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For Diabetics And Their Devices, The Present Is Never Enough

Type 1 diabetics seem to always be living in a transitional phase. The technology we have currently is always about to be replaced with newer, better, fresher technology, It’s exciting on one hand and exhausting on the other.

When I was diagnosed, the technology of the time was almost certainly going to be replaced by transplants. The experts weren’t sure what was going to be transplanted — the entire pancreas, just the islets of Langerhans — but all of this fiddly glucose meter and insulin needle stuff was going to disappear.

We know what happened there. While the transplants were done, and while some of them had limited success, they weren’t cures for Type 1 diabetes. So the attention of medical professionals and diabetics themselves shifted.

Insulin pumps, which were once bulky and rarely used , got smaller. They were manufactured in cool colors, and diabetics liked the notion that they could manage their condition 24-7. Flexibility sells, as does the notion medical needs shouldn’t limit your life.

As I mentioned last time in this column, that doesn’t happen to be quite true. Insulin pumps offer unparalleled opportunities for tight control. But they require vigilance, and they aren’t always as precise as advertised. They allow for flexibility, yes, but it’s a rigid kind of flexibility.

Attention has recently turned to continuous glucose monitors. Again, they offer great potential. But they’re not precisely what people think they are. They give users an understanding of trends and general blood glucose levels, but they’re not always specific enough to gauge insulin doses.

So we’re once more pointed to the future. The artificial pancreas — a device uniting the functions of both pump and CGM — will be the next big thing. Everyone says so, and several trials are under way. Users report positive experiences.

But if you look at this history, and if you think about it, it should be perfectly clear that the artificial pancreas is going to fall short in some way. It’s difficult to know exactly how. Perhaps it will require frequent calibrations with finger sticks. Perhaps it will need continual fine-tuning of insulin dosages. Perhaps it may simply be too expensive for most diabetics to use.

Whatever the case, once the devices come out, Type 1 diabetics will once again be told to look toward the future. A new generation of technology will be coming soon. We just need to hold on, and all of the problems will be solved.

We can hope. But at this stage, I’ve become content to use the technology I have, appreciate what it can do, and understand the limitations. The future will arrive on its own.

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