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Type 1 Diabetes: Innovative Treatment, the Bionic Pancreas Brings Hope for Many

Updated on September 30, 2018
tobusiness profile image

Jo has been an ITU nurse at the London North West NHS Trust for 14 years. She obtained her RN at University College London Hospital.

Bionic pancreas out performs Insulin Pump


Hope for a cure for type 1 Diabetes

Insulin shot may soon be a thing of the pass


Diabetes is a serious condition that affects both children and adults; its prevalence continues to grow rapidly worldwide.

There are approximately 500,000 children aged under 15 with type 1 diabetes in the world (Patterson et al. 2014).

The need for new innovative treatment for diabetes is also growing, the artificial or ' bionic pancreas' that started its first human studies in 2008 could be the answer to many prayers.

World Health Organisation (WHO) defines diabetes as a chronic condition that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.

Type 1 diabetes can develop at any age but typically occurs in childhood and young adults. Managing the condition can be a real challenge for both the children with diabetes and their parents, particularly when newly diagnosed.

People with type 1 diabetes must very carefully balance their insulin doses either by injection several times per day, or by continuous infusion through an insulin pump. They must also measure their blood glucose (sugar) levels by pricking their fingers several times a day, be aware of what foods they eat, even then, they must still overcome the risk of life-threatening high or low glucose levels.

Cause of Diabetes Mellitus

The precise cause of type 2 diabetes is unknown, risk factors include, genetic inheritance, obesity and a sedentary lifestyle. In a healthy person, the blood glucose level is maintained within a normal range by several complex mechanisms involving the production of Insulin and glucagon by the pancreas.

Diabetes Mellitus often describe as a disease of paradoxes; while the disease typically affects older people, research shows that young and middle-aged individuals are most venerable.

The condition is prevalent in people who are overweight and obese, but emerging statistics suggests that for lean people with diabetes, the outcome can be worse. Uncontrolled, diabetes can lead to life-threatening complications. As the prevalence of diabetes increases, a tremendous burden is placed on health care providers for the future.

While there is no definitive cure for diabetes presently, the race is on for a more efficient way to manage the disease until a cure can be found, hopefully, in the not too distant future.

Complication of Diabetes Mellitus

Uncontrolled diabetes can lead to serious complications in both the short and long term. Short-term complications include:

Hypoglycaemia (low sugar)

Diabetic ketoacidosis (DKA), most common in people with type 1 diabetes, but can also be a complication of type 2 diabetes. DKA occurs where there is a severe lack of insulin and the body is unable to use glucose for energy. Instead, fat is broken down and utilized by the body as a source of fuel. This process results in the production of ketones, a toxic chemical that can build up in the body to cause acidosis, giving rise to the dangerous complication known as ketoacidosis.

Hyperosmolar hyperglycemic state (HHS) occurs predominantly in people with type 2 diabetes in which high blood glucose causes severe dehydration, increase in osmolarity with high risk of complications, coma and death

Long-term complications include damage to small blood vessels by high levels of glucose that can also result in 'furring up' of the arteries (atherosclerosis). When the condition is poorly controlled, many of the organs of the body can be affected such as:

Eyes (diabetic retinopathy) leading to blindness, however, with regular check-ups, most people with diabetes have only minor eye problems.

Cardiovascular diseases (CVD), people with diabetes have a higher risk of developing CVD.

Kidney failure is much more common in people with diabetes

Stroke, diabetes significantly increases the risk of stroke

Neuropathy (Nerve Damage), People with diabetes, are much more likely to be admitted to hospital with foot ulcer than people without diabetes. This is due to poor circulation and reduced feeling in the feet as a result of nerve damage.

People with diabetes often require amputation of toes, feet or legs. According to the American Diabetes Association, more than 60% of non-traumatic lower-limb amputations occur in people with diabetes.

Managing Diabetes

In some cases, type 2 diabetes can be controlled by eating a healthy well-balanced diet and by regular exercises. Some people with type 2 diabetes may need oral medication in conjunction with diet and exercise, preferably a diet that is recommended by a registered dietitian, some people with type 2 diabetes may also require injection of insulin.

Unlike type 2 diabetes, type 1 cannot be controlled or managed by lifestyle changes. A person with type 1 diabetes needs a healthy balance diet, but also frequent injections of insulin. The adjustment to a life that revolves around eating the right foods, testing blood glucose levels and administering insulin can be hard to make and maintained. A father whose child developed type 1 diabetes at 11 months old made it his quest to find a better way to manage the disease. Edward Damiano set a goal to have his invention ready by 2017, the year that his son is due to start college.

The new innovative systems that mimics the function of the Pancreas known as the “bionic pancreas” may well be the answer to many prayers.

The device has out-performed the most traditional means of managing the disease by monitoring glucose levels and manually calculating the dose before administering the required amount of insulin by injection or via an insulin pump.

Cause of Type 1 Diabetes

Insulin is a hormone that is produced by specialized cells in the pancreas. Type 1 diabetes, once known as early-onset, juvenile or insulin-dependent diabetes, develops when the pancreas produces insufficient or no insulin.

The exact cause of type 1 diabetes is unknown, risk factors include genetics, in most cases the condition is thought to be an autoimmune disease. This is where the immune system that usually protects the body from foreign invaders such as bacteria and viruses produces antibodies that mistakenly attack and destroy the special beta insulin-producing cells of the pancreas (islets of Langerhans).

The incidence of type 1 diabetes has increased on average, 3% per year between 1960 to 1996 in children under 15 years of age. In the US recent data show that the prevalence of type 1 diabetes increased by 21% in children, between 2001 and 2009 (Dabelea et al. 2014).

Environmental factors may have played a part in the rise of type 1 diabetes in recent times; there appears to be a correlation between the increase of industrial and agricultural chemical production and the rise in type 1 diabetes.

Some studies have suggested that diet may play a role in developing type 1 diabetes. The theory is that Infants who are breastfed and those receiving vitamin D supplements may have a reduced risk of developing type 1 diabetes, while infants with early exposure to cereal proteins and cow's milk, may have an increased risk of developing the disease. More studies into the link between infant nutrition and type 1 diabetes are needed.

One in three adults in England shows evidence of pre-diabetes.The World Health Organisation (WHO) predicts that diabetes will be the 7th leading cause of death by 2030.

Diabetes is predicted to hit 6.25 million people in the UK by 2035, with the increase comes a price tag for the National Health Service (NHS) of £1 million per hour.

The number of people worldwide with the condition is said to be around 347 million, an estimated 3.4 million people died from the consequences of high fasting blood sugar in 2004, says the WHO.

While a cure for diabetes remains an elusive dream, scientists are trying to find out what triggers the disease, each tentative step hopefully taking us closer to better management of the condition and a possible cure. Innovative treatment like the bionic pancreas and the development of vaccine promises to make managing the condition much easier and safer. New advances in embryonic stem cells may be able to affect dramatically how the condition is treated in the future.

Scientists are using a new technique similar to that used in the cloning of animals to make insulin-producing cells. DNA from a woman's skin cells was placed into donated human eggs. The eggs were then grown in early embryos from which stem cells with the potential to develop into any cell type in the body are grown into insulin-producing cells.

Earlier this year, stem cells were created from a single drop of finger-pricked blood to generate human induced pluripotent stem cells, these are cells that can give rise to all the cell types that make up the body. By genetic reprogramming, matured cells like blood cells can be transformed into properties that are very similar to human embryonic stem cells. The race for a cure is well and truly on, not only for diabetes but many other chronic diseases.

Bionic Pancreas Developed by Ed Damiano Associate Professor, Biomedical Engineering at Boston University and Colleagues

Facts About Diabetes from the American Diabetes Association

  • In 2010, 79 million Americans aged 20 and older had pre-diabetes. The statistic for 2012 was 86 million
  • Around 1.9 million Americans are diagnosed with diabetes every year
  • An estimated 7.0 million American have undiagnosed diabetes.
  • 25.6 million 20 years or older or 11.3% of the people in this age group have diabetes
  • The death rate of adults with diabetes from heart disease is about 2 to 4 times higher than adults without diabetes.
  • Diabetes is the leading cause of new cases of blindness among adults aged between 20- 74 years.
  • Diabetes accounts for 44% of all new cases of kidney failure
  • Hearing loss is twice as common in adults with diabetes as in those without the condition
  • Around 60% to 70% of people with diabetes have mild to severe forms of neuropathy
  • Number of Non-traumatic lower limb amputations performed in people with diabetes annually is about 65,700 or 180 per day
  • 85.2% of people with type 2 diabetes are obese or overweight
  • If present trends continue, 1 in 3 American adults will have diabetes in 2030
  • Diabetes kills more Americans each year than AIDS and breast cancer combined
  • An individual diagnosed with diabetes at the age of 50 dies six years earlier than someone of the same age without diabetes
  • The total costs of diagnosed diabetes in the US in 2012, $245 billion

Treatment for Diabetes, the Bionic Pancreas

Researchers have been attempting to create a device that mimics the function of the pancreas for quite some time, the search for a device that can seamlessly control and stabilize blood glucose levels in people with type 1 diabetes may not be far off.

Recent results from two trials funded by the National Institute of Health (NIH), and published in the New England Journal of Medicine, indicated that a prototype for a bionic pancreas developed by a Boston University/Massachusetts General Hospital research team may be on the right track. The intelligent device consists of a smartphone hardwired to a continuous glucose monitor and two small pumps that deliver doses of insulin or glucagon, (an antidote for insulin) every five minutes.

The prototype is controlled by the smartphone through an app built by Edward R Damiano Ph.D. and his team. The wearable bi-hormonal, bionic pancreas improved mean glycemic levels with less frequent hypoglycemic (low glucose levels) episodes, among both adults and adolescents with type 1 diabetes Mellitus

The device was better able to keep blood glucose levels consistent, than patients who managed they own glucose levels. Researchers found that the patients in the study needed 37% fewer intervention for hypoglycemia. In both adult and teen study, participants demonstrated overall improvements in glucose levels using the device, particularly during sleep, a challenging time for someone with diabetes to maintain stable blood glucose levels.

Dr. Edward Damiano, a biomedical engineer whose 11-month-old son was diagnosed with type 1 diabetes in 2000, decided to create a device that would allow his son and millions of others to manage better their condition.

The first-generation device produced by the team of scientist from Boston University was clinically tested in 2009, the second phase in 2010. A series of longer trials got the go ahead starting this month, and will hopefully see the device approved by the US Food and Drug Administration to be ready by 2017 when Damiano's son begins college.


British scientists are confidence that insulin deficiency disease would be wiped out in the next 25 years; I very much hope the prediction will prove to be correct. As the number of adults with diabetes continues to rise, it is estimated that 5 to 10% of adults with pre-diabetes will progress to “full blown” type 2 diabetes in any given years.

Pre-diabetes, also known as borderline diabetes is a condition where blood glucose levels are abnormally high, but less than the threshold for the diagnosis of diabetes. Most people with pre-diabetes will go on to develop type 2 diabetes.

There is an estimated 79 million American with pre-diabetes. The good news is that pre-diabetes can be reversed in many cases. However; it requires some serious lifestyle changes.

Results from research from a large-scale study known as Diabetes Prevention Program shows that for every year after the initial diagnosis of pre-diabetes, there is an 11 % chance of developing type 2 diabetes, with a greater risk of also developing stroke or heart attack when compared to people with normal glucose levels.

Information gathered from the Health Survey for England (HSE) found that there was a significant increase in the proportion of people aged 16 or older with pre-diabetes between 2003 and 2011, an increase from 11.6% in 2003 to 35.3% in 2013.


Mobile Apps Help Manage Diabetes


A Sensible Diabetic Diet, Foods with a low Glycaemic Index (GI)


Natural foods to improve health in type 2 diabetes

Diet to provide
Soluble Fibre
apples, apricots, beets, citrus fruits, berries, carrots, squash and oats
Help the body to absorb sugar slowly, Soluble fibre help to keep blood sugar levels stable
Low Cholesterol
garlic, onion, vegetables and moderate amounts of sweet fruits
Help to lower LDL cholesterol (bad cholesterol) and raise HDL (good cholesterol)
Vitamin C, flavonoids, carotenes
Help prevent fat from oxidizing to cause damage to the artery walls which can lead to plaque formation and heart disease.
Low Sugar
Basil leaves, ginseng, cactus nopalitos or prickle juice, leaves of bilberry plant, leaves of the fig tree
Help to reduce glucose levels
improved circulation
improve brain function and circulation

Be always mindful of using natural medication that lower blood glucose levels, especially when taking insulin or oral medication, contact a herbalist and always consult with your doctor first.

Most people with diabetes are only diagnosed when hospitalized for other conditions

Have you been tested for Diabetes?

See results

Gene Therapy

 An adenovirus vector is used to insert a new gene into a cell, if successful, the new gene will make functional protein to treat a disease.
An adenovirus vector is used to insert a new gene into a cell, if successful, the new gene will make functional protein to treat a disease. | Source

Most Current Statistics About Diabetes in America


Diabetes Worldwide



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    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Faith, great to see you!!

      I do appreciate the visit and wonderful comment, but I'm much happier to see that all is well with you. Yes, it is very disturbing to see how many children are affected by diabetes and the numbers are still growing. We need to get the message through, diabetes is a very serious disease, it takes its toll on every organ in the body, we need to do what we can to stop it in its tract.

      I hope you're having a lovely weekend and not working too hard. Take care and my very best to you and the family.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Nell, always a pleasure. Yes, the new device looks promising, but a cure would be something to really celebrate. I hope you're enjoying the weekend, yesterday was wonderfully sunny but today we're back to rain and more rain so I'm relaxing and enjoying the tour de France. Take care and my best as always.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Crystolite, I'm always very happy to share. Thank you so much for the visit and comment, much appreciated. My best to to you.

    • Faith Reaper profile image

      Faith Reaper 

      7 years ago from southern USA

      Fascinating hub, dear Jo! You always present such well researched and well written hubs. It is so disturbing to me just how many children have Type 1 Diabetes. This bionic pancreas certainly provides hope and thank you for bringing more awareness here about this new technology.

      I appreciate how you so that I am able to understand these new medical advances in technology.

      Vote up and more and away

      Blessings always

    • Nell Rose profile image

      Nell Rose 

      7 years ago from England

      Hi Jo, fantastic information, and that new device is the way forward isn't it? I do hope they find a real lifelong cure for it one day, its so common but so awkward to manage, great job! have a wonderful weekend, nell

    • crystolite profile image


      7 years ago from Houston TX

      Wow,that is an interesting hub you've got. Diabetes can be so deadly! thanks for sharing!

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Hello Kathleen, so nice to see you. glad you liked the hub, thank you for taking the time, this one is close to many hearts. Take care and my very best to you.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Hi Audrey, lovely to see you! thanks for the visit, comment and for helping to spread awareness. I hope all is well with you, my best as always.

    • Kathleen Odenthal profile image

      Kathleen Odenthal 

      7 years ago from Bridgewater

      Wow! Great hub! Thanks for covering such an important topic that is very close to my heart and bringing attention to a terrible disease.

    • AudreyHowitt profile image

      Audrey Howitt 

      7 years ago from California

      This is amazing Jo! Passing this to my diabetic friends!

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Glutathione PRO, thank you for taking the time and for the wonderful comment, much appreciated. I totally agree with you, the more light we can shed on this terrible disease, the sooner we will be able to bring the statistics down. Take care, and my best to you. Interesting hub name, something to do with antioxidant? I'll have to come over to find out. :)

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      nicediabetes, I do hope the bionic pancreas will be able to help the millions of people w ho are struggling to control type 1 diabetes, but a cure would be a real miracle indeed. Thank you for stopping by, much appreciated, my best to you.

    • Glutathione PRO profile image

      Ken Williams 

      7 years ago

      What a fantastic hub on an extraordinary subject! Thank you so much for sharing this in depth info, diabetes is a growing concern and this sheds a bit of hope on the subject!

    • nicediabetes profile image


      7 years ago from Australia

      I know I'm keeping my fingers crossed for progress in the bionic pancreas area... hope this is more good news on the eternal quest for a cure. Great hub

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Hi Genna, thanks for taking the time, much appreciated. I'm sorry about your mum, diabetes can affect the body in so many ways, and all bad. We owe it to ourselves to avoid it if we can. We can't do much about insulin dependent or type 1 diabetes right now, but we can certainly keep type 2 at bay. Yes, the bionic pancreas looks promising. Appreciate the share. Take care now!

    • Genna East profile image

      Genna East 

      7 years ago from Massachusetts, USA

      Jo, as always, your articles are beautifully researched and presented. Becoming insulin dependent due to diabetes (my mother was for the last several years of her life), is not something to take lightly. I found this article on the Bionic pancreas to be fascinating. Thank you for sharing this! :-)

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Thanks Devika, a pleasure to see you. Yes indeed, a healthy balance diet and exercise gives us a fighting chance. Exercise doesn't have to be too exhausting either, a good walk regularly can be very beneficial. Take care and my very best to you.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Hi travmaj, so sorry to learn about your son and grandson. Type 1 diabetes does occur in families unfortunately. New treatment like the vaccine and the bionic pancreas gives us real hope for the future, a cure maybe just over the horizon. Thank you for stopping by and commenting, much appreciated. Take care and my best to you.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      quildon, lovely to see you. You're right about diabetes being a frightening disease, even more so when you see how many people are now diagnosed with the condition. As a critical care nurse I get to see the end result and it is scary.

      Sorry to hear about your husband, unfortunately, as much as we would love to, none of us are able to eat what we like and get away with it. Diabetes can be very unforgiving, tell your hubby to get smart. :)

      Take care and my best as always.

    • DDE profile image

      Devika Primić 

      7 years ago from Dubrovnik, Croatia

      An informative hub! A well-balanced diet prevents many health issues I try be active daily a to avoid that sedentary lifestyle. Voted up and useful.

    • travmaj profile image


      7 years ago from australia

      Most informative and so well documented. I shall pass this on to my friend whose son and grandson have type 1 diabetes. This seems to be a genetic form. Good to know all the research is progressing re - bionic pancreas. All the information on diabetes 2 is valuable, seems like someone in my circle of friends is diagnosed frequently. Thanks and voting.

    • quildon profile image

      Angela Joseph 

      7 years ago from Florida

      You always do such informative hubs, and this one is chuck full of information. Diabetes is such a frightening illness. I am not a diabetic, but my husband is Type II so he doesn't take insulin, but he likes to eat whatever he wants. Voted up and useful.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Word55, thank you for taking the time to read and comment, much appreciated. The choices we make can hugely affect our health, that is why it is so important to get all the facts to make informed choices.

      Take care and my best to you.

    • word55 profile image

      Al Wordlaw 

      7 years ago from Chicago

      This is very good info tobusiness, organized very well and understood for people to make better decisions about their health, whether or not to make lifestyle changes and if they want to live longer and healthier than they thought they would without changing from old habits of illness. Thanks Kim for sharing.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Shanmarie, you may well be right, to live a full and healthy life, we must put in the effort, a healthy lifestyle is a must. However, the increasing use of environmental and industrial chemical also play a part. The bionic pancreas is looking good, fingers crossed. Thank you for taking a look, much appreciated. Have a lovely Sunday, my best to you.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Hi Kim, thank you for the wonderful support. I always learn something new from writing these informative hubs, it's a plus when others also find them useful. the bionic pancreas may well be a game changer, I really hope it will achieve it's potential. Always lovely to see you, take care and my best.

    • shanmarie profile image

      Shannon Henry 

      7 years ago from Texas

      I think a lot of health issues could be addressed by a change of lifestyle. Nonetheless, this is an interesting article, especially for those that have diabetes unrelated to personal habits. It's amazing what bionics can do.

    • ocfireflies profile image


      7 years ago from North Carolina


      I agree with Bill. You produce balanced hubs and valuable information.

      I am glad I breastfed my boys. The stats are alarming, but a bionic pancreas is such an awesome idea. All-around V+/share Hub!! Thanks for providing such valuable information in a user-friendly way.

      Many Blessings,


    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Hi Ruby, it's sad to see so many youngsters suffering from conditions that were once only associated with middle aged overweight people living a sedentary lifestyle. I don't know why parents are not getting the message, it's certainly not from a lack of information. Obviously, type 1 diabetes is a different story, I really hope the scientists will find a cure soon. The new bionic pancreas device looks promising. Thank you for stopping by, I hope you're enjoying the weekend, my best as always.

    • always exploring profile image

      Ruby Jean Richert 

      7 years ago from Southern Illinois

      I read an article that stated that more children are obese and have type 2 diabetes than ever before. Inactivity is the culprit i believe. Your article is very well written. I've been reading about the new pump. I hope it is as great as they say it is. Thank you for your medical hubs they are always useful..

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Frank, the medical hubs takes more time but they keep my old brain active, I need the challenge. :) My friend, it's always a pleasure, I hope all is well with you, my very best.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Hi Jackie, I'm sorry about your dad, diabetes, especially type 1, is not an easy condition live with. You have good insight into the disease and are doing the right things, let's hope a cure is not too far away. Always lovely to see you. Take care, my very best.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Flourish, good to see you. I loved the very human story behind the development of this device, it must be soul destroying to see one's child suffering, but how incredible to be able to do something about it. My best to you, always a pleasure.

    • tobusiness profile imageAUTHOR

      Jo Alexis-Hagues 

      7 years ago from Lincolnshire, U.K

      Hi Bill, I appreciate you taking a look and hope your friend will find the information useful. Diabetes can be a very debilitating condition, unless it is well managed, this new device may make all the difference. Good luck to your friend and the very best to you. I'll be in touch soon, have a wonderful weekend.

    • Frank Atanacio profile image

      Frank Atanacio 

      7 years ago from Shelton

      wow, very informative.. and the work and research you must have spent on this hub.. awesome and useful tobusiness

    • Jackie Lynnley profile image

      Jackie Lynnley 

      7 years ago from the beautiful south

      Great informative writing Jo. You always do such a thorough, beautiful article. I worry about this since my dad died from it forming a blood clot because of it. I use preventative foods which of course has no medical standards but so far I am in good shape not having any showing of elevation so I guess I will just keep on and add anything more I may find out about. I gave my dad his insulin shots and I sure don't want to get started with any of that. ^+

    • FlourishAnyway profile image


      7 years ago from USA

      Very well written and informative. You always do a stellar job of explaining complex medical ailments in easy to understand ways, providing both the information and motivation to do something about it if readers are potentially at risk. I like that the biomedical engineer who designed that pump took a negative personal circumstance and made people's lives better.

    • billybuc profile image

      Bill Holland 

      7 years ago from Olympia, WA

      I have several friends with Type 1 Diabetes, and I'm passing this on to them. You write these so well, just the right balance of technical material delivered in a way that anyone can understand. Well done, Jo.

      Have a wonderful weekend my friend.



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