Post on 07-Jul-2015
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!! IMPROVING!!! LIVES.!CURING!!TYPE!1DIABETES.
Robert Kircher, Jr.
VP of Engineering and Regulatory Affairs
bob@dosesafety.com
FALL 2014 DiabetesMine D-Data ExChange Thursday, Nov. 20, 1-7:30pm
University Club of Palo Alto, CA
Artificial Pancreas (AP) Case Studies:
“Automating Diabetes Care”
www.dosesafety.com
Working to improve the lives of those with diabetes
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What does a Boeing jet have in common with T1D?
3 Airplane Closed Loop Control Systems
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How Dose Safety Started
Laura Matheson Diagnosed T1D
(1999)
Boeing 777 autothrotle presentation
Initial dosing algorithm prototype
Initial closed loop studies in Rick Mauseth’s clinic
Every 15 min: 1) Draw blood sample 2) Enter into computer 3) Pt doses on own pump
2002 2002 2003 2003-2004 www.dosesafety.com
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5 Original Dose Safety FL1 Closed Loop Algorithm
www.dosesafety.com
(1) Fuzzy Logic: A really bad name for really good technology
“If glucose is normal and steady I would dose Shawn 0.2 units every 15 minutes”
Codified expertise
R. Mauseth, MD
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Dose Safety Team
6 www.dosesafety.com
2008 2010 2011 2012-2013
!! IMPROVING!!! LIVES.!CURING!!TYPE!1DIABETES.
!! IMPROVING!!! LIVES.!CURING!!TYPE!1DIABETES.
I.Hirsch, MD
Benaroya Research Institute Poster DTM Bethesda
7 Algorithm Clinical Evaluation: Exercise studies
No pre-meal bolus No exercise announcement
Overall Results: 80% time in 70-180 mg/dL
0.5% time < 70 mg/dL
www.dosesafety.com 7
22 hrs
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No pre-meal bolus
Overall Results: Mean glucose = 205 mg/dL 20% time > 250 mg/dL
0.5% time < 70 mg/dL www.dosesafety.com
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9 hrs
Algorithm Clinical Evaluation: Pizza studies
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Closed Loop Autodosing is Not Enough
9 www.dosesafety.com
User dose override Sensor change CGM comm error Infusion set change Insulin refill Battery change
10 Operating Modes (controller v3.0)
Auto-dosing Manual bolus
Hypo predicted
Day-to day Interuptions
Disabled
Pump only. No automation
10 www.dosesafety.com
Suspended
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Clinical Evaluation (1Q 2015)
24-hr study visit on the CRC
3 weeks Guarded Outpatient 3-days at hotel 18-days at home
3 months remotely monitored at home
11 www.dosesafety.com
12 Call to Action
• CGM, pump, algorithms
• Regulatory guidance
Private insurance companies and government payers need to say: “If you (FDA, device mfgrs, …) do this, we will pay for AP pumps.”
AP pump!
13 Thank-‐You
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Back Up Slides
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References
Matlab FL tutorial: http://www.mathworks.com/help/pdf_doc/fuzzy/fuzzy.pdf
2008 DTM poster http://www.dosesafety.com/resources/DTS_2008_Poster_revD.pdf