My understanding is that it has a predictive algorithm based on what it's learned about the response of the user. Also we work out carbs and put them into the device 20 minutes before meals so that it can pre-dose. Another advantage is the minute to minute monitoring providing data that allows us to understand how well she is doing and what we need to do to improve her levels.

jimrandomh 5y ago

I'm a type 1 diabetic; I use OpenAPS, an open-source DIY system that does this, and have made some code contributions to it. So what this article is talking about is, basically, taking the thing DIYers are already doing, and making a more foolproof, FDA-approval-grade version. And I'm sure they're massively better in terms of how fiddly they are to set up and get working, but the end result is actually worse; they wind up not including features like autotune (which auto-adjusts basals and carb ratio based on historical data), because there's less risk of liability if they make doctors do the tuning, even if the doctor is only looking at the patient's data once every six months and is doing a poor by-eye approximation of what the algorithm does.

rStar 5y ago

i can’t wait till people start getting their internal organs hacked. and they still don’t care about privacy and operational security, and they are still buying their kids iot devices for christmas.