
FDA Approves Insulin Pump You Can Wear - pwg
http://singularityhub.com/2013/09/28/fda-approves-artificial-pancreas-you-can-wear/
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JunkDNA
It should be noted that this appears to be a highly accurate insulin pump.
That's a far cry from an artificial pancreas. If you have the death sentence
known as "pancreatic cancer" you can't get your pancreas removed and have this
take its place for example. Not saying it isn't important for diabetics, but
let's not get carried away.

~~~
VLM
"appears to be a highly accurate insulin pump"

The article was a little vague on how well the control loop is closed, but it
provided the impression that there was a feedback loop, as though a real
engineer told the journalist there was a feedback loop and the article is the
result of the liberal arts interpretive dance of the artists impersonation of
the concept of a feedback loop trying to play to the masses who don't know
what "feedback" is or Bode stability plots or whatever.

The creation of a feedback loop would make it much more of an "artificial
pancreas" than a mere free-running pump or traditional injection.

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justinpombrio
I think JunkDNA's point was that the pancreas does a lot more than just
regulate insulin.

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zekenie
What else does it do? (if you know... I'm curious)

~~~
deletes
Besides that, not anything significant (as far as we know).

[http://answers.webmd.com/answers/1195061/can-you-live-
withou...](http://answers.webmd.com/answers/1195061/can-you-live-without-a-
pancreas)

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cutcopypaste
OK.. What is going on here:

This is an incremental improvement in Medtronic's continuous glucose
monitoring system/insulin pump combination therapy that has been available for
5+ years already.

Medtronic is touting this as 'artificial pancreas technology' (not
specifically an artificial pancreas) because it has a feature now in the US
where the pump can turn off if your blood sugar drops below a certain patient
set threshold. This has been available for years already outside the US.

This is most definitely not an artificial pancreas..

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shanselman
[http://www.hanselman.com/blog/ItsWAYTooEarlyToCallThisInsuli...](http://www.hanselman.com/blog/ItsWAYTooEarlyToCallThisInsulinPumpAnArtificialPancreas.aspx)

It's WAY WAY too early for them to have said this.

~~~
cutcopypaste
I asked their twitter about it and got this:
[https://twitter.com/thedamon/status/384420935685910529](https://twitter.com/thedamon/status/384420935685910529)

Still think 'artificial pancreas technology' is an overstatement. Though
Singularity hub is also guilty of writing a ridiculous article esp with that
headline.

Edit: great write-up, Scott!

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shanselman
This is nonsense. They are totally overstating what they've done.

NOTE: I've been diabetic for 20 years and I wear both a CGM and a Medtronic
Pump (the model before this new one).

I'm so mad about this I've written it up IN DETAIL:
[http://www.hanselman.com/blog/ItsWAYTooEarlyToCallThisInsuli...](http://www.hanselman.com/blog/ItsWAYTooEarlyToCallThisInsulinPumpAnArtificialPancreas.aspx)

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cutcopypaste
Ugh.. Sensationalist headline of the day.

Article headline: we have an artificial pancreas

Article body: we do not have an artificial pancreas. we have a new pump with
some incremental feature improvements over our last model.

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andrewtbham
In the 90s I invested in MiniMed, and sales exploded. In the early 2000s they
were acquired by Medtronic. This was the goal of MiniMed and I'm glad to see
it come to fruition.

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bjornsing
My spontaneous thought when I saw this was "what took them so long?" Your
comment makes me wonder even more. How come this is such a difficult problem?

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ars
I was wondering the same thing - a simple feedback loop can't be that hard to
achieve can it?

Put in some limits in case of sensor or pump error and maybe allow the user to
boost sugar for activities, but otherwise this seems to me like a very very
simple thing to do.

What am I missing?

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SpikeDad
There have been several efforts at developing a blood glucose sensor that
could work on the skin rather than with an invasive probe. None of those went
anywhere.

I assume this means that this is a very difficult task. Believe me as a Type
II Diabetic that sticks their finger several times per day something that
could detect your blood glucose without blood would be worth a LOT.

I can't imagine what it would be worth to someone with Type I.

~~~
shanselman
It's complex because of LAG. Even a finger stick shows you your blood sugar
_in the past._ When you take insulin it ALSO has a lag, as long as 30 to 90
minutes.

Managing Type 1 diabetes is like controlling the Mars Rover.

Source: Type 1 for 20 years on a pump and CGM

Details:
[http://www.hanselman.com/blog/ItsWAYTooEarlyToCallThisInsuli...](http://www.hanselman.com/blog/ItsWAYTooEarlyToCallThisInsulinPumpAnArtificialPancreas.aspx)

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codva
My wife is a Type I diabetic and 15 + year Minimed pump wearer. She (and many
other diabetics) don't like the fact that with the CGM you have to have two
infusion sites (one for the monitor and one for the pump). Until they can
figure out how to do this with one infusion site I suspect it will not be
highly desirable by diabetics.

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fchief
Ditto for my wife. She also does not like the 45 degree "bent" insertion
approach because "it hurts more".

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karmel
In addition to all the accurate assessments that this is very far from an
artificial pancreas, I would like to point out that the glucose monitor being
marketed by Minimed is a far cry behind even the best-in-class available from
Dexcom
([http://www.dexcom.com/dexcom-g4-platinum](http://www.dexcom.com/dexcom-g4-platinum)),
and not near accurate enough to allow for closing the loop. Notably, a number
of the farthest advanced artificial pancreas research projects are moving away
from Minimed products-- for example:
[http://bionicpancreas.org](http://bionicpancreas.org)

~~~
shanselman
I moved off of the Medtronic for the Dexcom G4 for this very reason. The
difference between 30 minute lag and 5 minute lag is SO noticable. My A1c is
now 5.5 and I attribute that to the Dexcom, 100%.

~~~
cutcopypaste
I must say I recently was testing the new Enlite medtronic sensors and found
them far more accurate than the older ones whatever they were called (I gave
up on those quickly). Can't compare directly to dexcom but that's good to
know!

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drakaal
Considering there are places where they will steal your purse which might be
worth $3k. Imagine what the theft rate will be for artificial Organs that
could be grabbed right off you.

No need to knock a person out and leave them in a hotel bathtub with their
kidney's removed, you can just catch them on the subway.

~~~
VLM
Its a pity you got downvoted; discussion of the social issues relating to
technology is one good definition of hard science fiction, which the world
certainly has a lack of. Soft sci fi is that boring "search and replace" dreck
applied to existing generes.

Another societal issue is militarized cops and the like beating people and
ripping away their electronics, which we've been conditioned to feel is
"normal", but its kinda queasy/gross to imagine cops physically ripping
needles and stuff out of peoples bodies when they give a good ole american
beatdown for jaywalking or driving while black or other similar criminal
activities.

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anigbrowl
This is good news for diabetics, although I find it pretty depressing that
something like a quarter of the US population needs something like this in the
first place.

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templaedhel
Before making sweeping statements about a disease you obviously don't
understand please read up on the difference between type 1 and 2 diabetes, and
what the causes and treatments are for both.

TL:DR - This pump would be used for type 1 diabetics. This type means your
body does not produce insulin, so the treatment is to artificially inject it
(via this device for example). It's not caused nor limiting to diet. Being
unhealthy/overweight doesn't increase your chances of getting type 1. It's a
genetic, juvinile onset disease.

Type II is the type you're most likely thinking of. The body becomes less
sensitive to insulin, so you need to consume less carbs and generally eat
healthier. This pump would not be used by type II diabetics.

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stephengillie
Off topic: this site is painful to use on mobile with Javascript off.

~~~
jrockway
Also, the pictures don't load if I turn images off.

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smtddr
jrockway, you've really changed. You weren't always this cynical. What
happened?

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jrockway
Pretty sure I've always been this cynical.

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guard-of-terra
Why can't we just fix one letter in the DNA and make diabetes not happen?
Diabetes is stupid. All internal organ illnesses are stupid.

Still that's the best we can do atm. Still all those anti-GM people actively
hurt our chances to get real treatments soon.

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alphaoverlord
Because that's not how diabetes works

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guard-of-terra
Wikipedia tells us that diabetes type I is usually genetic.

If you're susceptible, you might get it, might not; if you aren't, you aren't.
Guess what, no point of carrying bad genes around.

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micro_cam
The genetics are complex and not yet understood.

(I am a diabetic who does genetics)

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guard-of-terra
Are you sure it's possible to understand them fully without actually doing
some hacking? How would you be sure when you understand enough to start
acting?

~~~
micro_cam
They do "hacking" etc in mouse models but it is expensive and time consuming.
You might have about 700,000,000 genomic variants to choose from so we need to
do other studies to try things.

For the time being one of the most effective means of studying a disease is to
sequence a pedigree of individuals some of whom have the disease and analyze
the inheritance patterns until you narrow it down to the point you can be
sure.

You can also do studies where you just sequence a ton of people with and
without the disease but those can be more problematic statistically because of
the number of possible variants.

