Diabetes Technology Society: World’s Top Minds Convene on Helping Patients Now

The world’s largest organization dedicated to applying technology to treating diabetes is meeting right here in the Bay Area this week (Nov. 10-12)! This under-publicized group has the potential to directly impact the lives of 21 million Americans (according to the Centers for Disease Control) now living with diabetes.

Researcher_2The Diabetes Technology Society is the is the brainchild of Dr. David Klonoff, clinical professor of medicine at UCSF and director of the Mills-Peninsula Diabetes Research Institute, also founder and editor of the monthly journal “Diabetes Technology & Therapeutics.”

Starting this Thursday, the Diabetes Technology Society (DTS) will hold its 5th annual meeting at the SFO Hyatt Regency Hotel, sponsored in part by the CDC, the US Army, NASA, UC Berkeley Dept. of Bioengineering, and Georgia Tech’s Emory Center for the Engineering of Living Tissues. This year, they expect more than 650 top physicians and medical researchers from around the world — conferring on new treatments and inventions to optimize diabetes control.

Try as I might, I won’t be there (despite living practically around the corner!), because the group does not grant journalists press access to the event. BUT Dr. Klonoff was kind enough to grant me an interview late last week for a sneak peak of what’s hot this year:

* CONTINUOUS GLUCOSE MONITORING: Dr. Klonoff says the biggest roadblock is the lack of a universal standard to aid the FDA in evaluating these exciting new products. In a move that will hopefully “jumpstart” continuous monitoring product approval and innovation, DTS has established a global expert panel to help craft standards for performance of continuous monitors.

This quest to cultivate continuous monitoring is by far the biggest issue this year. The panel’s goal is to propose a set of standards that goes beyond today’s static measures of point accuracy. What’s needed is a mathematical formula for evaluating the ongoing “trend data” that new continuous meters will provide. The FDA is not obligated to accept the panel’s recommendations, “but they have told us that the method we’re using — bringing together these types of world experts — usually results in reasonable standards and adoption of those standards,” Klonoff says.

If and when a universal standard is adopted, it would immediately step up the FDA approval process, getting continuous monitors into patients’ hands much faster. Also, the introduction of universal standards in any industry tends to promote a flurry of activity, since engineers now have clear guidelines for developing new products. Cross your fingers for the panel’s success!


* THE “ARTIFICIAL PANCREAS” CONCEPT
: the latest in many years of pursuing a “closed loop” system that combines continuous blood glucose sensing and insulin delivery. Development is particularly slow going because of the high risk factor: lives would depend on a machine that decides when and how much insulin to deliver. Substantial mistakes could be fatal.

Understandably, there are quite a few obstacles and concerns on this one. Besides a “patient override” mechanism, other important elements to build in might include a glucagon store to counteract overdoses or exercise, and perhaps a pedometer as a source of information on physical activity — so your “pancreas” knows when to reduce insulin delivery.

Anyway, perfecting the continuous monitor is key here. Once that half is in place, it’s a matter of connecting that device with an “automatic” insulin delivery mechanism -– some kind of “sensor-augmented pump.” Klonoff says developers are experimenting with both internal and external models.


* ALTERNATIVE INSULIN DELIVERY
: Inhalable Insulin from Pfizer and Sanofi-Aventis, TechnoSphere inhalable insulin powder from MannKind Corp., large porous particles from Eli Lilly & Co., “aerosolized” from Novo Nordisk, buccal (cheek) insulin delivery from Generex, and even a nasal spray from a company called Nastech. Where are we now?

The FDA has pushed off the Exubera vote until January, but that’s still just three months away! Inhaleinsulin_1Dr. Klonoff says setting doses for the inhaled insulin is not as difficult as it sounds, and that it most likely WILL be approved by the FDA for “specific patient profiles,” i.e. adults with healthy lungs and no additional medical conditions.

Nastech, on the other hand, is just now beginning to test its nasal-spray insulin on human patients.

The most colossal impact of non-injectable insulin will actually be on people not now using insulin, Klonoff notes. The easy and painless delivery systems will “break down the barriers” to taking insulin and could thus help millions of Type 2’s get their diabetes under better control.


* NANOTECHNOLOGY FOR DIABETES CARE
: The science of tiny molecular particles has tremendous potential for helping treat diabetes:

~ glucose-sensing “smart tattoos” made possible by polyethylene glycol beads that are coated with fluorescent molecules. Still in early development stages, but showing promising results in tests with rats.

~ a new generation of ultra-powerful biological sensors will be highly useful for improved and/or implanted glucose monitoring

~ “Nano-engineered” particles can improve insulin delivery in the body

~ A myriad of uses for drug development and tissue regeneration

* ANNUAL DIABETES TECHNOLOGY SURVEY: This is the cool interactive part of the conference. All the experts in attendance get to vote on which drugs and technologies hold the most promise, which they expect to come to market quickest, and so on. Engineers and researchers take their cues here, so the vote has a direct impact on industry activity. (Results are published in the Diabetes Technology & Therapeutics Journal.)


* STANDARDS OF CARE
: Other topics include standards of care in the hospital (some of the worst glucose monitoring apparently happens in the hospital!), and the notion of moving away from pure focus on the A1c number to a more quality-based measure of glucose levels over time.

The catalyst for the latter is of course Dr. Irl Hirsch’s acclaimed work around using the standard deviation to evaluate glucose level “swings” rather than relying on a simple average. The A1c number may well be an “artificial” middle point between severe highs and lows.

So, you’re probably thinking (like I was): What about pursuing a cure?

Walkforcurehands_1Dr. Klonoff says: “A cure will probably occur someday in the future, but that day might be 50 years away. Meanwhile it’s important for the scientific community to be funding engineering research that will help people RIGHT NOW …”

“No other disease requires so much patient monitoring, and people with diabetes can benefit greatly from technology that will let them monitor their sugar more easily, more accurately, and more often — that will help insulin be delivered more easily, more exactly in terms of dosing, and more often…”

“There are many steps that people with diabetes need to take that will be solved by better engineering.”
~ ~ ~

More DTS details to come. Meanwhile, please note that Nov. 9 has been officially christened “D-Blog Day.” So if you’ve got a blog and have anything at all to say about diabetes, Wednesday’s the day!

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11 Responses

  1. Andrea H.
    Andrea H. November 7, 2005 at 1:41 pm | | Reply

    Wow Amy, thanks for collecting all that information. I’m sure I speak for many when I say how appreciative I am that you’re ferreting out and sharing all this valuable information — and unpaid, too! Your blog is the first one I check on my Bloglines subscription every day.

  2. The Biotech Weblog
    The Biotech Weblog November 16, 2005 at 8:58 am | | Reply

    Innovations in Diabetes, Genetic Screening of Embryos, and Migraine Drug Alternative Featured at the Grand Rounds 2.08

    This week’s collection of the best in medical blogging is hosted by Doc Shazam. Other biotech-related entries to this issue of the Grand Rounds are: Diabetes Mine’s preview of the 5th annual meeting of the Diabetes Technology Society to…

  3. Justin H.
    Justin H. November 16, 2005 at 2:47 pm | | Reply

    Concerning Exubera… How can they think that it will “affect people not currently taking insulin…” more than those of us who’ve been injecting ourselves for 20+ years? Do you have ANY idea how much easier it would be to talk myself into taking my shot when I’m supposed to if WEREN’T a shot!?

  4. AmyT
    AmyT November 16, 2005 at 4:58 pm | | Reply

    Hi Justin:
    I think they meant biggest effect on changing their diabetes control. Presumably, people already on insulin get better control than those who ought to be on insulin but aren’t yet.

  5. Joan
    Joan January 19, 2006 at 11:01 am | | Reply

    Hi Amy,
    I visited your blog a few times and find it most helpful. My dream would be of course a “cure” for the big D. Part of that dream would include a way of continuous monitoring in order to eliminate the finger pricks 10 times a day. This disease takes up a lot of time and adds baggage to a simple day, as I “never leave home” without my monitor and journal. My pump does all the carb calculations for me so that is pretty simple and with the pump there is no need to carry around insulin or needles. Lucky me. Well, will check in from time to time and thanks for your hard work for all who visit. Have a good one…Joan

  6. dLife Today
    dLife Today January 19, 2006 at 2:03 pm | | Reply

    Diabetes Technology

    dLife columnist Amy Tenderich has a sneak peek of this week’s Diabetes Technology Society conference over at Diabetes Mine. From nanotechnology to glucose sensing tattoos, there’s lots of cool stuff on the horizon….

  7. Dr.Md.Ibnul Hassan
    Dr.Md.Ibnul Hassan September 21, 2006 at 9:29 am | | Reply

    Story of a new hope

    Diabetes is a disease that affects millions of people across the globe. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.Being a medical professional I know the owes of diabetic peoples.It took a great deal of courage to take my decission to try to find sometging with our indigenous herbs that really works.I knew that our country is abounding with some herbs that are used to treat diabetes for decades .I started searching the herbs that has the hypoglycemic effect and listed them according to the family,use and effect of sugar reducing capability.After a number of initiatives the most powerfull hypoglycemic herbs was found. The main focus of my work continued to the development of new oral hypoglycemic drug that is cost effective,easily available and with least or no adverse effects. Based on thoroughout investigation and meticulous research i started clinical trials to develop a new generic which reducess blood sugar to a greater extent. Over the last 5 years i have applied it around 200 patients with diabetes and all of them have responded well and maintained a very good quality of life with normal bood sugar level and the most important aspect was that it was better than i expected.I would like to take the opportunity to say it was truly much more than I anticipated. The positive finding from this study so far is that female with DM responds quickly than male diabetics .The stability of the bloodsugar level depends on the dose of the drug .I aim to continue with this trial and to work on improving the significance and durability of responses to the drug. In addition to improvements in therapeutic protocol it is my aim to collaborate with colleagues around the world , using the knowledge gained from previous research in a clinical trial ,to formalise this data. Over the last few years i have completed significant amount of study and evidence sugests that it also plays an important role in irregular bowel habbit as diabetic patients with constipation reports regular bowel clearence after taking this drug. It should be noted that the results reflects a non-specific activation/increased sensitivity of beta cell receptors to better recognize insulin which virtually eliminates insulin resistance and interferes with glucose absorption from the intestine and prevents adrenal hormones from stimulating the liver to produce glucose, both of which directly reduce blood sugar levels.I belive one day in near future we will be able to treat diabetes with more clear results and with half the cost they are now spending.So it is my hope to carry on this research and if I can work in a team with hightech fascilities i am sure that we will have the honour to usher a new way to treat diabetes successfully. Regards,

    Dr.M.I.Hassan
    Bangladesh
    dihrsl@yahoo.com

  8. Logen
    Logen March 4, 2007 at 10:27 pm | | Reply

    Hi all,
    I came across a nanotechnology device which generates a constant positive energy which helps to bring back the molecular structure of water. This had help many diabetes patient in Malaysia to cure.I experienced it myself. So, I decided to share to this forum. Take a look at http://www.questbiodisc.com…It would be very helpful.

    Regards,
    Logen

  9. Vicki
    Vicki May 22, 2007 at 8:53 pm | | Reply

    Last time I looked, January was definitely more than 3 months away.

    (“The FDA has pushed off the Exubera vote until January, but that’s still just three months away!”)

  10. SABO SAMUEL
    SABO SAMUEL April 28, 2008 at 1:18 am | | Reply

    MY MUM IS SUFERRING FROM DIABETES I NEED HELP PLEASE COS IT HAS BEEN LONG.

  11. Mirna Garcia
    Mirna Garcia June 20, 2011 at 6:27 pm | | Reply

    Buenas tardes, he enviados correos a Diabetes Technology Sociaty preguntando si realizan trasplantes de celulas madres adultas de la medula osea, me podrian confirmar por favor.

    Mi madre padece diabetes tiene 83 años y quiere someterse a este tratamiento.

    Por favor

    En espera de respuesta… Mil gracias

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