I was reading the other day about the amount of Federal Stimulus grant money still remaining. Given the large amount of money allocated in the past year for grants, it is not entirely surprising that a large amount remains up for grabs for enterprising grant applicants. The most interesting segment to me is the money still available via the National Institutes of Health, as that’s the money that goes toward disease-focused research and development:
National Institutes of Health has spent 45 percent, or $4.73 billion, of its $10.4 billion ARRA allocation. Approximately $4.35 billion has supported 12,788 grants, and $379 million has supported contracts. In FY 09, nearly 60 percent of ARRA funds supported new projects and nearly 40 percent supplemented existing projects. Over the summers of 2009 and 2010, approximately 5,000 students and science educators will gain hands-on experience in top research laboratories.
$4.73 billion. That’s a lot of money. And it starts me thinking: well, if I had a grant of say, $10 million, and I hired a team of researchers and engineers, what would I build? In other words, “If I could build my diabetes dream device, what would it be?”
This is a fun game to play, and very similar to the “If I were fabulously wealthy…” game I sometimes play. But, to make it meaningful, and not just completely fantastical, we have to have some rules: these are smallish grants, usually, so no be-all-end-all solutions; “artificial pancreas” and “a cure” don’t count, and the device/drug/whatever should be reasonably achievable within a few years and in the millions of dollars.
So what would I build? These are some of the first to mind (As far as I know, none of these exist yet; if they do, please do tell):
1. One hole, please. There are pumps, and there are continuous glucose monitors, but every implementation I have seen thus far requires two separate insertion points. The reasons for this are clear– it’s very difficult to get an accurate blood glucose reading in the same location as you are constantly injecting insulin– but surely there must be some way to unite the two? I have a pump now, and I will gladly make an extra hole in my stomach every few days for a sensor as well, but it would be nice if I didn’t have to. Wearing a bikini and finding undamaged skin on my torso with just one insertion point is hard enough.
2. Smaller! I have many times been asked if my pump is an MP3 player; I am surprised, not because I expect people to know what an insulin pump is, but rather because I have not seen an MP3 player that large in years. Have you seen iPods lately? The Shuffle is tiny! Why can’t my insulin pump be that small? Where’s my sticker-size pump, with a svelte bag of insulin that no one notices? I would gladly purchase small, obscure batteries if that meant I could wear my pump under a dress without needing my current ridiculous garter contraption (a ring of velcro I wear around my thigh, with a string attached and pinned to my underwear; the pump hands on the velcro at my inner thigh, so as not to contort the lines of the dress).
3. Smarter than a doornail. This is the one that sticks out to me, probably because I know more about software than I do about medical devices, but in any case: every piece of diabetes machinery I have should be able to talk to every other piece, and they should confer and advise or decide as to the best course of action. I should be able to scan the UPC of a food item I’m about to eat, and my insulin pump should know how many carbohydrates that is, and that given my metered blood sugar, my current heart rate, the time of day, and my history of carbohydrate-to-insulin ratios and subsequent blood glucose measurements, I should take 1.3 units of insulin.
These things are possible, and I want them. Now.
I feel like I’m thinking too inside the box here, though; the listed items would be nice, but they are variations on things already had. What do diabetics want? If you had money and a team of scientists and engineers, what would you build? Diabetics, parents of diabetics, doctors for diabetics, friends of diabetics– what’s on you Diabetic Wish List? (Shout out here to some of the recent discussions and requests I’ve seen concerning more accurate glucose monitoring.)
Scientists, engineers, and grantors, take note!