Life for Juvenile Diabetics is About to Be Improved by the “Artificial Pancreas”(Pedcast by Doc Smo and Sonya Corina Williams) - a podcast by Dr. Paul Smolen "Doc Smo"

 

Photo compliments of Pixabay

Today, we’re talking about an interesting development in pediatric medicine that will likely revolutionize the management of  childhood onset diabetes, a disease also known as type I diabetes.  The advance is known as the “artificial pancreas”. It sounds like science fiction, but as you are about to see, it’s not and it’s almost here.







Musical Intro



 Detour Down Science Lane



In order to understand this new “artificial pancreas” technology, we need to take a detour down science drive, and make sure your knowledge of glucose metabolism is up to speed. Glucose is what is known as a simple sugar because it is very easy for your child’s cells to burn for quick energy or to store as fat. Your child’s body has to keep their blood sugar in the “Goldie Locks” range in order to be in good health, with a blood glucose not too high and not too low. A high blood glucose will produce diabetes symptoms like excessive thirst, excessive urination, fatigue, and possibly even coma and death. Low blood glucose can be equally dangerous since your child’s brain almost exclusively uses glucose for energy. Without enough glucose in their blood, your child will first get sweaty and weak and, if low enough, then slump into a coma. As you can see, whether high or low glucose, it’s all bad. Insulin, a hormone made in your child’s pancreas, is the hormone most responsible for regulating the glucose system. In a non-diabetic child, insulin unlocks your child’s cells to get glucose into cells and therefore out of their bloodstream, thus lowering their blood glucose. When glucose is scarce, like during fasting at night, insulin levels are usually low. When glucose is plentiful like after a big meal, your child’s pancreas is busy making insulin to push that excess glucose into fat cells. So, you can see that your child’s pancreas, the place where insulin production is controlled, acts as the master regulator of your child’s very important blood glucose level.  And remember, a pancreas does this all automatically.



 



Now let’s consider what is happening in a child with childhood onset or type 1 diabetes. Unfortunately, in this condition, the pancreas cannot make adequate insulin in response to a meal since the cells that produce that insulin were destroyed by an autoimmune process when the child first became diabetic. A type 1 diabetic child has to control their own blood sugar by a combination of carefully measured food intake balanced with exercise and insulin injections. Balancing all this is very difficult as you might imagine. This is a continuous job, 24/7, year in and year out, for the rest of the diabetic child's life. No wonder so many teenage diabetics rebel and just refuse to manage their disease, often with horrible consequences as a result.



 



 



 



 



History of the Management of Type 1 Diabetes



To understand just how big a leap the artificial pancreas is in the management of diabetes, it helps to know how it has been managed in the past. The treatment goal when helping a child with type 1 diabetes has always been the same, keep the child’s blood glucose in the narrow range that the child’s pancreas did before they got sick. In the early days of diabetes management, doctors did this by having children taste their urine to see if was sweet or salty. You see, normal urine is salty and diabetic urine has a sweet taste because some of the excess glucose in their blood has spilled over into their urine. When the child’s urine turned sweet, that meant they needed an insulin injection to lower their blood glucose. Next, came what was known as the sliding scale management method, measure the amount of sugar in the urine with as chemical reaction rather than with taste buds. Insulin administration was thus adjusted by the amount of glu...

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