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First "at home" trial for an artificial pancreas

Spiker said:
My grumpy frustration has driven me to research pump hacking. I think from available information put out by hackers, I could hack a pump and hack a CGM so that a 3rd device could sit in the middle, read the CGM (by hacking) and control the pump (by hacking). The whole system then would form an artificial pancreas. My message to the pump and CGM companies would then be, as the great Eric Cartman once said, "Screw you guys!" ;-)
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Is that before or after you have it all taken away and locked up for some form of copyright?





Type 1 diagnosed 1990
HBa1c current 8.3
Pump and CGM used (animas vibe)
 
Did you see this from a couple of the people that used it...https://myglu.org/articles/the-bion...facebook&utm_campaign=bonicpancreas_recap_1yr - talks about some of the issues. It is frustrating as initially you get told about the 10year cure and then it is a fight from then on in to try and get tools that will help you, and then most of the time you end up self funding if you need it and it really comes back to being down to you and your focus on it - I dream of day where I don't have to think about everything several hours in advance and take loads of backup food or stuff like that incase of surprise...a day to be free of it would be lovely :)
 
As if by magic, I get this in my Facebook feed today:

http://typeonenation.org/2014/04/23/jdrf-partners-with-thermalin-on-ultra-rapid-insulin-2/

It's development of a new ultra-fast acting insulin. This would solve the delay. There's also a nice diagram showing the PK curves (profiles) of various insulin compared to pancreatic insulin.

There's also an insulin in clinical trials that has a response time, by the look of it, the same as pancreatic insulin, but it's AUC (exposure) is smaller. It's called Affrezza, here's a link:

http://pharmapeek.com/metabolic/page/4/

So, there's increased hope!
 
Love some hope :) Hopefully it will get to market quicker than the 10 year cure :D
 
SamJB said:
As if by magic, I get this in my Facebook feed today:

http://typeonenation.org/2014/04/23/jdrf-partners-with-thermalin-on-ultra-rapid-insulin-2/

It's development of a new ultra-fast acting insulin. This would solve the delay. There's also a nice diagram showing the PK curves (profiles) of various insulin compared to pancreatic insulin.

There's also an insulin in clinical trials that has a response time, by the look of it, the same as pancreatic insulin, but it's AUC (exposure) is smaller. It's called Affrezza, here's a link:

http://pharmapeek.com/metabolic/page/4/

So, there's increased hope!
Click to expand...
I was wondering how further along they were getting with this, I'm really tempted to change my insulin in my pump to one with a quicker rate, I hate have to bolus before and have it all planned out in advance. I wonder also how they are getting on with the glucagon? At present I believe it's only stable for 24hrs of use so has to be changed and wasted, after that time or it degrades.
From reading the american study on this, they were waiting on new faster insulin and stable glucagon. Also as far as the lag system goes, The device would still be used in the same way as a pump therefore you still had to tell it when you were going to eat and do excercise or be stressed etc. It would also let you input if you were having a regular dinner, lunch, tea, snack, or whether you were say going out for a massive dinner. So that it could release the bolus in a similar way to it would usually do or be prepared to do more corrections and adjustments, delayed release of insulin etc. I believe from reading it and seeing the data that the algorigthm is constantly changing as it learns your bodies patterns, and corrects itself from the orginal programme, so that someone 2 years down the line of wearing it will have tighter control than someone 2 months of wearing it, and will be tighter than someone 2 days of wearing it.
I was amazed how much out I was when I got my CGM, It's very surprising the little spikes you have and don't notice because you're not checking every 5 mins. I don't think that this will be too big of a difference when compared to normal pancreas function (obviously not as good as) but not as far as you imagine. Still think it'll be another 5 years off yet before you can buy one, I doubt they will be on the NHS, at least for 10 years. Sign me up to have one though!
 
Unfortunately, Viaject from Biodel got so far then scrapped so something else is in the pipeline to make the existing analogues work a bit quicker.... Alfreeza looks promising

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pumppimp said:
I was wondering how further along they were getting with this, I'm really tempted to change my insulin in my pump to one with a quicker rate, I hate have to bolus before and have it all planned out in advance.
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Interesting. What are you using now? For me, Humalog works significantly faster than Novorapid, and also has a slightly stronger effect.
 
Spiker said:
Interesting. What are you using now? For me, Humalog works significantly faster than Novorapid, and also has a slightly stronger effect.
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Really? I've been telling my DSN for years that novo rapid doesn't work quickly (doesn't touch for 2hours after going in) but she just shrugs...


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Here's some research on aspart (Novolog/Novorapid) vs lispro (Humalog)

http://care.diabetesjournals.org/content/24/6/1120.full

The main finding of our study is that the free insulin profiles of aspart and lispro resemble each other, but insulin lispro shows a more rapid uptake, reaches the maximum peak concentration earlier, and shows a more rapid decline than insulin aspart. We believe this finding may be of clinical importance.

This matches my experience. I use both insulins at the same time, but I use Novorapid when I need a slower action (eg for protein bolus). As a caveat, another study around the same time found no significant differences between the two.
 
Spiker said:
Here's some research on aspart (Novolog/Novorapid) vs lispro (Humalog)

http://care.diabetesjournals.org/content/24/6/1120.full

The main finding of our study is that the free insulin profiles of aspart and lispro resemble each other, but insulin lispro shows a more rapid uptake, reaches the maximum peak concentration earlier, and shows a more rapid decline than insulin aspart. We believe this finding may be of clinical importance.

This matches my experience. I use both insulins at the same time, but I use Novorapid when I need a slower action (eg for protein bolus). As a caveat, another study around the same time found no significant differences between the two.
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I'm on Humalog, but would like to give aprida or actarapid a go. It makes sense to me to use the fastest acting possible in the pump, but have been refused every time I've asked to try it. There may be a reason for it but they didn't have one, just got the generic it's not suitable!
 
pumppimp said:
I'm on Humalog, but would like to give aprida or actarapid a go. It makes sense to me to use the fastest acting possible in the pump, but have been refused every time I've asked to try it. There may be a reason for it but they didn't have one, just got the generic it's not suitable!
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Actrapid is a synthetic human insulin rather than a genetically engineered insulin analogue like Humalog and Novorapid, so it's an earlier generation of insulin and would not be faster than Humalog, it would be slower. The insulin that would be faster than Humalog is apidra. Who is refusing you apidra? A GP or a diabetes specialist unit? Your point should be that you are getting temporarily high blood sugar after meals. They may say this doesn't matter of course. You can say to them, well what's the harm? They will say, increased risk of hypos (which is true). You need to convince them you will manage that risk, through testing. And actually do it. :-)

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Thanks I had the name actarapid in my head I thought it was because it was a fast one I wanted to try. Anyways paprika was the one I asked for and got told I wasn't suitable to use in a pump. They couldn't give a reason for it any of the Times I've asked for it now I have the chm they might change there minds. Do u think it's more expensive and that's why?


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Well it looks like the manufacturer thinks Apidra is suitable for a pump. Although they mention some special requirements - you must replace the reservoir tubes and infusion set every 48 hrs (maybe all manufacturers say this?) and Apidra dose "units" are not calibrated in UI like other insulins? That might be an issue on a pump but obviously there are ways to solve it.

http://www.medicines.org.uk/emc/med...0+Units+ml,+solution+for+injection+in+a+vial/

This blog report says that the 2 day limit on Apidra is because of a higher risk of occlusions vs other insulins (with links to studies).

http://www.diabetesmine.com/2013/02/thinking-twice-about-using-apidra-in-insulin-pumps.html

Interestingly the same blog report says that the FDA advice is that insulin in pump reservoirs is good for 7 days, and in tubes/canulas for 3 days. That's different than what I was taught on my pump course. But there you go!
 
I think that the reason why Apidra is not recommended is because it is thought that it might crystallise in the tube and restrict the flow to the cannula causing high bg levels, whrreas with novorapid, this doesnt happen. Howevrr, as long as the tube is changed every 3 days, the risk of crystals building up is very minimal. The insulin has a faster onset but the acting time is still just as long as the bolus insulins plus there's the possibility that more insulin in the ratio might be needed, so its as long as its short really

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I am a type 1 diabetic on insulin nova rapid and levemir and I am very interested in be on a trail for a cure to diabetes
 
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