An interview with Peter Lord

We had the chance to interview Peter Lord, member of MuSiC4Diaetes' Advisory Board. He answered our questions about his ambitions for the porject and his personal views on future challenges in diabetes innovation.

MuSiC4Diabetes is just the right project for you – what makes it special in your opinion?
The intraperitoneal artificial pancreas (AP) has the potential to become the therapy of choice for people with diabetes. The kinetics of insulin in the intraperitoneal space are faster than subcutaneous insulin. For this reason, an intraperitoneal AP can control mealtime glycemic excursions and nocturnal glycemia without user input.

As a fully implanted device, the burden for the patient is essentially eliminated, that is, infusion sets, insulin reservoirs and other supplies are no longer required. Users do not have an infusion site to maintain. In my opinion, fully automatic control and the elimination of user management can be considered a functional artificial pancreas.

This aspiration for the scientists, engineers, nurses, educators, physicians, and patients who have devoted their personal and professional energy for decades to this objective is becoming a commercial reality at Portal Diabetes, Inc. and other companies.

This is a special time for people with diabetes. The promise of a functional artificial pancreas will be realized soon as a commercial product. It will become the therapy of choice with the breakthrough technologies including multianalyte sensing/algorithms developed by the Music for Diabetes (M4D) project.

Where do you see the tech developed in the project in five to ten years?
In five to ten years, the multianalyte technology developed in the M4D program will give us the most effective and the safest option for managing diabetes. The multianalyte algorithm will control glycemia during exercise and will have an early signal for control of DKA. MEMS technology has the potential to reduce the size of commercial intraperitoneal AP devices by 50%. Importantly, MEMS technology is a high volume, low cost approach to manufacturing a precision pump. MEMS technology will allow manufacturers to achieve pricing that will compete with subcutaneous systems. The Music for Diabetes project incorporates an insulin that will be suitable for a three month refill interval.

I believe that:

• Pediatric Diabetes: The use of a multianalyte sensor and algorithm will provide the safety and reliability required for hands-free control. This, with the attributes of greatly reduced size and very small, precise strokes will make the intraperitoneal artificial pancreas a compelling option for pediatric type 1 diabetes.
• All insulin dependent adults and children: The reduced cost of the MEMS pump mechanism will make the system competitive with subcutaneous insulin delivery. With the support of 3rd party payers, this technology will become ubiquitous.

You are working with devices for diabetes management for decades now - how does MuSiC4Diabetes fit in there?
Yes, I have been on this path for decades. I am thankful for the European Research Council’s support of Music for Diabetes and expect to work in this field diligently to see that the M4D technology becomes commercially available to people worldwide with diabetes.

What would you think are the biggest challenges in diabetes management?
From the highest level, the most important challenge in diabetes management are the long term complications of blindness, kidney failure, neuropathy and amputations. These tragic outcomes are too frequently the rule rather than the exception for people with diabetes. The statistics indicate that in spite of the extraordinary efforts of patients, parents, clinicians, insulin scientists and engineers, there is a limit to what today’s tools can make possible for the full population of people with diabetes.

The key to the prevention of long-term complications is consistent, life-long control of glycemia in range. A very small implantable artificial pancreas, designed to be suitable for both children and adults, featuring multianalyte sensing and algorithms would safely control glycemia in range for the life of a patient without user management. This is the objective of the Music for Diabetes project. Such a device would provide a burden free quality of life, and has the potential to eliminate the long-term complications of diabetes

Discover the MuSiC4Diabetes Consortium here.