A NaNoWriMo Update and Other Thoughts

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We’re closing in on halfway through NanoWriMo and my word count is over the 22K mark. I’m a touch ahead of the minimum word count, so that’s OK for now, but I need to get far more ahead, because Thanksgiving is coming…

I found an interesting technology tidbit today. I’m fairly certain that I’ve never mentioned I am a Type I diabetic, at least not in anything published on this site-maybe on a previous site. I’ve been diabetic since I was thirteen years old, so that is creeping up on thirty-five years living with an incurable, but treatable disease.

As with most incurable diseases, especially ones that affect millions of people, there is a sizable support community on the Internet. There are multiple foundations working hard to find a cure, but they are all hampered by the need for any commercial solutions to be approved by the FDA or other regulatory bodies before they are available to the public.

Well, open source technology is trying to make an end-run on this bottleneck. It is succeeding to some degree. Before I dive into how, let me explain the mechanics behind diabetes, particularly Type I diabetes. To simplify this explanation, I will take some shortcuts that medical professionals might feel are inaccurate, but I’m not writing a dissertation, just trying to explain what is broken.

In Type I diabetes, the pancreas, which is responsible for producing insulin (among other things) stops working. This is the root cause of the problem. Without insulin, the body’s cells cannot process sugar, or more accurately, glucose. Levels of glucose build up in the blood, causing a condition called hyperglycemia, or elevated blood sugar. The short-term effects are intense thirst, excessive urination, lethargy, and a craving for sweets or food in general. The long-term effects are damaged organs and bodily systems from dealing with the excessive amount of glucose in the blood.

When a pancreas functions normally, it can react to higher levels of glucose in the blood and produce more insulin to allow the body’s cells to process the glucose. In diabetics, this doesn’t happen. Unless the body gets insulin, a person will eventually slip into a coma and die. There have been dozens of attempts to replace a damaged pancreas – transplants, insulet cell (the part of the pancreas that produces insulin) implantation, and other weirder methods have been tried, all in an attempt to bring the glucose cycle back to normal – a person takes in carbohydrates, the digestive system breaks them down and the pancreas produces insulin to process the resulting glucose.

Insulin therapy, whether shots or pumps, has always been complicated to balance because to properly dose insulin you must know your blood glucose (bg) level. This requires, for most diabetics, pricking their finger and using a test strip and an electronic meter to determine their blood glucose level. They then can use a formula to determine how much insulin to take. Unfortunately, taking insulin after eating, when bg levels are high, has been determined to be less effective at preventing long-term complications of diabetes, which are many, some of which are more dangerous than the disease itself.

It was discovered that the better way to treat with insulin is to determine how much insulin to take prior to eating, to keep bg levels from rising too high. This requires knowing how many carbohydrates are in your current meal, and also knowing how much insulin it takes for your body to process that amount of carbohydrates, which varies from person to person.

The ideal system would eliminate the finger sticking and insulin calculations and coordinate information from a continuous glucose monitor (CGM) and feed that directly into a insulin pump, so that the pump can automatically determine how much insulin to deliver. This would essentially create an artificial pancreas. That’s exactly what two open source projects are doing now. Check out the main website for these amazing projects. They do a much better job than I would in explaining what they are doing.

Here is the Looping website and here is the OpenAPS site, both of which are making strides toward creating an artificial pancreas system. Pretty exciting stuff.

I’ll check back in once I top 30,000 words.

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