Yes that is absolutely true, we as doctors need to continue pushing the dietary and exercise changes! I am really happy to know about people like you that are able to take control and change the outcome. Congratulations!
I myself was diagnosed with type-II diabetes about a year ago and my sugar level had reached 300(fasting)/500(pp) mg/dl.
Even with such severe sugar level, the doctor refrained from starting me on insulin and recommended a set of pills along with diet control.
Now after about 9 months I am almost free of any medication and able to maintain my sugar levl at 100(fasting)/140(pp) with moderate diet control and a regular exercise regime.
I am against using the artificial Pancreas for type-II diabetes patients as they will lose the will power to control their diets and follow the exercise routine and will become wholly dependent on that machine.
Sure, it is demonstrated that starting with insulin in type 2 patients might have better outcome, however patients dislike the idea of having devices like this that make them feel they are "ill". Adaption rate will be highly influenced by the form factor and how easy to use they are, also reimbursability might be a key factor here. Said so, I still think type 2 will not like to use the close loop solution and that doctors might be a little reluctant to prescribe them as a first alternative.
@Jose: Good point. We opften get caught up in cool technology and forget the human factor.
Mir Imnran was making a similar point about the Neuropace epilepsy implant recently--that the pool of pstients is pretty small who do not respond to drugs and would benefit from an implant despite its risks.
Yes, I agree. But even if you keep it in open loop and just monitor blood glucose, it gives type 2 guys much better indication of what to eat or not to eat. And if blood glucose is regulalry maintained below 6/7, all organs get much more extended life. Damage to nerves, eyes and kidneys is at minimum.
It also acts like holter monitor for blood glucose.
Hi, thank you for your comment. Yes it could be used for type 2 diabetics. But let's be honest, who would like to use a device that is midly invasive, probably would cost most, than to just take a couple pills. We as doctors never start a treatment of a type 2 diabetic patient with insulin, first we modify diet/exercise habits with some oral drugs, and then if that doesnt work we might add combinational oral drugs and then if none of these work, the insulin.