I have a four year old daughter with type�1 diabetes, and I am hopeful something new will be available by the time she is first grade and gone from home most of the day. Is there any more information on the closed loop pumps? I heard they were close to being ready for marketing in “a couple of years”, but I heard this two years ago. Was that just wishful thinking or will they be a reality sometime soon? Also, is there anything else that might be as helpful to the daily care of diabetes that might be available soon?

I think it very unlikely that a closed loop insulin pump will be authorised by the FDA in the next few years although a Swiss group has started clinical trials in Britain along these lines. The main problem has been the difficulty of achieving impeccable reliability of the glucose sensor so that for the time being it has seemed safer to keep pump and sensor distinct.

In the meantime of course, there are steady advances in new insulins, new insulin regimens and less invasive devices for measuring blood sugars. I sense though that what you are really hoping for is something approximating a cure.

This is a possibility albeit nearer ten than two years away. There is at the moment, a great deal of research now on circumventing the two major problems of islet cell transplantation, namely the shortage of donors and the present need for lifetime immunosuppression. The NIH is supporting a consortium of five centers to evaluate the possibility of implanting various surrogate insulin producing cells such as stem cells or genetic ally modified cells and already there are beginning trials of some very sophisticated manipulations of the immune system that promise to induce life long tolerance to grafts in a very short time.

DOB