Tomas Walker, DNP, APRN, CDE, who has focused his nursing career on helping patients with diabetes and endocrine issues since 1999, now is a major player in the development of an artificial pancreas, according to an article on the University of Las Vegas Nevada website.
The story details how in 2006, while working as a nurse practitioner and clinical investigator at the Joslin Diabetes Center affiliate in Las Vegas, Walker understood the significance of a new medical device tracking a person’s blood sugars every five minutes.
The devices were quickly adapted into clinical trials, and as a full-time clinician and investigator, Walker became responsible for recruiting study participants, conducting intake exams, managing follow-up care and coordinating data collection — activities that traditionally have been under the purview of physicians.
“[At the time], there was great resistance to using the devices among care providers,” Walker, a 2012 doctoral graduate from UNLV, said in the story. “Many did not understand the technology well, and they believed their patients would not be able to handle the additional information.”
Walker recognized the potential that more data could bring and believed patients would use the information to improve their own health. The monitor measured a person’s glucose levels 288 times a day. Working with his patients, Walker used the reports to identify which activities, such as eating or exercise, created a pattern of glucose spikes and dips.
Believing in the patient
He found the beginnings of proof that patients would use the data when he participated in a diabetes chat room as a silent observer. One participant said she noted what she ate and when she administered her insulin doses — the same information Walker requests from his patients.
Three months later, he prescribed a continuous glucose monitor to a young woman. During the next six days, she dramatically improved her blood glucose control with zero intervention from him or his staff.
“At that moment, I realized our patients knew what we, as clinicians, had not yet come to accept,” Walker said in the story. “Patients could and would use the monitors to self-manage their glucose levels. I knew right then these devices were going to change lives by reducing hypoglycemia, which remains the No. 1 barrier to achieving diabetes control.
“After having this big ah-ha moment, I became involved with the work that could make these devices available to more people with diabetes.”
Development of an artificial pancreas
For the next nine years, Walker was active in more than 30 clinical studies. He grew more convinced the continuous glucose monitors, and how patients use them to manage their sugar levels, were key to making an artificial pancreas.
Dexcom, the manufacturer of the medical devices tracking a person’s blood sugars every five minutes, offered a consultant’s position to Walker, then hired him full-time in 2014 as director of clinical projects, according to the UNLV story.
“We are striving to build the best glucose monitor we can to enable the development of an artificial pancreas that is so intuitive patients can begin using it with confidence almost immediately,” Walker said in the UNLV story.
Artificial pancreas details
The artificial pancreas uses one or two insulin pumps. One will provide insulin to lower blood glucose, and the other, if used, will deliver glucagon to raise blood glucose. The artificial pancreas will communicate with a continuous glucose monitor using a control algorithm and an iPhone, according to the UNLV story.
The artificial pancreas is being designed to take data from the glucose monitor and run it through the algorithm, analyze the data and then administer the necessary insulin or glucagon dose. Patients can see their glucose levels on an iPhone and will have the ability to share the data with someone remotely.
Walker predicts the artificial pancreas could be available within the next three to five years, according to the story.
Walker is also helping to develop the next generation of continuous glucose monitors, making them able to display glucose levels, meal and insulin dosing history, and other data, as well as giving parents the ability to monitor and track their children’s levels when they are away from home.