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Cornell Student Articles on Topical Affairs

The Future of Diabetes Management

Advances in a plethora of technologies have assisted varying industries in progressing forward at a rapid pace. Over the past few decades, technology has advanced to a great extent with various innovative advancements that have revolutionarily changed the way we do things now. This constant technological evolution has positively affected many aspects of our life, simplifying how things are done, improving productivity, facilitating communication and enhancing both the provision of educational and healthcare services. The modern age has given us ways to make our life easier, and ultimately, the quality of life is constantly improved as technology advances, the testament of which is the recently-introduced continuous glucose monitoring (CGM Devices). In the early days, patients with diabetes had to undergo tedious and time-consuming treatments. The technology today places little constraints on the lifestyles of diabetic-stricken people and allow them to live a normal life.

Diabetes prevalence has been rising, the extent of which has been greater in low and middle-income countries. According to the World Health Organization, the number of people with diabetes has increased from 108 million in 1980 and 422 million in 2014. In the US, it has been reported that currently, 21 million Americans are diagnosed with diabetes. The ratio of the number of diagnosed people to the number of people who have the test still remains at 80 per 1000 American adults. One of the common causes of diabetes is obesity, the rate of which has been rising in the US. Diabetes is the direct result of our bodies not being able to create enough insulin to keep our blood glucose levels within the normal range.

Insulin is a hormone produced by the pancreas. When we consume food containing carbohydrates, it travels down our esophagus to our stomach where acids and enzymes decompose it into tiny little pieces, the process of which releases glucose. The released glucose goes into our intestines where it is absorbed. Subsequently, it passes into our bloodstreams. When released into our bloodstreams, insulin attaches to and signals the cells to absorb glucose from the bloodstream. Our bodies are designed to keep our blood glucose levels constant. The pancreas of patients with diabetes have trouble producing insulin, causing their blood glucose levels to stay high. This can result in multiple health complications. Many people diagnosed with diabetes had died until the year of 1921 in which insulin was discovered. In 1922, insulin was first used to treat diabetes. Since then, many inventions have occurred, improving diabetes treatments.

In 1971, Anton Hubert pioneered the very first blood glucose meter. The meter was able to provide a blood glucose number by means of reading a test strip that had been inserted into the meter. It showed BG numbers via its swinging needle mechanism. However, results given were only approximate and the overall process involved multi-step sequences. Users had to wait, after applying droplets of their blood, precisely 50 seconds to get their results. The blood sugar meters in the market now are compact, easier to use and give us more accurate results within seconds. In addition to this glucose meter creation, insulin therapy has also seen a remarkable progress in terms of technological innovation. 

The first insulin injection pen was invented and introduced into the market in 1985. Before that, insulin had to be injected via large glass syringes and reusable needles. After being used, these needed throughout sterilization, and the needles had to be sharpened with a pumice stone before they could be reutilized. That overall was process was time consuming. The first insulin pen was a metal pen loaded with a disposable insulin cartridge with an attached syringe. With this invention, patients had more control over their lifestyles. Ever since the introduction of the first insulin pen, many improvements have been made to this insulin delivery method. Currently, there are two types of insulin pens, disposable pens and re-usable pens, both of which are comparatively easy to use, inflict less pain and portable. However, most patients using insulin injection pens are required to inject themselves with insulin several times a day while relying upon the use of blood glucose meters to manually check their glucose levels. 

To achieve an automated insulin delivery and monitoring system, in 1974 the first insulin pump was invented. The size was approximately that of a microwave oven. The pump was made to function like a non-diabetic pancreas, measuring blood glucose levels and dispensing insulin into the bloodstream. However, due to its large size, it was used for medical research purposes only and to treat certain types of diabetics. A few years later, the idea of a portable delivery system was brought up by a researcher at Yale University. The current insulin pump is small, having the ability to deliver insulin continuously or quickly for carbohydrate intake. It can be programmed to meet the demand of the person wearing it. However, it does not show any information regarding the user’s blood glucose level. Users have to check their blood glucose levels manually and set their insulin pumps accordingly. Recently, a new automated insulin delivery and monitoring system has just undergone a clinical trial and the outcomes are impressive.

An artificial pancreas system is a recent medical invention combines an insulin pump with a continuous glucose monitor. A continuous glucose monitor has existed in the market for quite some time. However, it was not until recently that an insulin pump was successfully integrated with a continuous glucose monitor. The system is designed to automatically monitor users’ glucose levels and adjust insulin delivery. Users are able to track their glucose levels throughout the day and night. The system takes glucose measurements at set intervals 24 hours a day and convert the readings into meaningful data, creating glucose rate of change and direction. It completely eliminates patients’ reliance on testing their glucose levels by means of a blood glucose meter and manual insulin injection.

Given such continual technological advancement, patients living with diabetes will soon be able to have their blood glucose levels controlled automatically. Medical researchers have also started creating internal organs using human cells. Perhaps, real artificial pancreas may really exist in the future, replacing the pancreas of diabetic patients.

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