On March 7, 1973, when I was 9 years old, the medical future came into my living room in Brooklyn, N.Y., via a 25-inch Zenith color television.  On that night, Steve Austin, a civilian astronaut, crashed in a test flight accident and lost his right arm, left eye and both legs.  Luckily for Colonel Austin, a Vietnam veteran who had walked on the moon, he was able to be “rebuilt” with artificial legs that allowed him to run at 60 mph, a prosthetic arm that could lift 150 pounds (and had a Geiger counter for radiation detection) and a bionic eye, complete with a 20:1 zoom lens and infrared capabilities, thanks to the generosity of the American Broadcasting Company.  Total cost?  6 million dollars.

Forty-one years later, on June 15, 2014, the New England Journal of Medicine published an original article about something that Steve Austin never had, the world’s first outpatient bionic pancreas.  The technology consists of a smart phone (iPhone), two hormones (insulin and glucagon), a glucose monitor and an insulin pump.  The researchers, based in Boston, looked at a total of 52 patients (20 adults, 32 adolescents) with Type 1 diabetes, in a series of five-day protocols with both the bionic pancreas and the patients’ prior insulin pumps.  The study was done in a random order crossover design.  Adult patients could eat whatever they wanted and were followed closely by the researchers for blood testing.  Adolescent patients were together in a “diabetes camp” and monitored closely.  A subcutaneous sensor sends glucose readings back to the smartphone, which then calculates the insulin and glucagon dosing every 5 minutes.  It can correct for both hyperglycemia and hypoglycemia.  The results showed that for both adults and adolescents, plasma and blood glucose levels were improved in the bionic pancreas group as compared to the traditional insulin pump treatment.  Limitations of the study included wireless connectivity problems, a small population, and only allowing for moderate alcohol intake in the adult group.  See articles by The New York Times, CNBC and NPR.

Up to 3 million Americans are living with Type 1 diabetes.  This new combination device holds a promising key for improved disease management and quality of life for these patients, quite likely allowing them to control their diabetes much easier, with better outcomes.

Before we leave that fun childhood memory of watching cyborgs jump up two stories with the greatest slow-motion sound effects ever (what would Lieutenant Dan and Forrest Gump have thought of those legs?), you might think that building a 6 Million Dollar Man in today’s dollars would cost more than $30 million.  Guess again.


Stuart J. Glassman, MD

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