# "artificial pancreas to revolutionise diabetes care in England"



## Windy (Apr 1, 2022)

BBC article on a trial in T1s of an artificial pancreas hybrid closed loop system


----------



## gillrogers (Apr 1, 2022)

My husband just rung me from work cos he heard about this on the radio.  Please forgive my ignorance as I've only been a type on for just over a year .  What's differant with this to what I see and hear off the pump thats about now?


----------



## Windy (Apr 1, 2022)

Morning @gillrogers, I'm T2, so this isn't really stuff I know about, but from what I read, it's a trial being run for a thousand T1s with a closed loop system where the BG monitor "talks" to the pump so that it adjusts the insulin automatically, but you still need to tell it what you're going to eat, so it can adjust for the carbs in the meal.
I don't know where the trial is being run, or how they pick their T1s to be part of it though.
Sarah


----------



## gillrogers (Apr 1, 2022)

Windy said:


> Morning @gillrogers, I'm T2, so this isn't really stuff I know about, but from what I read, it's a trial being run for a thousand T1s with a closed loop system where the BG monitor "talks" to the pump so that it adjusts the insulin automatically, but you still need to tell it what you're going to eat, so it can adjust for the carbs in the meal.
> I don't know where the trial is being run, or how they pick their T1s to be part of it though.
> Sarah


Thanks Sarah.  I just said to my husband that it can't be fully automated because it has no way of telling how many carbs you've just eaten. So you need to dial that in.  So the pumps in use currently don't have the link with the sensor .  Be interesting to find out more


----------



## Windy (Apr 1, 2022)

gillrogers said:


> So the pumps in use currently don't have the link with the sensor


I believe there are pumps which can be linked to a sensor already, but they're v expensive, and not widely used because of the cost.


----------



## gillrogers (Apr 1, 2022)

Windy said:


> I believe there are pumps which can be linked to a sensor already, but they're v expensive, and not widely used because of the cost.


I've been starting to look into them as I'm so sensitive to the insulin while I'm moving about but as soon I sit down it grinds to almost a halt lol.  I've got days where I can be busy all morning and nothing in the afternoon except paperwork. So I adjust my basal down then find I need it back up later.  Sadly I'm just under the criteria for one with my hba1c . Having said that I've got a review Monday so who knows lol.


----------



## Windy (Apr 1, 2022)

I normally wouldn't wish for someone to have a higher HbA1c, but I hope yours sneaks over the threashold for the criteria,
Best of luck with your review Gill 
Sarah


----------



## gillrogers (Apr 1, 2022)

Windy said:


> I normally wouldn't wish for someone to have a higher HbA1c, but I hope yours sneaks over the threashold for the criteria,
> Best of luck with your review Gill
> Sarah


Haha I know what you mean.  To be honest I think it probably will lol


----------



## helli (Apr 1, 2022)

I was surprised to see this article on the BBC today because, I believe, the trial started in the summer last year.
Anyone know why it suddenly has high profile?

And (sorry for the questions) how does this differ from what Medtronic and T-Slim offer today?


----------



## gillrogers (Apr 1, 2022)

helli said:


> I was surprised to see this article on the BBC today because, I believe, the trial started in the summer last year.
> Anyone know why it suddenly has high profile?
> 
> And (sorry for the questions) how does this differ from what Medtronic and T-Slim offer today?


Is it the link with the sensor? I don't know enough about them to start with keen to know as I'm feeling I need to go down the pump route.


----------



## helli (Apr 1, 2022)

gillrogers said:


> Is it the link with the sensor? I don't know enough about them to start with keen to know as I'm feeling I need to go down the pump route.


Yes, here are a number of pumps available today such as those I listed which are connected to a CGM. 

The Medtrum pump which I have links to its CGM (which I have trialled) but only to suspend basal when low; it does not add more when high. 

Pumps linked to CGMs are more expensive so less available unless you chose to self fund the CGM.
However, there seems to be an understandable reluctance to move people onto a pump until they are very very familiar with MDI so that they can revery easily in the stressful situation when a pump fails. 
Feel free to ask your DSN about pumps but do not be surprised if they decline at the moment.


----------



## Docb (Apr 1, 2022)

I heard the stuff on the radio this morning and got the sense that the "journalists" were reacting to a press release either from the NHS looking for a "good news" story or a manufacturer looking to drum up business from the NHS rather than providing a balanced refection based on their looking at the issue in the round.    Closed loop systems have got to be the way to go but my understanding from reading comments on this forum are that there is much to be sorted out before they could be rolled out with confidence.  Large trials indicate progress which is to be lauded but describing the system  as "an artificial pancreas" is, for me, just another example of lazy journalism.


----------



## rayray119 (Apr 1, 2022)

Docb said:


> I heard the stuff on the radio this morning and got the sense that the "journalists" were reacting to a press release either from the NHS looking for a "good news" story or a manufacturer looking to drum up business from the NHS rather than providing a balanced refection based on their looking at the issue in the round.    Closed loop systems have got to be the way to go but my understanding from reading comments on this forum are that there is much to be sorted out before they could be rolled out with confidence.  Large trials indicate progress which is to be lauded but describing the system  as "an artificial pancreas" is, for me, just another example of lazy journalism.


Partha shared it today on Facebook so and from a post from him yesterday it sounds like he's been involved.


----------



## Pumper_Sue (Apr 1, 2022)

I've just seen the report on BBC news, It's nothing new from what I can gather.
Only thing of note was the young lady being interviewed with her dog. Dog needs a face trim as it can't see where it's going and that amount of hair around it's eyes can not be good for it


----------



## gillrogers (Apr 1, 2022)

helli said:


> Yes, here are a number of pumps available today such as those I listed which are connected to a CGM.
> 
> The Medtrum pump which I have links to its CGM (which I have trialled) but only to suspend basal when low; it does not add more when high.
> 
> ...


Yes I had thought that might be the case. I had been wondering what happens if they fail and how they fail.


----------



## SB2015 (Apr 1, 2022)

I was pleased to find that they have broadened the list of sensors , and now include those for the Medtronic pumps.  I wonder if that was a result of the slight price drop in their sensors/transmitters.

It is still likely to be difficult to get these but so was the Libre at the start, and the prices differences are getting smaller. Who knows where we will be in a few years.  With more of these available it will certainly help to reduce the development of long term side effects, but that will be a long term saving rather than short term, and so unlikely to fall under the same umberella.

Partha has been a big advocate for access to tech and was instrumental in getting the trial of the looping set up.  Long May we have him as our advocate.


----------



## Martin62 (Apr 1, 2022)

BBC News - Artificial pancreas to revolutionise diabetes care in England








						Artificial pancreas to revolutionise diabetes care in England
					

It can eliminate the need for finger prick tests and prevent life-threatening attacks, say experts.



					www.bbc.co.uk


----------



## helli (Apr 1, 2022)

Yep - take a look at the conversation about it earlier in the day 


			https://forum.diabetes.org.uk/boards/threads/artificial-pancreas-to-revolutionise-diabetes-care-in-england.99340/


----------



## mikeyB (Apr 1, 2022)

The systems will always be an approximation of a real pancreas. Only when you can take a photo of the food you are about to eat, with an algorithm to calculate the carbs which inputs to the pump while at the same time considering the current BG value, will there be an artificial pancreas. It isn’t beyond current technology, if anybody wanted life easier for T1s.


----------



## everydayupsanddowns (Apr 1, 2022)

Frustratingly journalists have been using the phrase “world’s first artificial pancreas” with every iteration of sensor-augmented insulin pumps ever since Medtronic’s Veo with low glucose suspend 

Eventually there may be a fully automated system which delivers insulin that can act more responsively/rapidly (and will switch off just as quickly) and won’t need us to faff around with carb counting and all that nonsense - but by then the allure of the phrase will surely have worn off and people won’t care any more


----------



## trophywench (Apr 1, 2022)

The BBC News report riled me - showing a little child with a Dexcom sensor and pump, looped.  Child liked it because she no longer needs to 'have needles or  prick her fingers'.  At least her mother said 'since she's had a loop ....'  but this was presented as 'new' - well OK it isn't ancient but the new sensor they're trialling  is implanted not worn on the outside of the arm ....


----------



## Bruce Stephens (Apr 1, 2022)

trophywench said:


> it isn't ancient but the new sensor they're trialling is implanted not worn on the outside of the arm


Is it, though? Or is it just a Dexcom G6 (or maybe their new Dexcom One), which could be said to be "implanted" in the sense that a little bit of it is under the skin? If it's really a different implanted device, how long does it last and how annoying is it to change when it needs changing? (Not sure how well the Eversense is going. Oh, OK, the E3 can last "up to 6 months" which would be decent. Still a bit annoying, but might be worthwhile for small children, though there's still the pump which is presumably external.)


----------



## Rob Oldfield (Apr 1, 2022)

gillrogers said:


> I've been starting to look into them as I'm so sensitive to the insulin while I'm moving about but as soon I sit down it grinds to almost a halt lol.  I've got days where I can be busy all morning and nothing in the afternoon except paperwork. So I adjust my basal down then find I need it back up later.  Sadly I'm just under the criteria for one with my hba1c . Having said that I've got a review Monday so who knows lol.


Hi @gillrogers 

I was given a pump as my team decided that the fact I was experiencing 'dawn phenomenon' qualified me, while my HbA1c was within the 'good' range.  I'd suggest that your insulin sensitivity might put you in the same boat.

Of course, different trusts are going to work in different ways so you're best placed to deal with them, but it might be worth thinking about stressing that your routine can vary and that the different basal profiles available on a pump (where you can modify the ongoing 'background' insulin you're getting) would be useful.


----------



## gillrogers (Apr 2, 2022)

Rob Oldfield said:


> Hi @gillrogers
> 
> I was given a pump as my team decided that the fact I was experiencing 'dawn phenomenon' qualified me, while my HbA1c was within the 'good' range.  I'd suggest that your insulin sensitivity might put you in the same boat.
> 
> Of course, different trusts are going to work in different ways so you're best placed to deal with them, but it might be worth thinking about stressing that your routine can vary and that the different basal profiles available on a pump (where you can modify the ongoing 'background' insulin you're getting) would be useful.


Thanks @Rob Oldfield , that was going to be the angle I would take. It was what was making me think this might be better for me.  It's really starting to impact my job.


----------



## SB2015 (Apr 2, 2022)

Hi @gillrogers I eventually got my pump as I was very sensitive to insulin, so 1/2 unit changes just didn’t match what I needed.  I was also finding exercising very difficult to manage and having loads of hypos.  I am very pleased I did the switch.

As far as I know the ‘artificial pancreas’ in the news is nothing more than what some are already using such as the Medtronic 780G and T-slim pumps used as a closed loop.  I suppose our sensors are ‘implanted’ under the skin in a way in that we fire them in each time in much the same way as the Libre goes in.  I don’t think it is anything new, and yes we still need to let the pump know how many carbs we are eating.  

I took me some time to get used to the new pump and the time it took the pump to get to know my metabolism but I am very happy with the reduction in hypos and how I need to think a lot less about diabetes each day.  There is still the carbs and pre bolus interval to consider, but the rest is done for me.

I have recently had COVID and have been pleased to have the system spot the increased need for basal and get on with any adjustments for me.  I had expected to have to switch back to manual but as my symptoms are mild, the pump is coping well, and leaving me to rest and recover.  A bit of a difference from being ill on my old pump.

Funding  for these closed loops will understandably be limited but if they get down to a smimilar price as Libre then there may be wider access. Who knows what is to come, as things change so much year by year.  So this is nothing new and I think it may be the revision to the NICE guidelines that has  the press release.  I know I have had a lot of conversations about my closed loop system with friends this week!


----------



## gillrogers (Apr 2, 2022)

Thanks @SB2015 , Thursday I just pushed a few small tables , 2 or 3 around the lounge at the hall , took a tray of cups and saucers into the kitchen and put the hoover round and ended up spending Thursday evening battling to stop a fast approaching hypo an hour after dinner.  I'd already reduced my basal that day as I knew I was going to be a little more active as not sat at my desk working as usual. It's definately affecting my work as I'm now scared of how much physical effort I put into it.


----------



## SB2015 (Apr 2, 2022)

Gather your data, @gillrogers ask for a review and match your data to the NICE guidelines for accessing pumps.  It may take time to get a pump but it makes life a lot easier, so long as you are happy to put in the work that is needed


----------



## gillrogers (Apr 2, 2022)

Cheers, I've got a review on Monday so I'll tackle it then.


----------



## trophywench (Apr 2, 2022)

I read that the new one had the sensor implanted in the thigh via a cut in the skin.  Bit like hormone implants for ladies, except they are inserted in your tummy, via a cut.


----------

