Saturday, April 22, 2017

The Artificial Pancreas Scares Me

After 40 years of testing urine, and not really knowing my blood sugar levels, it was wonderful to have my first glucometer in the mid 1980's. My control was really bad those first 40 years. After using a meter it was obvious that my BG had been much too high during those years. I was seeing numbers in the 200's very frequently, and numbers in the low 300's, too. I felt comfortable at those levels, but I felt uncomfortable below 150, and hypo below 120. It took a lot of adjustments with my diet and insulin dosages to feel good while having numbers in the low 100's. Control was better, but still not so good, until synthetic insulin was available in the 1990's. By the end of the 1990's I was able to use carb counting, and a fast acting insulin. Then my numbers  were so much better, and my A1c's were in the high 5's. I do not know how I survived for 50 years on animal insulin, and type 1, without having any serious diabetes complications. 

Improvements in the 21'st century are happening so fast, perhaps too fast. There are several artificial pancreas devices being developed, and tested on human subjects. They depend on a CGM for measuring the blood glucose levels. I am using a Dexcom G4, and it is very accurate about 80% of the time, but there are times it is as much as 30 or 40 points different from my meter. If I was using an artificial pancreas device, and I had a false high, I could be given insulin that I did not need. That would give me a hypo, maybe one that would put me in the hospital! There are devices being developed that would give us insulin when we are too high, and glucagon when we are too low. We would not be making the decisions. The device would be making the decisions for us. I feel very uncomfortable with that. The almighty CGM is not accurate enough to have the device do the decision making. I know that the Dexcom G6 is being developed, and it will be more accurate, but I cannot believe that the accuracy will be good enough that we would never have occasional false highs and lows with that CGM. For that reason I will not use an artificial pancreas, even if one was given to me as a gift.

The "Guardian® sensor 3 continuous glucose monitoring sensor Introducing the most accurate sensor from Medtronic, now with up to 7 day wear and easy insertion. It is the FIRST and ONLY continuous glucose monitoring sensor FDA approved and trusted to control insulin dosing." That one is being sold now, but I will not use it. I am chicken! I am eligible for a new pump in May, but I will be getting the Medtronic 630g. That one can be used without the CGM supplement. I will be wearing my Dexcom G4 CGM, and I will be making all of my own decisions!! I have made my own decisions for 71 years, and I have done very well. I want it to stay that way for the rest of my life. :)

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