The day before she turned 5, Claire Bickel was diagnosed with Type 1 Diabetes.
"She spent her fifth birthday in the hospital, learning to get insulin shots," remembered Francesca Bickel, Claire's mother.
Type 1 diabetes is an autoimmune disease that kills the insulin-producing cells in the pancreas. Insulin is the hormone that allows the body to process and store glucose. Over the next decade, Claire learned to manage her diabetes, balance nutrition, exercise and proper blood glucose monitoring techniques with the rest of her life's priorities.
"Diabetes is a 24-hours-a-day, 7-days-a-week disease. The day Claire was diagnosed was the day her life – and ours – radically changed," said Francesca, adding that the overnight hours were the most stressful. "The biggest issue for parents of kids with Type 1 diabetes is the night time when she was asleep. I had to set an alarm and get up in the middle of the night to check her blood sugars. It's not fun to be woken up at 1 am to eat goldfish crackers and drink juice."
"I used to have to eat at specific times, eat specific carbs, and test my blood sugar five to seven times a day with a meter," said Claire. Whenever she ate or her blood sugar levels got too high, she had to manually press a button to tell the pump to give her extra insulin on a device that would release a pre-set amount of insulin.
In April 2017, Claire became the first pediatric patient in the world to receive a MiniMed 670G hybrid closed loop system. Once referred to as an "artificial pancreas," the closed loop system includes a glucose sensor that "talks" to the insulin pump, which enables the pump to automatically deliver the correct amount of insulin directly into her bloodstream only when she needs it. In addition, the system constantly self-adjusts to keep her sugar levels in range.
Jennifer Sherr, MD, PhD, has been Claire's endocrinologist at Yale New Haven Children's Hospital since she was first diagnosed. In fact, Dr. Sherr gave Claire her very first insulin shot. Ten years later, she is delighted that Claire was chosen to be the first pediatric patient to receive the hybrid closed loop system.
"The Yale Pediatric Diabetes Team has a long-standing history of research and innovations to improve the management of diabetes," said Dr. Sherr. "With this system, we have seen Claire's glycemic control come into targeted range, and her mom can sleep without worrying about the risk of hypoglycemia (low blood sugars) overnight. Having Claire incorporate this technology into her care has meant that some of the burden of her chronic medical condition can be offset to the system – and away from her and her family."
For Claire – and for her mother – the hybrid closed loop system has been a great relief.
"This is the technology that allows moms to sleep through the night, and the thing that allows children like Claire to be a normal kid," said Francesca.
"I'm 15 years old, and I have millions of things to think about: friends, field hockey, AP classes, football games, family functions," said Claire. "When you have diabetes, you have diabetes – it doesn't go away. But now I can pay more attention to the kinds of things a kid should be thinking about."