Trust me, I'm a doctor BBC2

[Northerner]

I have been informed that JDRF funded Dr Roman Hovorka will be on BBC2 at 20.30 tonight, discussing the artificial pancreas 🙂

http://www.bbc.co.uk/programmes/articles/1KYpXw7078xsp5Lb8518Znt/artificial-pancreas

 

[HOBIE]

Timer set. Thanks Northy 🙂

 

[Lucy Honeychurch]

I'm watching 🙂

 

[HOBIE]

!st part of prog not good But. A MEDTRONIC pump, Mobile phone & a sensor BANG An Pancras ? 😎 "Tech is getting better"

 

[trophywench]

Conversely I thought it was really interesting that carbonated drinks increase Grelin production and hence make you hungrier than when you drink 'still' drinks. Didn't need to know this but it's still interesting!

The artificial pancreas was interesting of course but I can't see they will pay for the CGMS for everyone even though with the interaction between it and the pump delivery of insulin as and when, we'd certainly all benefit and presumably potentially be able to cost the NHS less in future.

However - couldn't see where he was entering the carbs etc - was that the pump, is the bolus wizard on the pump itself with a Medtronic?

 

[mikeyB]

It responds to the measured BG. Normal human beings don’t enter the carbs for each meal. That’s why it’s called an artificial pancreas.

 

[Robin]

It responds to the measured BG. Normal human beings don’t enter the carbs for each meal. That’s why it’s called an artificial pancreas.

In that case, why was he weighing his potatoes? I don't think it's a fully artificial pancreas yet. Yes, it can learn to predict your dawn phenomenon. But with all the clever algorithms in the world, it still doesn't know that you're about to eat a load of fast carb, and artificial insulin is still too slow acting for it to be able to react fast enough when it senses your blood sugar rising after a meal. So it must have a manual override.

 

[Mrsbairdo]

Conversely I thought it was really interesting that carbonated drinks increase Grelin production and hence make you hungrier than when you drink 'still' drinks. Didn't need to know this but it's still interesting!

The artificial pancreas was interesting of course but I can't see they will pay for the CGMS for everyone even though with the interaction between it and the pump delivery of insulin as and when, we'd certainly all benefit and presumably potentially be able to cost the NHS less in future.

However - couldn't see where he was entering the carbs etc - was that the pump, is the bolus wizard on the pump itself with a Medtronic?

Hi Jenny, He puts the carbs into his pump and the bolus wizard is on the pump, it’s a Medtronic MiniMed 640. The algorithm which links with the sensor and delivers extra insulin controls is on a Samsung Galaxy phone, but it can’t be used as a mobile phone or for anything else. So it’s an extra device to carry at the moment, they’re talking about developing a pump which includes the algorithm (I think one exists in America?) He’s doing really well on the closed loop and keeping good control thanks to the technology.
Helen (James’ Mum)

 

[Lucy Honeychurch]

I wonder how many of us would be successful if we were to try and acquire this entire system. I'm going with zero!

 

[Mrsbairdo]

In that case, why was he weighing his potatoes? I don't think it's a fully artificial pancreas yet. Yes, it can learn to predict your dawn phenomenon. But with all the clever algorithms in the world, it still doesn't know that you're about to eat a load of fast carb, and artificial insulin is still too slow acting for it to be able to react fast enough when it senses your blood sugar rising after a meal. So it must have a manual override.

You’re right, it can’t predict carbs, so he does have to enter everything he eats manually as any other pump user does. As you say it predicts times during the day when he is going high (like early mornings) and it gives extra insulin based on these patterns and his CGM readings. It’s not a fully artificial pancreas but it is really helping control his glucose levels, his Hbc1a and he’s doing really well with it.
Helen (James’ Mum)

 

[Lucy Honeychurch]

Sorry I meant to add funded by NHS & CCG 's. I can't even get pump therapy!

 

[Robin]

Hi Jenny, He puts the carbs into his pump and the bolus wizard is on the pump, it’s a Medtronic MiniMed 640. The algorithm which links with the sensor and delivers extra insulin controls is on a Samsung Galaxy phone, but it can’t be used as a mobile phone or for anything else. So it’s an extra device to carry at the moment, they’re talking about developing a pump which includes the algorithm (I think one exists in America?) He’s doing really well on the closed loop and keeping good control thanks to the technology.
Helen (James’ Mum)

It certainly looked, from the glimpses of the BG trace we could see, that his control was excellent. I could certainly do with one for my overnights!
Oh, and welcome to the forum, by the way!

 

[Mrsbairdo]

I know Lucy, one of the reasons we said yes to going on the trial was the chance of getting a pump. We were told that there was no way James would get a pump ordinarily, he’d be on injections. We’ve been very lucky. The trial is for two years, I’m dreading when James has to give all the kit back

 

[Lucy Honeychurch]

I know Lucy, one of the reasons we said yes to going on the trial was the chance of getting a pump. We were told that there was no way James would get a pump ordinarily, he’d be on injections. We’ve been very lucky. The trial is for two years, I’m dreading when James has to give all the kit back

And therein lies the problem

 

[Flower]

Great to see progress and good to see it being covered but it was simplistic to describe the set up as a few off the shelf consumables and a phone app. The hurdles to get funding for a pump let alone cgm weren't mentioned but it seemed to be presented as a potential panacea for all.

 

[AceFace]

I know its early days in the trial and people have pumps, I just don't like machines regulating you, don't like the thought, but that's just me, I don't like what I have to do but I have control on what I eat and inject just feels safer to me, but what do I know

 

[everydayupsanddowns]

I was a bit frustrated with it as it all seemed rather old news to me (perhaps inevitably). Sounded a bit like DIY ‘loop’ systems that people are hacking together from various components.

It also looked a bit like the MM670G which as had been said is out in the US. What I did find interesting was the suggestion that the phone app ‘learned’ from previous results. I also wondered if it was rather more configurable than the MM670G which I’ve heard some interesting (and frustrating) stuff about in a Gary Scheiner review.

If the trial is going so well, I wonder what the imperative is for them to release the app early to people who are already using MM640G with sensors (this can happen with other trials).

 

[everydayupsanddowns]

You’re right, it can’t predict carbs, so he does have to enter everything he eats manually as any other pump user does. As you say it predicts times during the day when he is going high (like early mornings) and it gives extra insulin based on these patterns and his CGM readings. It’s not a fully artificial pancreas but it is really helping control his glucose levels, his Hbc1a and he’s doing really well with it.
Helen (James’ Mum)

Fantastic to have you here Helen! Great to hear the details from the sharp end.

Such a shame that you have been told you will have to give the tech back - hopefully the results achieved will provide compelling case for continuing with sensor-augmented pump, even if you won’t have access to the phone part.

 

[Mrsbairdo]

Fantastic to have you here Helen! Great to hear the details from the sharp end.

Such a shame that you have been told you will have to give the tech back - hopefully the results achieved will provide compelling case for continuing with sensor-augmented pump, even if you won’t have access to the phone part.

Thanks! We always knew once the trial ended we’d have to give everything back, but James’ consultant has assured us she will make a very strong case for him to continue with pump and sensor after the trial ends, as that’s all he has known. And she is excellent so that’s reassuring.

 

[Lucy Honeychurch]

I know its early days in the trial and people have pumps, I just don't like machines regulating you, don't like the thought, but that's just me, I don't like what I have to do but I have control on what I eat and inject just feels safer to me, but what do I know

Don't fret, you've got more chance of the moon being delivered to you on a stick than you have of being offered this system in its entirety