THE LOOP CLUB - TOWARDS ARTIFICIAL PANCREAS

Type 1 diabetes mellitus remains one of the most common chronic incurable diseases of childhood and adolescence and is a major health problem worldwide. The successful use of continuous subcutaneous insulin infusion and continuous glucose monitoring in recent years and the growing interests in closing the loop between the two systems, brought a group of pediatric endocrinologists to the idea of establishing the Loop Club.

The founding event of the Loop Club was its first meeting organized before the 42nd Annual Meeting of ESPE on September 17th, 2003 in Ljubljana, Slovenia. This event aimed at getting together of professionals to discuss their clinical work and meet with the industry, start up companies and others who would like to participate in this important venture of closing the loop between insulin pumps and glucose meters.

After a short welcome and introduction by Prof. Tadej Battelino from Ljubljana, Slovenia, Prof. Moshe Phillip from Tel-Aviv, Israel gave an overview of the background and rationales for clinical use of insulin pumps and glucose sensors. He emphasized the fact that each patient needs an individually tailored therapy that should give an answer to his/her specific needs.

The session on "New frontiers in glucose sensing" was started with a lecture by Ms. Dalia Argaman from Glucon Medical of Tel-Aviv Israel, presenting the experience with photoacoustic non-invasive continuous measurement of glucose. The Glucon devise is detecting ultrasound waves generated by absorption of light in a designated vessel, usually a vein close to the wrist. This ultrasound signal is subsequently translated to blood glucose concentration.

Dr. Kerstin Rebrin from the research laboratory of Medtronic/MiniMed in Los Angeles, USA presented the development and results of mathematical models and algorithms for their internal loop system and the newest external loop system consisting of a wireless continuous glucose monitor guardian and the Medtronic/MiniMed insulin pump paradigm 712. Data obtained from canine experiments showed remarkable success in mimicking the physiological secretion of insulin by the artificial external loop.

Prof. Michel Polak from the Paris, France was the first speaker of the clinical session where the clinical experience with clinical use of insulin pumps and glucose sensors. Prof. Polak spoke about his experience in managing neonatal diabetes using continuous subcutaneous insulin infusion, which proved to be safe and efficient in neonates and toddlers.

Prof. William Tamborlane from School of Medicine at Yale University opened foreseeable horizons of the future by speaking about fulfilling the promise of pump treatment in diabetes. Prof. Tamborlane presented clinical data proving the pump treatment to be safer and better than any other treatment modalities. At the same time he clearly showed that the promise to the patients could be fulfilled only by closing the loop between an insulin pump and a continuous glucose sensor.

Each lecture was followed by vivid discussions. Prominent pediatric endocrinologists, including Prof. Francesco Chiarelli from Chieti, Italy and Prof. Valentina Peterkova from Moscow, Russia contributed to the exchange of scientific and clinical ideas and experience within an audience of more than 80 professionals from all over the world.

This meeting has proven to be a stimulating beginning of intense collaboration between clinicians, scientists and industry with well-defined goals to improve the management of diabetes by developing a reliable “artificial pancreas”. By closing the loop between blood glucose monitoring and insulin delivery, many dangerous complications of diabetes could eventually be reduced or eliminated.