‘Artificial pancreas’ gives patient with diabetes a certain freedom

January 31st, 2018
Patient Tia Mollander stands and shows off an insulin pump that she wears clipped to her right front pocket.
Tia Mollander’s insulin pump is clipped to her right front pocket.

Tia Molander’s insulin pump, clipped to her right pants pocket, is a constant reminder of the limitations of Type 1 diabetes.

But last summer, thanks to cutting edge research performed at the Barbara Davis Center for Childhood Diabetes on UCHealth’s Anschutz Medical Campus, Molander took one step closer to finding the elusive “artificial pancreas” that will someday give her the freedom she wants.

“All they do at Barbara Davis is diabetes, and they were so much more informative to me about my disease than anyone else ever was,” Mollander said.

In September 2016, based on research provided by a pivotal clinical trial led by Dr. Satish Garg, the founder and director of the Barbara Davis Center’s adult clinic, the FDA approved the Medtronic MiniMed 670G for public use. Molander, one of more than 200 people to receive the device, started using hers last July.

“Honestly, I don’t know what I’d do otherwise,” said Molander, an outpatient physical therapist at UCHealth Physical Therapy and Rehabilitation Clinic – Harmony Campus in Fort Collins. “It’s helped my life a lot.”

Insulin is normally produced by the pancreas, and transports glucose (sugar) from the bloodstream into the body’s cells, providing energy. In Type 1 diabetics, however, the pancreas produces little or no insulin, leaving glucose no way of entering cells.

“Type 1 diabetics die unless they can get insulin in one of two ways, with injections or through a pump,” said Christie Beatson, MS, RD, a certified diabetes educator and clinic manager at the Barbara Davis Center. Over the last eight years, Mollander has used different varieties of insulin pumps, which delivered the vital hormone directly into her bloodstream at preset levels. This limited her need for self-injections but didn’t take into account her body’s normal fluctuations in blood sugar throughout the day, based on meals and activity level.

Tia Mollander, who has Type 1 diabetes, sits at her desk and smiles.
Tia Mollander, who has Type 1 diabetes, said she found innovative care at the Barbara Davis Center for Diabetes at the Anschutz Medical Campus.

“I have literally been brought back from the brink—unconscious—from hypoglycemic episodes,” said Molander, a wife and busy mother of two teenage boys. “Being a Type 1 diabetic requires a lot of acceptance that no matter what you do, some days just aren’t going to go well for you.”

Beatson points out that sensors have been available in insulin pumps for years. But the 670G is the first to accurately monitor blood sugar levels every five minutes, and deliver the right amount of insulin when it’s needed, like a normal pancreas would. This dynamic, real-time “Hybrid Closed Loop” system allows Type 1 diabetics like Molander to spend more time doing what they want, and less time worrying about whether they’re going to crash.

Medtronic warrantees the 670G for four years, including providing free upgrades or replacement if the pump malfunctions, according to Beatson, who has trained more than 200 patients on use of the 670G. And with another study in progress that began last June, UCHealth and Medtronic will follow patients for a full year and continue to partner on ongoing research, including developing an even more aggressive algorithm for future pump models.

“For the first time, (the trial participants) felt that their spouses could travel and they could be home alone and not have to worry about significant hypoglycemia,” said Beatson. “And the interesting thing about the study was that when it was over, the patients wrote to Dr. Garg saying they didn’t want to give back the device.”

While the pump can certainly reduce the stress of constant blood sugar monitoring and insulin injections, patients still have to be willing to put some effort in, Beatson said. For example, users still have to calibrate the sensor a couple times a day, input how many grams of carbohydrates they eat with each meal, and give themselves extra insulin according to those numbers. And, according to the dietitian, some patients remain weary, preferring instead to manage things themselves.

“Not everyone is comfortable giving up their diabetes control to a device,” Beatson said. “But the ultimate goal is for people to think less about their diabetes and more about other things in their life. Hopefully this is just one more way for them to manage their illness without more effort.”

Diabetes patient Tia Mollander sits at her desk and looks down at an insulin pump.
Tia Mollander examines the insulin pump that helps her control Type 1 diabetes.

Molander, a patient at the Barbara Davis Center since 2013 and a participant in previous clinical trials, sees her doctor every six months. She also uses an online software system to download all of her blood glucose measurements—taken every five minutes by the 670G’s sensor—which her doctor can scan remotely for patterns or other concerning issues. All in all, she said, the 670G has given the lifelong healthcare provider hope for even better solutions—for her and others like her—in the future.

“Working in healthcare gives me perspective,” Molander said. “There’s definitely some pride in being part of the system, part of a family. I wouldn’t have known about the pump without being part of this big health system that is cutting edge.”

 

About the author

Andrew Kensley is a Colorado freelance writer, published author and physical therapist for UCHealth Poudre Valley Hospital in Fort Collins.