The long wait

November 2017

I started dreaming and praying for an artificial pancreas 38 years ago when I was diagnosed with Type 1 diabetes. It was Easter Sunday 1980 and I was 12 years old. ‘Five years’ they said. ‘We’ll have a closed loop system in five years!’

MeAtFifteen

There was even a handy diagram of what a closed loop system might look like in the first how to manage your diabetes book I was given, the one that contained the highly alluring forbidden food list. My mother and I marvelled over that diagram.

Diabetes was challenging practically and emotionally and the page with the artificial pancreas diagram became a dog-eared beacon of hope.

In those days we soaked our glass syringes and reusable needles in methylated spirits every night for our daily injection and tested our ‘sugars’ using a Clinitest tablet in a test tube of wee. There was no way to tell the difference between a normal blood sugar level and hypoglycaemia, lack of glucose to the brain, apart from the shakes and sweats we used to have with the old pork insulin.

TestTubesWithWeeToTestUrine
Photo courtesy of tudiabetes

Home blood glucose testing arrived in the 1980s. It meant that we could test our blood sugar levels for the first time but it didn’t necessarily follow that we could control them.

Ames-Glucometer-II
Photo courtesy of tudiabetes

And the finger-pricking devices were a bit of a shock! I used to call mine the ‘blood grinder’.

TheBloodGrinder1980sFingerPricker

I remember staring at it for a full twenty minutes before I had the courage to press the lever for the first time.

Some time in the 1980s we changed from having a single daily injection to at least four injections a day. Balancing food and insulin was tricky. We were told we could ‘live a normal life with diabetes’  but hypoglycaemia and the prospect of acquiring long-term diabetes complications created anxiety for many of us.

The first real breakthrough for me was the insulin pump in 2000, twenty years after my diagnosis. It got me away from injections and some of the rigidity of type one diabetes and allowed me to have two gorgeous healthy babies. It was the first step towards closing the loop and with each iteration of the pump, I waited for good news.

We got iPads and iPhones and tech research boomed but the pump pretty much stayed the same. Continuous glucose monitoring (CGM) technology was advancing but aside from that, medical devices for diabetes seemed to be lagging at least a decade behind. Each diabetes system came with its own proprietary software and downloading cables. I couldn’t access my own data or interact with it in a way that was usable to me. There were reliable insulin pumps and an accurate continuous glucose monitor but the promise of good diabetes control was thwarted by the lack of interoperability and for many, affordability.

One of my friends with type one diabetes had a kidney/pancreas transplant and another was developing charcot foot. The years ticked by and the artificial pancreas seemed to be nowhere in sight.

Over the years people would often comment, ‘Isn’t technology amazing’ when they saw my blood glucose meter. ‘No’, I told them, ‘given what we could have right now I am very disappointed with what we do have.’ My friends’ faces fell. They were only trying to say something nice.

What I hadn’t realised was that a revolution was already taking place…

Next … The dawn of the artificial pancreas

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