The Long Journey to an Artificial Pancreas

This biotech could transform type 1 diabetes care

- By Carrie Arnold

EDWARD DAMIANO CARVED his life into precise 90-minute intervals. In 2000 his then 11-month-old son, David, developed type 1 diabetes when an autoimmune response in his tiny body attacked the beta cells in his pancreas, which manufacture and secrete the hormone insulin. No beta cells meant no insulin. If Damiano or his wife, Toby Milgrome, a pediatrician, didn't give David injections of the hormone, the baby's cells could no longer use glucose, a vital energy source. Within hours David could be in a coma or dead. With their son's pancreas no longer functioning, Damiano and Milgrome had to take over the organ's work by measuring every gram of carbohydrate David ate and dosing the right amount of insulin. To ensure his son didn't receive too much or too little of the lifesaving medicine, Damiano checked David's blood glucose every hour and a half, rain or shine, day or night.

When David first became ill, Damiano, a bioengineer at Boston University, kicked it old school to monitor his son, accumulating a set of spiral-bound notebooks in which he or Milgrome logged every drop of insulin and morsel of food. Each day the couple flipped over a new page and started again, building a complex calculus of sugar grams per sip of Juicy Juice measured against units of insulin and blood glucose that would allow David to thrive. Even for a physician-scientist team, the work was grueling and relentless. Damiano also knew that he was one of the lucky ones.

“The hardest part of diabetes management is making all those decisions. And if you give yourself a little too much insulin, you could end up in the ICU,” Damiano says.