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Aaron Kowalski Part 3, JDRF Research At ADA 2017

In part 3 of this Exclusive Interview, Dr. Aaron Kowalski talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about exciting research applicable to health care professionals.

Aaron Kowalski, PhD is the Chief Mission Officer and Vice President of Research at the JDRF. He is an internationally recognized expert in the area of diabetes technologies and has been a leader of JDRF’s Artificial Pancreas Research Project, a multimillion dollar initiative that began in 2005 to accelerate the progress toward automated insulin delivery systems.

Transcript of this video segment:

Steve Freed: So, we’re here at ADA, the scientific sessions. So, let me ask you what are some of the JDRF-supported studies that presented results here at ADA this week? And you may have answered already, what results were the most exciting to you and to healthcare professionals?

Aaron Kowalski: We’ve funded research across the spectrum and again I think the nearest term studies that are reporting out that are going to be applicable to healthcare professionals are the device-based studies. Medtronic’s 670G system launching to the market. JDRF doesn’t fund commercial development of these systems, but we did fund a lot of the research that went into the building of the AP systems. Medtronic’s is coming to the market and a number of other companies that are following. People who have type 1 diabetes and are wearing pumps are going to migrate very soon, and in fact it’s happening right now, to hybrid closed loop control and it’s transformational. We’ve heard a number of reports. Overnight glucose levels normalized. Much less variability. Less time hypoglycemic. So that’s great. Another study that was reported out that JDRF funded that I’m excited about is what’s called the “REMOVAL Study” and this was looking at using metformin in type 1 diabetes and trying to reduce the risk of cardiovascular outcomes and the results were very positive. So, if you think of an application when you have type 1 adults who may be at risk, we know of course both forms of diabetes have increased cardiovascular risk, here’s another potential means to reduce risk and that will have direct clinical impact. You’ll hear from Dr. Greenstein about some of the more advanced immuno work that we’re doing, which is going to take time. These are first very important read-outs that we’re getting and I think its super exciting.

Steve Freed: So, let me ask you about one of the items you just mentioned, the artificial pancreas. What are some of the takeaways from your presentation on the artificial pancreas technology that could be useful to healthcare professionals? And we keep talking about an artificial pancreas. It’s not an artificial pancreas. I don’t know why we even use that term. It’s the first step toward an artificial pancreas.

Aaron Kowalski: I wrote a paper about this and I catch some flak so if you want to blame somebody you can blame me. But the short version is the artificial pancreas, a machine that replaces what your pancreas did before you have diabetes is kind of the goal. Along the way, what we’re trying to do is take the tools we have now and make them work better. Much better. So I think we kind of inherited the term artificial pancreas. I always say there’s no single artificial pancreas. There are going to be iterations of more advanced insulin pumps that will reduce highs and lows and reduce user burden. Meaning the decisions you have to make. It’s closing the loop is the other term that you often hear. It’s not completely closed but it is going to work. The data is unbelievable. The data that’s been reported out. JDRF has funded over 100 million dollars in this field and I’m now hearing people wearing these pumps at these scientific sessions. Overnight glucose normalized. Hypoglycemia reduced by almost two thirds. Hyperglycemia reduced. Significantly more time and range. So the artificial pancreas or hybrid closed loop systems are coming to the market and this is the first meeting where we have a system that’s out on the market dosing insulin automatically. The other thing that we’ve talked about, and you heard a number of presentation, is okay well how would you make it more like the functioning islet? We know that we need faster acting insulin. That’s another gap. The reason we call it hybrid is you need the bolus at meal time because the insulin doesn’t work fast enough. It doesn’t work like a pancreas’ insulin works. We heard that people don’t want to wear devices. So I always joke that people without diabetes don’t wear insulin pumps. So when you wear an insulin pump what you want to get is some return on that investment, but the other side is if we can make these devices smaller and easier to wear I think it would be better and you might see more people adopting some of the advances here. So I’m really excited about this year. I think it’s a seminal year in terms of technology because it’s the first year that we can talk about people actually out in the audience wearing hybrid closed loop systems.

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