June 14, 1999
Question from Seattle, Washington, USA:
I read about a watch that would give a measured dose of medication for diabetes, at predetermined times during the day. (No more self injections.) The wristwatch is/was in use in Europe and presently being tested in the USA (for FDA approval). Would you have any information or know where to find it?
The GlucoWatch has finished clinical trials and is expected to be reviewed by the FDA and probably will be available commercially later this year. The MiniMed pump group have also produced a sensor contained in a needle which needs to be replaced every three days. For the time being this sensor cannot be used to control pump insulin dose directly and it will probably be several years before this can be achieved reliably. In the meantime the problem of how to maximally utilise the greatly increased blood sugar information that these instruments afford has not really been worked out.
Additional comments from Dr. Robertson:
I think that you are confusing two pieces of technology which will eventually be combined but not for some time. insulin pumps are now very sophisticated and can be set to change rate several times in a day to correspond with activity. Additionally, you can give bolus doses just before food. There is a separate gadget, to be available from Spring 2000 from MiniMed, which will monitor blood sugar continuously by means of a tiny needle that sits below the skin for up to three days at a time. This will, in the first instance, not give readings directly but will be downloaded by a physician to help understand fluctuations in sugars and to decide therapy. A hypo alarm version is being developed and eventually a continuous readout will be available.
[Editor’s comment: We have asked the members of the Diabetes Team to see if anyone is aware of a device that does exactly what this question proposes. None of us are aware of any such device. Dr. O’Brien discusses the two most likely candidates for new blood-sugar sensing equipment that might someday be modified to link to a pump directly, but neither of these is capable of interfacing directly to an insulin pump at the present time, nor in the near future. WWQ]