Since the fundamental problem in Type 1 diabetes (or juvenile onset, diabetes mellitus) is that the islets cells in the pancreas no longer produce insulin (as opposed to Type 2 diabetes, in which the insulin produced is inadequate in form or amount), the solution to Type 1 is "simply" to replace this function. For all intent and purpose, this is how Type 1 diabetes has long been managed, with blood glucose testing combined with insulin injection to regulate blood glucose levels. Currently, testing is either via test strips or, more recently, via continuous blood glucose monitors, while insulin delivery is either via injection or insulin pump. The "holy grail" of Type 1 diabetes management is to consolidate the glucose testing and insulin delivery in a biofeedback loop, wherein insulin is delivered automatically based on blood glucose levels. The "perfect" alternative to this is, of course, an approach such as an autologous pancreatic islet cell transplant or other cell therapy, combined with a method to either protect the transplanted pancreatic cells from being attacked in the autoimmune response (or to preempt the immune attack) that is at the root of Type 1 diabetes. This perfect solution has steep technology hurdles, though progress on this front is being made rapidly.
So, the more near-term, practical solution is the closed loop glucose monitor and insulin pump, often referred to as the "artificial pancreas. To this end:
The Juvenile Diabetes Research Foundation (JDRF) and Animas, a unit of Johnson & Johnson, have joined forces to create an artificial pancreas—of sorts. The “pancreas” is actually a wireless system composed of continuous glucose monitoring devices, insulin pumps, and advanced software. JDRF has been collaborating with academic centers for years to develop a device that can check blood throughout the day and automatically deliver insulin as needed without the patient having to do anything.
“This is going to be a research and development first step, toward creating an artificial pancreas,” said Henry Anholt, MD, director of medical affairs for Animas.
JDRF plans to spend $8 million over the next three years on this project. The foundation would like to have a device submitted for regulatory review within four years.
Medtronic and others are also pursuing this technology solution which promises to have as much benefit to improved glucose management in type 1 diabetics as to improved quality of life for those type 1 diabetics who effectively managed their diabetes but only through rigorous, painful and vigilant attention to their disease.