Thoughts on an artificial pancreas

I’ve been wondering for a while now whether a bit of joined up thinking might not be in order.

We use a number of new technologies to help manage Samuel’s diabetes. He has an insulin pump linked by bluetooth to a control handset with built in blood glucose meter. We have an iPhone app called ‘Carbs & Cals’ that allows us to calculate the carbohydrate content of the food he eats. We also download the data from the insulin pump control handset to my laptop, to allow us to see how his control has been over the last few weeks.

I have also been wondering about CGM systems, not that we use one at the minute as none are currently available on prescription from the NHS (except in certain circumstances). I think something like a Dexcom 7 would certainly help to control Sam’s bloods, especially at times like in the last couple of weeks when he has had a cold and his insulin sensitivity is all over the place.

All of these technologies help enourmously, but all of them have been designed and operate separately from each other.

Has anyone looked at putting them all together? I mean, if you had a calibrated pump connected to a CGM, the insulin delivered could be adjusted every (say) ten minutes to account for changes in BM levels. And the control of both pump and CGM could be run from an iPhone app that incorportated all the carb content of any food consumed. Accurate blood BM levels pre-meal and two hours after (as normal) could help keep the window of control tight. And if the app was simple to use, kept account of active insulin, calculated corrections, and alerted the user when re-testing was required (say after a hypo), I suspect the whole system would go a long way to tightening down control for a lot of T1 diabetics, especially when faced with eratic BM’s (exercise, stress, virus related etc).

None of this is based on technology that isn’t in the market place and proven. Does anyone know anybody using these in a connected manner? The software would be the key really. Ask any decent Software Engineer and they will tell you that software is the glue in any decent system.

An intelligent application that would bring a pump and CGM together in a coordinated way doesn’t seem to me like it’s that hard. Effectively, it could go a long way to closing the loop and making an actual artificial pancreas (of sorts).

Does anyone know if anybody is working on something like this? Or is this a flight of fancy? Are CGM’s just too wooly in their readings?