The iLet - Using mathematics to treat diabetes...five minutes at a time

I just finished watching an interview TuDiabetes ran earlier tonight with Scott Scolnick, Senior Research Scientist on the Bionic Pancreas project, originally out of Boston University. The original Boston group ran under the banner:

"Using mathematics to treat diabetes...five minutes at a time"

Nice (geeky, but nice!) The new tag line Scott used was "Diabetes Without Numbers" That must really cheese-off the engineers and scientists that have poured over the equations driving this Artificial Pancreas (AP) :-) But of course he's referring to the patient's far lower workload in managing T1D with one of these devices....

Their latest prototype AP, the iLet, hit the headlines last month when their Principal Investigator Ed Damiano  presented the  prototype at this year's Friends for Life conference. Dr Damiano has a great TED presentation up on You Tube:

The iLet is a dual-shot AP, holding and delivering both insulin (to bring blood glucose numbers down) and glucagon (to bring BG up). There is a healthy debate on-line about whether APs should be (need to be) dual or just relying on insulin.

I won't repeat all the details here - there's plenty on the web, but here are some of my favourite features:-

• It "learns" each user in around 18-24 hours from switching on
• No need to input any information except patient weight...
• No carb counting
• No basal adjustments
• No planning ahead
• No home filling, mucking around getting the bubbles out - uses standard pen insulin cartridges
• "Long-life" stable glucagon - from Xeris, giving 6 days of use (you still need to change infusion lines every 2-3 days as now)
• Bluetooth-linked BG meter (much like the Bayer Contour Link 2.4 with our 640g)
• Tidepool designed user interface

It relies on CGM of course to give it a continuous (every five minute) update on glucose levels. They plumped for the Enlite CGM system....ok, ok, no, they went for Dexcom, currently the G4 Platinum, as, it appears, is everyone in the AP game (except Medtronic of course)

http://sites.bu.edu/bionicpancreas/

The current prototype is about the size of a iPhone 6 (twice as thick), with a colour LED screen. What I hadn't heard before is that they plan for the first generation commercial product to use an e-ink display (much like the Pebble watch or Kindle) - presumably with a back-light - which should increase battery life considerably and a reduction in size to an iPhone 3G. Sounds Janki sized to me :-)

In the event of loss of CGM data, it has a "Safe-Mode" using BG readings and knowledge of your previous patterns to keep you on the glucose straight-and-narrow. Looking at the demo, it appears that even then you don't have to carb count - just let the pump know you are about to eat, whether it's typical for the meal / snack you usually have and it'll take its best guess.

The iLet appears to bring together the previous iterations of the Bionic Pancreas, the last of which was based on an iPhone interfaced with pump hardware:-

Boston University

One other thing that I was impressed with is that these guys have already conducted Clinical Trials on children (6 years old and up) as well as on adults. How refreshing.

They aim to go to market in 2017 - I wish them well and you can follow their progress at http://sites.bu.edu/bionicpancreas/ or on Facebook.