There has been a great deal of buzz about stem cell research and diabetes. The theory there is that if we could grow a new pancreas using our own stem cells, we could transplant a new organ without the need for damaging anti-rejection drugs. Maybe. But this prospect is distant at best.
On the other hand, we are tantalizingly close to a technology -- the artificial pancreas -- that, while not a cure, would dramatically improve the lives of diabetics (including many with Type II). Continuous glucose monitors (CGMs) have just begun to be marketed. Using a subcutaneous probe, they measure BG every five minutes without the need for finger sticks. So we now have two technologies: the CGM and the insulin pump, one that measures blood glucose and one that doses insulin. They are the two halves of an artificial pancreas. The brass ring will be getting the two to speak to each other.
The Juvenile Diabetes Research Foundation (www.jdrf.org) is about to begin a clinical trial to measure whether CGMs improve the overall blood sugar control of diabetics. Early indications are that they do. (Those who wear the devices are amazed at how little information they had been receiving from finger sticks alone.) Next the challenge will be to develop the algorithms to permit the CGM to speak to the pump -- and to do so safely. If the algorithm is not foolproof, the wrong dose of insulin could kill the patient.
David is now 13. He owes his life to Dr. Frederick Banting of Toronto, who discovered insulin in 1921. But his long-term prospects are in the hands of thousands of researchers, government officials, doctors and insurance company executives who will decide whether the next great leap in diabetes treatment is vital or not.