It's WAY too early to call this Insulin Pump an Artificial Pancreas
The diabetic internet and lots of mainstream news agencies are abuzz about the new insulin pump from Medtronic. Poorly written news articles that are effectively regurgitations of the Medtronic Press Release have exciting headlines like this:
- FDA approves artificial pancreas you can wear
- Medtronic's Artificial Pancreas Approved for US Diabetics
- FDA Approves First Artificial Pancreas For Patients With Diabetes
Other news outlets have slightly better headlines like
But then ruin it with vague subtitles that are missing important context:
- FDA approved the company’s automated insulin delivery system.
This is Step 1, possibly Step 0.
TO BE CLEAR. This new Medtronic 530G pump is NOT an artificial pancreas. It is an insulin pump, similar to the very model I'm wearing right now. It is paired with a revision of Medtronic's CGM (Continuous Glucose Meter) system and it does one new thing.
This new pump will turn off if you ignore its alarm that you may be having a low blood sugar.
Read it again, I'll wait.
Note the JDRF chart above describing the steps we need to towards a true artificial pancreas. This new 530G from Medtronic is arguably Step 1 in this 6 step process. It's the first step of the first generation.
But wait, doesn't your pump just handle things for you? You don't have to stick your fingers anymore, right? Wrong.
Let's stop and level set for a moment. Here's a generalization of your day if you're not diabetic.
Here's what a Type 1 diabetic (like me) does:
If I get this new pump that news outlets are incorrectly calling an artificial pancreas will anything in this cycle change? No.
There's NOTHING automatic here. I want to make that clear. Today's insulin pumps are NOT automatic. I set them manually, I tell them what to do manually. Yes, they "automatically deliver insulin as I sleep" but only because I told it to. If I eat and do nothing, I WILL get high blood sugar and today's insulin pumps will do exactly NOTHING about it.
If I only make decisions about insulin dosage based on my CGM then I WILL eventually get in trouble because today's CGMs are demonstrably less accurate than finger sticks. And, here's the kicker, finger sticks aren't even that accurate either.
Even more insidious is the issue of lag time. Medtronic's last generation of CGM lagged by 20 to 30 minutes BEHIND a finger stick. That meant I was getting "real time values" that in fact represented my blood sugar in the past. It's hard to make reliable altitude changes in your plane if your altimeter shows your altitude a half hour ago.
The Medtronic Press Release says that this new Enlite Sensor is 31% more accurate. I hope so. I personally continue to use a Medtronic 522 pump (this new one is the 530G) but I have given up on Medtronic's CGM in favor of a Dexcom G4. I am thrilled with it. The G4 has about a 5 minute lag time and is astonishingly accurate.
NOTE: I have no personal or investment relationship with either Dexcom or Medtronic. I am not a doctor or a scientist. I write this blog post with the expertise of someone who has been a Type 1 Diabetic for 20 years, a user of a Medtronic Pump for 15 years, a user of a Medtronic CGM for 4 years, and more recently a user of a Dexcom G4 for a year. My most recent A1C test was 5.5 putting my blood sugars at near non-diabetic levels on average. TL;DR - I'm a very good diabetic who uses the best available technology to keep me alive as long as possible.
I am extremely disappointed in the lack of research, due diligence and basic medical common sense in these articles. If you are a Type 1 Diabetic or have someone in your life who is, do the research and the reading and please spread the word so people can make informed decisions.
- The Sad State of Diabetes Technology in 2012
- Scott's Diabetes Explanation: The Airplane Analogy
- YOUTUBE: How my diabetes equipment works