Discussed in a press release from the University of Virginia Health System, "Aritificial Pancreas Proves Effective in Treating Type 1 Diabetes Overnight in Pilot Study."
Researchers at the University of Virginia Health System are reporting remarkable results from their pilot clinical study of the artificial pancreas, a computerized, subcutaneous system that could one day revolutionize the way Type 1 diabetics manage their disease.
The system, which uses an individually-“prescribed” control algorithm to regulate blood glucose levels, achieved excellent overnight control of glucose levels in Type 1 diabetics and a five-fold reduction of hypoglycemia. A condition produced by lower than normal blood sugar levels, hypoglycemia can result in coma, seizures and even death.
Several years ago, while attending a pediatric diabetes association (PADRE) retreat, I spoke with a lead researcher from UCSF (I am scouring past files to find his name) regarding the prospects for pancreatic cell transplants for the treatment (reversal?) of diabetes. The answer, from a researcher who focuses on cell transplant therapies, surprised me and that was that the most practical solution to diabetes, one not likely to be bettered for a long time to come, was going to be an artificial pancreas of the type described above in which a glucose meter is linked in a biofeedback system to an insulin infusion pump. The reason this surprised me was that, in my idealistic view of biotechnology in general, and cell therapy specifically, the use of devices was always going to be imperfect compared to the "pure" solutions possible (aka "rational therapeutics") from the biotech arena, since biotech solutions are often focused (via cell therapy, gene therapy or other disciplines) in effectively reversing the root cause of a particular disease, rather than on addressing symptoms alone, even comprehensively.
However, as elaborated by the UCSF researcher, cell therapy is already available, but is encumbered by (among other things) the need for expensive and side-effect-plagued anti-rejection drugs. Even the advent of autologous stem cells (which would theoretically avoid immunogenecity problems, since the cells transplanted are patient’s own) is not practical solution compared to a biofeedback device, since the hurdles to sctem cell transplantation have provide to higher than anyone anticipated.
Having focused on the medical device arena and having harped on previously about this idea that there is the "ideal" biotech solution that may never come while the "here and now, treat the symptoms effectively" solution of the device arena can be so pragmatic (and sustains big medtech markets), I am eminently sensitized to the polemic between the two.
The UVHS development is a practical demonstration that the technical hurdles of providing a relatively simple system of a biofeedback device for blood glucose regulation through insulin infusion are dramatically less challenging than cell therapies.
Having said this, I can still be comfortable in the notion that one day a cell therapy, or a gene therapy or some other "rational therapeutic" will be developed that can cure each case of diabetes in a practical, affordable way. Until then, I am exceedingly pleased to know that medtech development is capable of getting the job done now.
The author has someone very close to him who has Type 1 diabetes.
