Diabetes both type 1, which is an incurable autoimmune disorder, and type 2 which is a lifestyle disease that can be reversed or cured are among the fastest-growing diagnoses in the world. Left untreated, they can cause life-threatening conditions and death. So its not surprising that the medical establishment is pumping resources into new methods of management.
What makes them worthy of talking about here on Geek is that technology is playing a major role. Todays diabetic is often wired up with Bluetooth sensors and custom software that turn them into virtual cyborgs with an awareness of their body chemistry that normal people cant match.
Heres a quick rundown of diabetes if youre not familiar with the condition. When you eat food, its split into three basic categories: carbohydrates, fats, and proteins. Carbohydrates, which are found primarily in plant products, break down into a sugar called glucose in your digestive system. That glucose is turned into fuel to power your mind and muscles.
The body does that conversion with a hormone called insulin, which is produced by beta cells in the pancreas. Type 1 diabetics dont make it at all their immune system destroys those beta cells for an as yet unknown reason. Type 2 diabetics make it, but for some reason its less efficient at breaking down glucose into energy.
When the body cant break down glucose, it has to get energy from other places mostly fat, but nothing is safe. That leads to a state of ketosis, where acids released from fats build up. Those acids can cause a wide variety of nerve and tissue damage.
So the life of a diabetic is basically monitoring their carbohydrate intake and then injecting an appropriate amount of insulin, based on a series of complex mathematical formulas, to match it. Too little and they go into ketosis. Too much insulin can drop their blood sugar dangerously low, which can lead to comas and death. Its a delicate tightrope that they walk every day.
The last few decades have seen advances in diabetes treatment that will blow your mind. To put them into context, lets rewind 50 years or so to look at what treatment was like.
Back in the day, a diabetic would wake up every morning and pee into a test tube. Theyd then drop a tablet into it that would change color to tell them what range their blood sugar was in high, normal or low. Theyd then take a single injection of long-lasting time-release insulin that would do for the entire day and hope for the best. When they were done, theyd take the syringe, boil it on the stove to sterilize it and put it back for tomorrow.
Needless to say, the life expectancy for diabetics was pretty short. Without a way to detect highs or lows, their bodies were at the mercy of a variety of factors and many died.
So there were two problems facing diabetics: being able to monitor blood sugar and being able to deliver the appropriate amount of insulin, no more, no less.
Monitoring got easier with the invention of the fingerprick blood glucose monitor in 1981. A drop of blood is introduced to an enzyme, and then an electrical current is passed through it. The number of electrons the sample loses correlates to the amount of glucose present in the sample. This allowed for significantly more precision, delivering a numerical representation of the patients current blood sugar.
That was coupled with the development of faster-acting insulin, so diabetics could treat highs as they happened. The next wave of diabetes care required them to be a more active participant in their management, checking glucose throughout the day and making adjustments as needed. As cool as this was, technology was about to get involved in a big way.
Fingerprick glucose is accurate but requires the diabetic to go through a process every time they want to check (and only works when theyre awake). The threat of low blood sugars at night is a very real one, as glucose levels can drop quickly. An accidental scientific discovery in the mid-1990s helped change the lives of diabetics around the world.
Researchers were experimenting with the bodys cell fluid in the skin and discovered that it basically mirrors the blood glucose level with about a 15-minute delay. In 1999, MiniMed got FDA approval for the first continuous glucose monitor an electrode thats inserted into a diabetics skin that transmits a reading every five minutes without the need to draw blood. Now patients could get real-time feedback on their blood sugar throughout the day. Those early sensors were good for about three days before the bodys immune system rejected them, but modern ones can go for a week or more before theyre changed.
Monitoring that accurate is all well and good, but a diabetic would still need to give themselves an injection to bring high blood sugar down. However, an earlier invention made that process significantly easier. In 1973, Dean Kamen (inventor of the Segway) debuted the worlds first wearable insulin pump, a device that could dose any amount of insulin to a diabetic through a cannula, or small tube, that attached to the body. This gave diabetics even more control over their treatment, enabling them to microdose and control exactly how much of the hormone they receive.
Pumps have advanced significantly over the last decade, with one the Omnipod not needing a tube at all, but affixing directly to the skin and communicating wirelessly with a control device. Patients who manage diabetes with these devices are uniformly in better condition, and even though only one in a thousand diabetics currently uses a pump, that number is rising.
The next step is the artificial pancreas, a device that combines the two into one. These have passed clinical trials and are being rolled out slowly by endocrinologists around the country. Using complex algorithms, they monitor blood glucose and treat it at the same time in a closed-loop system, also administering glucose when blood sugars are too low. Early results are incredibly positive. Like existing pumps and CGMs, they still have to be changed out regularly, but the system marks a significant advance in treatment.
The future of diabetes is even more exciting. Companies are working on insulin that doesnt have to be injected, but rather is absorbed through the skin with a sound-activated patch. Another brand can be inhaled before a meal. Google is collaborating with contact lens manufacturer Alcon on a lens that measures blood sugar through the eye.
So if you see somebody walking around with some little gray boxes attached to their arms or stomach, its highly possible that theyre toting around a cyborg pancreas, wired into the cloud and keeping them healthy.
Read more from the original source:
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