Bionic Pacreas Sets Bar Too Low

I recently listened to a podcast called Medscape Diabetes and Endocrinology dated July 1, 2016. In this episode, Dr. Ed Damiano describes his bionic pancreas. Dr. Damiano has a son with type 1 diabetes and predicts his bionic pancreas will simplify the treatment of type 1 diabetes. In summary, this bionic pancreas uses wireless bluetooth communication to transmit cgm data directly to a pump that automatically delivers sub-cutaneous doses of insulin or glucagon in an effort to maintain near normal blood glucose levels.

I was, at first, elated by this stunning technological news. Then I heard Dr. Daliano relay how excited the test patients were that their blood glucose levels were maintained between 80 – 180 mg/dL. First of all, blood glucose levels near 180 mg/dL is NOT normal. Second of all, I can maintain better blood glue values using diet, lifestyle, a blood glucose meter, and multiple daily injections (MDI).

Don’t get me wrong, I think there are certain people for whom this technology will be a godsend. I’m thinking of young children and adults with diabetes with multiple chronic disorders that exacerbate diabetes and lead to highly unpredictable blood glucose levels. However, for the majority of diabetics, this levels of blood glucose control (80 – 180 mg/dL) should be achievable with better diet and lifestyle decisions and not through fancy technological algorithms.

I’ve said it before on this blog. T1D is a pain in the ass. However, this disease has given me unique insight into my own body. I can very clearly see how food and activity affect blood glucose levels. In a healthy person, blood glucose levels are maintained between 70 – 100 mg/dL without even a fleeting thought. This disease has forced me understand on a deep level the consequences of my diet and lifestyle decisions. In a weird way, I’m grateful to this disease.

My final gripe with this conversation was the focus on blood glucose levels without any counterbalanced discussion of good nutrition and physical activity. I think an unbalanced focus on glucose numbers without any education on the effects of food and lifestyle will not lead to better health outcomes. I believe most people with diabetes will simply use this device to find more license to consume more of the standard American diet and lifestyle that is undermining our health.

This post is going to come across to many as arrogant. People will say that I poo-pooing and device that could save lives. I disagree. I think this device sets the bar too low. I think we can do better. I think we can use natural medicine to look, feel, and perform better. As for me, I’ll stick with MDI and use food as my medicine.


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