No Rest for Artie, How the Artificial Pancreas Keeps Us Safe While We Sleep

I am a son of a type 1, type 1 myself, and a JDRF (Juvenile Diabetes Research Foundation) staff member. I have invested both my life and my career to improve lives and to one day cure type 1 diabetes (T1D). I was diagnosed with type 1 diabetes on Christmas day when I was twelve years old. I started wearing my first insulin pump at 23 years old. I was told at that time I would soon be wearing an artificial pancreas system instead of an insulin pump. I was also told a cure was right around the corner. Unfortunately we still don't have the cure for T1D (type 1 diabetes) but the dream of the artificial pancreas is coming to fruition.

In February of this year I reached out and made contact with researchers at the University of Virginia Diabetes Center of Technology to learn more about the artificial pancreas system they had in development. I had recently read an ASweetLife article about teens at a diabetes ski camp participating in an artificial pancreas trial through the University of Virginia. You can read the article yourself here. I was very intrigued that artificial pancreas technology had progressed to a point that it could be worn under such extreme conditions and through such rigorous exercise. So I searched out the researcher in the article to find out more.

The next day I received a response from Dr. Boris Kovatchev and one of his researchers with a information on a couple artificial pancreas trial opportunities. One month later I would be flying to Charlottesville, VA to begin my artificial pancreas trial. The trial I have been elected to participate in is an 8 week trial to measure how the artificial pancreas can reduce hypoglycemia and hypoglycemia unawareness. After several hours of training I was heading home with my artificial pancreas system which I call "Artie". The past few years artificial pancreas trials were only done in an controlled in-patient hospital setting. I am participating in one of the first at home trials to experience how these systems will work in our everyday active and chaotic life.

Artie the Artificial Pancreas Remains Hard At Work While I Sleep:

The DiA's automated system on the artificial pancreas works to keep your blood glucose in a steady range of between 100-120mg/dl all night long. Before starting on the trial I was afraid to go to sleep with a blood glucose below 150mg/dl. I dreaded those nighttime lows. Having to wake up in the middle night to eat everything in your house to only over correct and get up in the morning at 250mg/dl. Those nighttime roller coasters are very exhausting. I hate waking up with the "diabetes hangover" from a poor night of glycemic control. The DiA's artificial pancreas system works to eliminate much of this. The Dia''s can be more aggressive a night in controlling blood glucose levels because we don't have as many variables that we face during the day like food and exercise.

That first night going to bed with Artie the Artificial Pancreas it was an odd feeling. I was torn. I didn't know what to expect and I wasn't sure how to give up control. I have been doing this diabetes thing on my own for 23 years. How do I now give up total control to a computer? It didn't have anything to adjust or fix. I didn't have to look at my CGM and decide if I needed to give myself insulin or eat a snack to keep me in "optimal" overnight range. I am not sure what it is like to be so called "normal" and not have to think about my diabetes 24 hours/7 days a week. This was the closest I would get to freedom. Only having to test my blood sugar one last time to calibrate my pump. Thanks to Artie I have to say I did feel just a little bit more free.

That first morning I woke up with a blood sugar reading of 114mg/dl. I spent most of the night in range but briefly dropped down to 72mg/dl. DiA's quickly corrected and brought my blood glucose up before I had to treat. It was an amazing first night with Artie by my side. That morning when I woke up I thought about my Mother and how difficult she had it when she was diagnosed at the age of 6 years old. I thought about the many debilitating lows I had to help her treat when I was a child. I thought about the terrible complications she had to suffer not because she didn't manage her T1D but because diabetes management was extremely difficult back in the 1960's and 1970's. I thought about how far we have common since my diagnosis. Thanks to dedicated researchers and committed organizations like JDRF we now have the CGM's, insulin pumps, and more accurate meters. Tools that we didn't have even 10 years ago that makes my life with T1D much easier. I thought about the 40,000 people that will get diagnosed with type 1 diabetes next year and how the artificial pancreas will greatly change their lives without them even knowing it. These three devices that form the "closed-loop" are not a cure but they are the next best thing. If the artificial pancreas works like it has in the trial it will be a huge improvement for our quality of life. The artificial pancreas should prolong and save lives and reduce the worry of tragic diabetes related complications. This technology will stabilize our blood glucose levels which for many of us is a challenge to do no matter how hard we try.

The DiA's "closed-loop" system has helped make a dramatic improvement on my blood glucose levels during the night. I tend to have the most extreme fluctuations in my blood glucose over night. With my Artie, the artificial pancreas, my control has greatly improved and my nighttime lows have almost completely been eliminated. Dexcom statistics comparing 15 days before the trial with the last 15 days during the trial show that between 11pm and 7am I have reduced my blood glucose levels by 17% while decreasing the number of lows. My average blood glucose overnight has reduced from 160mg/dl to 133mg/dl with less than 1% of reading being less than 70mg/dl. I would take the DiA's system in it's current form right now for full time overnight use. The DiA's system is a much safer option at night than what we have now managing with insulin pumps or injections. Artie has been incredible at reducing over night hypoglycemia. This is what many of us fear the most. It would be wonderful if we never heard another "dead in bed" story about another unnecessary loss of life again. Most of us can relate to having very scary episodes of hypoglycemia in the middle of the night. If right now we could only have a "night only" closed-loop system as the first artificial pancreas, I would still consider that a huge success.

Next week I will be sharing my experience about how DiA's responds to all the daytime variables like eating and exercise. If you missed the first post of my artificial pancreas trial series you can read it here. If you have questions you would like answered directly please email me at jeramieirwin@gmail.com. If you would like more information about artificial pancreas trials at the University of Virginia Center for Diabetes Technology please email artificalpancreas@virginia.edu.

Marc Breton PhD, one of the leading developers of the DiA's inControl AP diabetes management platform and founder of TypeZero Technologies will be the keynote speaker at the JDRF Kentucky & Southern Indiana TypeOneNation Summit on Saturday, May 14, 2016 at the Louisville Marriott East. Register at https://typeonenation2016-ky.eventbrite.com