Pumps and more pumps

Pumps and more pumps

Last week we learned that the Juvenile Diabetes Research Foundation (JDRF) had teamed up with Animas and Dexcom (NASDAQ:DXCM) to work on an artificial pancreases. Today comes news that JDRF has teamed up with Becton Dickinson (NYSE:BDX) on a program which according to a BD press release; “aimed at improving the treatment of type 1 diabetes by developing novel insulin delivery products to enhance the use of insulin pumps.”

According to this same release; “Through the program, JDRF will support BD’s research and development of new products that deliver insulin from a pump to a patient in either an infusion set or patch-pump configuration. Research indicates that there are significant opportunities to enhance pump therapy by improving convenience as well as minimizing pain, kinking, occlusions and site infections. An additional goal of the program is improving the speed at which insulin works. These enhancements are intended to improve how people with diabetes control their insulin therapy and have a positive impact on their overall level of glycemic control.”

It seems just a little odd that all this news regarding pumps comes at a time when the FDA is about to conduct a special panel meeting looking into insulin pumps. It has been known for some time that when used properly an insulin pump can be one of the most effective tools for patients with diabetes, type 1 or type 2. The issue has never been whether or not pumps are an effective treatment regimen. The issue, which will likely be the central issue discussed at the upcoming FDA panel meeting, is properly training patients to use an insulin pump.

Diabetic Investor is all for improving pump technology and making pumps more patient friendly. However, as we have noted too many times all this great technology is meaningless unless the patient actually understands how to use it properly. Yes it’s those pesky patients, the people who actually use this technology everyday, who need to be able use this great technology.

As we mentioned last week while attending the JP Morgan conference Diabetic Investor has seen several interesting pump technologies however few of these will do much to improve patient outcomes or their quality of life. Or put another way these systems were designed by engineers to be used by engineers. Looking over these various systems one has to wonder if anyone at these companies spoke with an actual patient while designing them.

One also has to wonder with all the great work the JDRF is doing will they remember that central to all this good work is having a system that a patient can actually use. This goes beyond design but extends to patient training too. While this training issue may seem inconsequently to some, consider that we have already seen two reported deaths for patients using the new Paradigm Veo™ from Medtronic (NYSE:MDT).  While not yet available here in the US, thank goodness, the system is available in the United Kingdom. Although Diabetic Investor does not have all the circumstances regarding these deaths, the mere fact they were using a semi-closed loop insulin delivery system demonstrates the severity of issues that can occur when a systems fails or is used improperly.

Hopefully the JDRF will be able to address these issues helping make these systems more reliable. Even so no matter how reliable they are it’s worth noting that even the simplest machines do fail. Most of us have no problem getting on an airplane and flying. Thankfully a plane crash is a rare event yet they do occur even with all the advanced technology available today. This doesn’t mean people shouldn’t fly however as we have seen there are multiple factors that can lead to a problem.

To Diabetic Investor this focus to develop even more sophisticated technology falls into the category of just because it can be done doesn’t mean it should be done. Yet as we have seen time and time again this won’t stop people from trying. It hasn’t stopped the quest to develop a non-invasive glucose monitor or inhaled insulin so why should it stop this effort to develop a closed-loop insulin delivery system. One has to wonder where we would be today if just a fraction of the time, effort and money spent on these attempts at whiz bang technology were directed instead to improving patient education. Would we still be facing a patient population where nearly 80% are not adequately controlling their diabetes? Would we still be facing a patient population that on average monitors their glucose levels less than twice a day? Would we still hear that one of the biggest reasons patients are not under control is because they are not compliant with their therapy regimen?

Diabetic Investor doesn’t have the answers to any of these questions but we sure would like to find out.