The Legendary “Artificial Pancreas”

There has been a lot of buzz recently regarding Medtronic’s new 640G insulin pump. Released to the public in Australia this week, it is the first insulin pump to suspend insulin delivery when it predicts there will be a low blood sugar event (this differs from the 530G model which suspends when a low blood sugar level is reached.)

But a lot of news outlets have been touting it as an “artificial pancreas.” But is it really?

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A real pancreas has two main functions that concern diabetics: to secrete insulin hormones to lower blood glucose levels, and to secrete glucagon hormones to raise blood sugar levels.

Medtronic’s 640G system does not deliver glucagon to raise levels. It simply turns off delivery of insulin until blood sugar levels [hopefully] return to normal. This system could fail in the situation that a meal was over-bolused for, resulting in too much insulin already being in the system and the liver not knowing to release extra glucose.

Also, the 640G system uses interstitial glucose levels through the use of CGM technology. This is a fundamentally flawed technology, with interstitial levels running 10-20 minutes behind real blood glucose levels. By the time a CGM thinks a low will be occurring, the person could have already been running low and dropping even lower for several minutes. Plus, I’ve experienced issues firsthand with compression lows (where the CGM registers a false low blood sugar reading due to the sensor/area around the sensor being compressed by laying on it, etc)

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So is it an “artificial pancreas”? I don’t believe it is. And I’d go as far to say that using such a fabulist term only hinders advocacy efforts for type 1 diabetics. Is that a little grandiose of me? Maybe. But while it’s great that technology is moving forward, the number of people who have sent me links this week to these artificial pancreas news stories, honestly believing that I’ll be cured, or at least, much better off, is depressing.

Please don’t get me wrong. Progress is progress, and I’m thrilled for it and for the people it will help. But the bottom line is, the Medtronic 640G won’t significantly alter my life, and most lives of diabetics out there. It won’t cure any of us. It’s still imperfect technology and calling it an artificial pancreas is, in my opinion, highly misleading.

(And, I think it looks like an uglier version of the mid-2000’s iPods. But that’s irrelevant.) 🙂

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3 Comments

Filed under CGM, publicity

3 responses to “The Legendary “Artificial Pancreas”

  1. I’m with you on this. After the 530g rollout in the USA, I saw quotes attributed to Medtronic officials, stating that they might have gone a bit too far with the Artificial Pancreas label. Now they’re touting the 640g as “The latest in Artificial Pancreas technology”. Which, it sort of is, but…

  2. Reblogged this on My Pump Blog and commented:
    Thanks for sharing this info – wow what a great looking pump. Yes I would love one 🙂

    Many thanks
    Andrew

    http://www.mypump.co.uk

  3. Hi Abby, You’re absolutely right: UK press jumped on the AP bandwagon too 😦 To be fair to Medtronic over here in the UK, I don’t think they’ve labelled it as an AP, just the next step towards one. You’re also right it’s imperfect, with the classic CGM time-lag and the odd calibration moment on ours…

    Our three-year old daughter just started on the 640g this week. Early days, but so far – touch wood 🙂 – it’s doing its job and using the predictive suspend (aka SmartGuard) is cutting down the number of hypos we’re seeing compared to previously. We currently get it to alarm at predictive and threshold lows. In time, we may turn off the predictive alarm, but not yet… The threshold alarm is still there to warn everyone that a basal suspend wasn’t enough… (Once we catch our breath we’ll post more updates at http://littlet1d.blogspot.co.uk). Keep up the excellent blogging Abby!

    Take care,
    Matt

    PS Yes, it really does look like an old ipod, but my daughter still loves it!

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