DiabetesPast

Present and Future

Rich Hartmann 5/11/2010

Familiar scenes for diabetics•Insulin, Monitoring blood sugar, Diet, Exercise •Leading to great blood glucose control

Teaching the world

Eating right with Exercise!

Diabetes Past and Present Advance Year

Research to harness insulin from pancreas 1915-1922

First human patient 1922

Insulin produced from cows and pigs 1923

Discovery intermediate action insulin – NPH 1937

NPH and Lente insulin approved by FDA 1948-1954

First oral diabetes drugs 1950

First insulin pump size of backpack 1965

Blood Glucose testing at home 1976

Size of insulin pump reduced to size of pager 1982

24 hour insulin approved by FDA 2000

24 hour continuous glucose monitor 2006

Diabetes FutureAdvances

Pancreas TransplantPortable Insulin pump24 hour continuous glucose monitor (CGM) Islet cell transplant Islet cell produced by stem cellsInsulin pump with CGM (Artificial Pancreas)

Advances in time

Advances Year Pancreas Transplant 1966Portable Insulin pump 198424 hour continuous glucose monitor (CGM)

2006

Islet cell transplant 2008 University of Minnesota

Islet cell produced by stem cells

Future

Insulin pump with CGM (Artificial Pancreas)

Future

Advances AdvantagesAdvances Year Advantages

Pancreas Transplant 1966 Organ delivers insulin continuously

Portable Insulin pump

1984 Programmed device to deliver insulin continuously

24 hour continuous glucose monitor (CGM)

2006 Programmed device to deliver insulin and monitor blood glucose continuously

Islet cell transplant 2008 University of Minnesota

Insulin producing cells release insulin as needed

Islet cell produced by stem cells

Future Insulin producing cells will not be attacked by immune system

Insulin pump with CGM (Artificial Pancreas)

Future Device to deliver insulin and monitor blood glucose continuously

Advances DisadvantagesAdvances Year Disadvantages

Pancreas Transplant 1966 Large doses of rejection drugs Must remove digestive enzymes

Portable Insulin pump 1984 Must be worn 24/7 to deliver subcutaneous insulin

24 hour continuous glucose monitor (CGM)

2006 Manual insulin injections or pump delivery

Islet cell transplant 2008 by University of Minnesota

Rejection drugs

Islet cell produced by stem cells

Future Unknown

Insulin pump with CGM (Artificial Pancreas)

Future Enormous testing to develop

Diabetes cure?•Found my diabetes in 1967 .•Heard every 10 years there will be a cure in 10 years!•The CURE is a treatment that approaches

normal blood sugar most of the time.

CURE

Thoughts on the future of Diabetes Research1. Nothing can be removed to eliminate the disease, like, cancer.2. Transplantation of foreign islet of Langerhans or the Pancreas

requires rejection drugs that carry risks.3. Insulin administered by a sophisticated electronic device requires

replenishment of insulin supply.4. The closest to a cure is generation of islet of Langerhans cells

from stem cells that are genetically exactly equivalent to ones own somatic cells,

5. This may still be a problem if the immune system was the one that attacked the islet cells in the pancreas to destroy them originally.

6. If the immune system caused the diabetes, then ensuing research might focus on suppressing the immune system that attacked the islet cells

Someday there will be a way to control blood glucose to normal levels!

I HopeI Hope

I HopeI Hope

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