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Bruce Bode Part 4, Ideal Candidates for the Artificial Pancreas

Dr. Bruce Bode talks with Diabetes in Control Publisher Steve Freed during the ADA 77th Scientific Session in San Diego about the impact of the artificial pancreas on parents of children with type 1 diabetes.

Dr. Bruce Bode, MD, FACE  is a professor of medicine at Emory University School of Medicine in Atlanta, GA. He has a strong affinity for working with children and young adults with diabetes and is considered one of the leading experts in the world on insulin delivery and glucose sensing. He is very active in clinical research on new diabetes products including pharmacological agents to prevent diabetes and control glucose and new insulins and glucose sensors.

Transcript of this video segment:

Steve Freed: Who are the candidates for this new “artificial pancreas”?

Dr. Bode: So as far as age goes, right now, by the label, it’s 14 and above. However, it’s contraindicated below 7 because they haven’t studied anybody. So you as a physician can write down to age 7 but it’s not in the label. We have several people on it down to age 7. We have even under 7 but by the label it says you should not prescribe it until it’s approved under age 7.  The other thing is the system would prefer they think they need 8 units a day. So if you’re under 8 units a day total daily dose, they’ve never studied that either. They’d say wait until we figure out is that feasible.

Steve Freed: What has this done for the parents of children with type 1 diabetes?

Dr. Bode: So, for the parents of children, they will tell you a couple things. One, they don’t have to get up at night anymore because they know they’re always safe. Typically, especially young kids, they might go to bed at 8 o’clock at night and wake up at 7 in the morning and they’re always down at 120. It’s totally flat and very predictable because you’re in auto-mode there, it’s automatically, auto-piloted, just bringing you right down to 120 so they really like it. But during the day, the kids, they like to eat, especially when they come home from school all the way to going to bedtime, especially teenagers. You still have to put your carbs in and you don’t put your carbs in and you go above 300 for an hour or two or longer, it’s going to kick you out, it’s going to tell you to take a correction dose, to get you back in and under 300. So, during the night it’s a miracle to the parents. During the day, they have to calibrate the sensor and if it’s a lost sensor, they have to calibrate and find out why it’s lost. If they need to change it, they got to change. But if you just follow what it says, it says glucose, check the glucose. If it says change the sensor, change the sensor. You always have this safe basal. If the sensor is lost, you go into a 90 minute period where you have a safe basal that the algorithm says this will be safe, you shouldn’t go low, you shouldn’t go high until you can get your sensor working again.