Could you please give me some more information about a closed loop pump system of diabetes management for type 1 diabetics? Is this an integration of both the pump and continuous glucose monitoring systems? How far has development of such a system come and is it suitable for use in children? I know from research that a cure appears to be something of a distant dream as yet and, as this sounds like the next best thing, I would like some information on what the future may hold for my child, and if that future may be injection free.

Also, I have read about a type of little tube that can be inserted into the abdomen and used for several days as an injection site, something similar to a pump connection but without the need for the constant attachment to a pump. Are either of these systems medically approved or freely available?

The closed loop works in theory and there actually are several working models, but it is not quite ready to be sold. The pump is “hooked” via radiotransmitter to a continuous glucose monitor and then the computer in the pump is programmed to respond to the glucose readings. The biggest problem is that this does not provide instantaneous blood glucose, but only interstitial fluid glucose, and there is some lag in this value compared to the blood glucose. So, it is more difficult than just hooking the two parts of the system together. There have been several intravenous glucose monitors hooked via computers to deliver insulin over many years but this is obviously not so practical for day-to-day use. You can find more information about continuous glucose monitors at the Abbott FreeStyle Navigator web page, the Medtronic REAL-Time CGMS web page, and the DexCom CGMS.

The other question you asked is probably about a small device called an insuflon or an I-Port. You can go to their web sites to learn more about this as well. The OmniPod insulin delivery system delivers insulin like a pump, but has no tubing. You use a separate controller to direct the pod to deliver insulin.

SB