Diabetes: Brains RequiredI had posted before that October was shaping up to be a diabetes month for me .  The Fort Worth Juvenile Diabetes Research Foundation (JDRF) walk was a highlight in October. The day of the walk was a beautiful, sunny Saturday. Our whole division including my small and proud team pictured to the right.

Rachel Donohue, the executive director for the Fort Worth JDRF, had the following comments on the walk:

We are thrilled with the participation for the Walk to Cure Diabetes. This year we had more than 5,300 participants at Trinity Park and are projected to have raised more than $600,000 from this event! The Cook Children’s team was our leading Corporate Team, raising more than $18,992.30 for research! This is truly an amazing achievement and we are so proud to partner with Cook Children’s!”

I have already written about newer trends in treatment in type 1 diabetes such as continuous glucose monitoring systems (CGMS). CGMS continues to be an expanding tool in diabetes care. There have been a couple of recent articles in the journal Diabetes Care covering use of CGMS in type 1 diabetes. The first article reported successful use of CGMS in adults with type 1 diabetes. The majority of study participants had improved diabetes control as reflected in lower hemoglobin A1C values. In addition, there was a reduction in the frequency of serious low blood sugars. The reduction is serious low blood sugars episodes (a blood sugar that could result in loss of consciousness or a seizure) is one of the most exciting results in this study because these episodes represent the limiting factor in achieving optimal control in diabetes.

The second article looked at factors that predicted consistent use of CGMS technology. The study unfortunately showed those younger than age 25 years were less likely to use the CGMS technology on a near daily basis compared to those above age 25. I think that the second study confirms what I have often told my patients and their family, an educated and motivated human brain is required in diabetes care. The difference in motivation also likely reflects the difference between the still developing teen brain compared to the adult brain.   

The most appealing leap forward in diabetes treatment is actually removing the human brain from diabetes care. In essence, returning to the state of living before diabetes when thinking about insulin doses and blood sugars required little to no frontal lobe time. The creation of an artificial pancreas such as the JDRF artificial pancreas project, I believe, will represent the next leap forward for all of us in diabetes care. An artificial pancreas that I’m referring to in this case is a system that combines an insulin pump, a computer, and CGMS. The system would use programming in the computer to monitor blood sugars and adjust insulin flow into the body.

 I’ll close with a video from the JDRF that documents the experience of a participant in a recent artificial pancreas trial.