Two of the most important milestones in the development of products for the treatment of diabetes include the development of the completely non-invasive glucose monitor and the “artificial pancreas”, or closed loop system that monitors blood glucose and administers insulin to produce a homeostatic-like control of glucose. Both systems represent areas of tremendous development activity, driving work at multitudes of companies and other institutions due to the chronic nature of diabetes and the high cost of complications arising from inadequate glucose control. Noninvasive glucose monitoring — being pursued through development of near infrared detection, interstitial fluid measurement, laser lancing and other methods — has long been foremost due to the comparative challenges presumed to exist for closed loop monitor/infusion pump. However, given the seemingly no-less-daunting task of achieving noninvasive and reliable monitoring technologies, while continuous monitoring and external and implantable infusion pump technologies rapidly evolved, the prospects for the artificial pancreas have grown.
At the 66th Scientific Sessions of the annual American Diabetes Association meeting, there was considerable focus on efforts to develop the artificial pancreas. Rather than summarize those efforts myself, I instead provide this excellent review by Andrew B. Muir, MD, on Medscape.The possibility remains for stem cell research to enable pancreatic cell transplant or similar cell based therapies, since the restriction on federal funding is regressive but destined to succumb to more enlightened consideration of the issue — science and ethics — than is possible with the current administration.