Here's to technology, science and math!!

I have been a Type I diabetic since I was 10 years old. My body makes NO insulin, so I have no choice but to put it in me, or die. Since insulin is a protein, it cannot be injested, as the stomach acids would destroy it.  It has to enter through my skin. I started taking shots once a day at first, then twice a day, and then as standards of care changed, I took up to 4 or 5 shots a day, timed to my meals, or to correct high blood sugars.  Taking MORE shots does not mean I was a BAD diabetic or my diabetes was WORSE than someone else's. Multiple daily injections was the "gold standard" for many years. Normal bodies dole out insulin all day long, in response to fluctuations, so it just made sense to have insulin come in more regularly.

So, along those lines, the first insulin pumps were developed (the first one is pictured...they have come a long way!), to mimic the body in dripping out small amounts all day, and then giving bigger surges, or boluses, at meal times when the blood sugar soared.  For the last  20 years, I have ussed an insulin pump. This device is attached to me with a small catheter under the skin that I have to change out every 4 or 5 days.  Yes, it goes IN, piercing the skin, with a needle, but then I pull the needle out, leaving a small plastic tube. The insulin travels from the pump and into me via 20" of tubing. I can disconnect the pump for a shower or to go swimming, but I can't be away from my "lifeline" for much longer than that. 

The pump is programmed by me to administer a tiny amount of insulin every few minutes, just like a normal body, to take care of my metabolic needs.....I test my blood sugar frequently to make sure I don't have too much sugar in my blood, or just as bad, too much insulin.  To do this, I poke a hole in my finger and test it on a little device.  Yes, it hurts a little bit.  

And that is where the math comes in. For example, I want to eat a bagel, which from package label I can see has 45 grams of carbohydrate.  Since I know that (for me), 1 unit of insulin will "take care" of 15 grams of CHO, that is easy math to figure out - 3 units of insulin for the 45 gm CHO bagel.  So, I test my blood sugar. and it is in a normal range, say 100, so I can take my three units and be done.  However, if my blood sugar is HIGH, say 200, FIRST I have to take enough insulin to lower me to a normal place (for me, that target is 100).  Since I know that one unit of insulin will lower my blood sugar ~50 points , that is easy math - I need to take 2 units to bring me down to 100, PLUS the 3 units for the 45 grams of carbohydrate.  Timing the administration of the insulin can also a tricky process. Insulin does not immediately bring my blood sugar down, so I have to take insulin well before I eat, so it has a chance to start working - especially if I am a little high - it needs to start bring me down before I add more sugar to my blood.

While taking insulin IS the only option, insulin is NOT a cure, and it is not a ideal solution to avoid the complications associated with diabetes...blindness, kidney and heart disease, loss of circulation and amputation as well as a whole HOST of unappealing options. It is pretty much a fact that even with very tight glucose control, many type 1 diabetics will develop complications anyway

Several years ago, "they" developed continuous glucose monitor - these little devices are also inserted under the skin, and they send a message every few minutes to yet another device, with a blood sugar level. They are really extraordinary devices, very accurate but just one more tool for ME to manage my blood sugar. Instead of testing my blood sugar 8 or 9 times per day, the CGM tests me every 5 minute, so there are 288 readings every day and I can more accurately program my insulin pump and administer meal boluses. But I will be the first to say that they are not always 100% accurate.I still test my blood the "old fashioned " way several times a day.

For a long time, we have dreamed of, if not a cure, then a "closed loop" system....Taking the person OUT of the mix, so to speak.  They now call this the Artificial Pancreas, and there are several versions currently being studied....one is gene therapy, another is a bioengineering approach using transplanted beta cells (Insulin producing cells that MY body does not have); and the third version is the Technology version - a pump and a CGM (which I already have), but the difference is they talking to each other and reacting, WITHOUT interference or input from ME!

Thanks to funding and research spearheaded by JDRF, this is now a reality in the United States. In theory, it has been approved by the FDA and it is currently in human studies in various places around the country. And I am thrilled to announce, that I have been selected to be a participant in Phase II of a trial for the Artificial Pancreas project!

I will be leaving for Santa Barbara next Sunday for the first of two 40-hour studies. I will wear 2 Dexcom 4 glucose sensors and wear a Tandem insulin pump from Sunday night until Tuesday morning. The devices will be hooked together with a modified Iphone, and I will be asked to eat, sleep and exercise.like a normal person while they watch how the iphone application works.  I will do it again the following week.  To say I am excited is an understatement....and I look forward to sharing the experience with my friends and family, many of whom have been donating to the JDRF for years in hopes of a cure.....

So,, let' hear it for technology, science and math!!! SUPPORT STEM EDUCATION!