Automatic insulin pump gives diabetes patients normal life

What is diabetes and what types are there?

Chris Houtmeyers: “Diabetes is a chronic disease that occurs when the glucose level in your body is not correctly regulated. Your pancreas does not work properly and does not produce enough insulin. Too little insulin means that your body does not absorb the glucose in your blood or does not do so properly. As a diabetes patient you have to seek the right balance between the sugars you get from your food, physical exertion and the insulin that you need for this. That is extremely difficult and changes from day to day.”

Chris: “There are two types of diabetes. With type 1, your body makes far too little or no insulin at all. You have to inject insulin several times a day or wear an insulin pump. With type 2, your body still makes insulin, but not enough. I myself am a type 1 diabetes patient.”

We are evolving towards distance monitoring of diabetes. That is far less costly for society than all the consultations and complications that have to be treated now.

Chris Houtmeyers, Customer Solution Architect at Proximus

What treatments are available?

Chris: “The standard finger prick tells you how much glucose you have in your blood. The disadvantage is that the mutual insurance fund reimburses you for a maximum of four finger pricks per day. So, you can’t get an accurate picture of how the glucose in your body is evolving.” “With Continuous Glucose Monitoring (CGM), a sensor measures how much glucose there is in the tissue between your body cells every five minutes. That’s 288 times per day.

That way, you can see the glucose in your body evolving and you can predict when you are going to need insulin. The technology can also be used to set alarms when there is too much or too little glucose in your blood. The disadvantage of this continuous measuring is the time lapse. The quantity that you see was the amount in your blood 15 minutes earlier.”

Chris: “You can inject the insulin yourself. There are slow-acting and fast-acting insulins. Slow-acting insulin works for 24 hours, fast-acting starts working after 20 to 30 minutes. Insulin pumps deliver a continuous amount of fast-acting insulin, which you can set yourself. The latest-generation pumps, such as the Hybrid Closed Loop pump, carry out continuous measurements and automatically regulate the quantity of insulin. In that case, you have to inject yourself with fast-acting insulin via the insulin pump yourself before every meal so that your body can process the sugars from your food. Hence the name hybrid.”

How does technology play a role in the treatments?

Chris: “As a diabetes patient, you have to take about 180 extra decisions per day, compared with healthy people. That’s a heavy burden, made more tolerable by the insulin pump that you carry in your inside pocket. With the Full Closed Loop pump, the next generation is ready.

It regulates everything automatically, so that as a diabetes patient, you can live a life of a normal person. A bionic or artificial pancreas goes a step further and automatically decides when your body needs insulin or glucagon. Glucagon is a hormone that has the opposite effect to insulin and works to increase the glucose in the blood. The two systems are awaiting approval.”

Chris Houtmeyers, Customer Solution Architect bij Proximus

How are the data shared between patients and doctors?

Chris: “An insulin pump is connected to the cloud and automatically uploads all the measurements. All the data sent from the sensor to the pump and from the pump to the cloud are encrypted. As a patient, you determine who can see your data. The Gasthuisberg hospital in Leuven, for example, links the Medtronic diabetes platform with the electronic patient’s file. This means that the doctors and endocrinologists always have the most recent data available. That enables distance monitoring. They can also request reports to see whether your diabetes regulation is under control.”

What impact does this have on the new way of working for doctors?

Chris: “Greater efficiency. As a patient, you see the reports yourself, too. We are evolving towards total distance follow-up, which means that as a patient you have to go and see the doctor far less frequently. If the doctor receives a warning, he can decide to schedule a consultation for you if necessary. Using these data in the cloud, new algorithms can be developed, as well. The pharmaceutical industry can improve its aids. It’s already clear that the Hybrid Closed Loop system together with the platform is far more advantageous than treating the complications suffered by diabetes patients afterwards.”

Are there any drawbacks?

Chris: “Technology is not infallible. From time to time, as a patient you still have to intervene and take a finger prick if you notice that a measurement is not right. The industry needs to look for sensors that measure more quickly and that significantly increase reliability. That way, the periods when you, as a patient, no longer have to take a manual measurement to calibrate the pump if any abnormalities occur will lengthen. And the pumps still mean that patients have to make an extra effort. But the advantages definitely outweigh the disadvantages.”