Course Syllabus

BME 3 Course Syllabus

 Course Number: BME 3

 Course Title: Engineering Innovations in Treating Diabetes (Abbreviated Title: Treating Diabetes)

 Course Goals and Description: The goal of this course is to introduce students to engineering in medicine.  The course teaches both a qualitative description of engineering innovations in medicine over the past century and numerical techniques to find approximate solutions to optimization problems.  Throughout the course, these medical engineering innovations are tied to optimization.  The idea that practical engineering solutions must be optimal is stressed.

Catalogue Description:  Innovations in diabetes treatment from the 1800’s until the present: purification of insulin, measuring and control of blood glucose, recombinant DNA, clinical trials and ethics.  Solving optimization problems in engineering with Excel.

Prerequisites: None.

Fulfills General Education Categories: II (Science and Technology), Vb (Quantitative, Symbolic, and Computational Reasoning)

Grading and Course Requirements: The final course grade will be determined by combining grades from the 10 quizzes (40%), 4-5 homework projects (25%), 9 reading and discussion assignments (25%) and a final exam (10%). 

Outline of Lectures:

Week 1:  Getting started.  How does this online class work?  Registering with perusal.com Download and install Microsoft Office Pro Plus.  Grading.  Readings/discussion, Homework, Quizzes.

Week 2: Diabetes Pre-insulin. The importance of basic research.  Diabetes discovery pre1800. The discovery of the pancreas.  Improvements in surgical technique.  Oscar Minkowski’s removal of the pancreas. Animals in testing, anti-vivisection. Understanding optimization problems.

 Week 3:  Living with diabetes before insulin.  George Minot’s background and life, diagnosis.  Elizabeth Hughes life and diagnosis.  Starvation diet for treating diabetes. Early 1900’s. Fred Banting’s work in Toronto. 

Week 4.  Industrialization and purification of insulin.  Collip’s alcohol purification.  Scaling up purification and pH.  Early pH meters.  Patent and Licensing.  Eli Lilly and the discovery of isoelectric purification. Using Excel’s to help solve combinatorial optimization problems.

 Week 5.  Complications from diabetes.  Peripheral arterial disease and foot, kidney, eye problems. Neuropathy and other complications. Examples with particular historical patients: George Minot and case studies. 

Week 6.   Glucose measurements.  Measurements from urine. Ames Reflective Meter. Detlev Müller and the isolation of glucose oxidase. Leland Clarke invents the oxygen electrode. Today, continuous glucose monitors. Control of glucose by changing food and insulin. NPH insulin.  Modern drug delivery. Using Excel's Solver to find an optimal circuit through 20 different points on a graph.

Week 7.  Clinical Trials.  Understanding the structure of clinical trials. The Tolstoi control controversy resolved by DCCT and fundus photography. Modern clinical trials with beta carotene. Interpreting clinical trials.  

Week 8. Recombinant production of insulin.  Projected insulin shortage in the 70’s.  Synthesis of insulin. Axel Ulrich clones insulin from an insulinoma.  Ethical concerns in the US about recombinant DNA research.  Eli Lilly and Irving Johnson mass produce recombinant insulin.  Modern engineered insulins.  Hand optimization of scheduling problems.

Week 9. Insulin delivery methods:  pens, pumps, breathable insulin. Artificial pancreas.  C-peptide therapy as a therapeutic for diabetes.

Week 10. Later advances in diagnosing and treating diabetes.  Anthony Cerami and Hemoglobin A1c tests.  Importance of diversity in engineering.  Margaret Crane and the home pregnancy test. Future of Technology for Diabetes.   Using Excel's Solver with scheduling problems.

Reading List (representative):  Excerpts will be posted to the course website.

• The Discovery of Pancreatic Diabetes, the role of Oscar Minkowski by BA Houssay, Diabetes Volume 1 p112, 1952.
• The Inquisitive Physician, the life and times of George Minot. By Francis Rackemann 1956.
• The Discovery of Insulin by Michael Bliss, 1982.
• The Manufacture and Discovery of Insulin, by Gene E. McCormick (Eli Lilly company historian, 1971)
• Irving S. Johnson Eli Lilly and the Rise of Biotechnology, an oral history by Sally S Hughes from the Bancroft Library at UC Berkeley, 2004.
• Irving S. Johnson, Trial and Tribulations of producing the first genetically engineered drug, Nature Reviews Drug Discovery, September 2003, vol2 p 747.
• David Mendosa, History of Blood Glucose Meters, Transcripts of Interviews, 2006.
• F. Clarke and J. R. Foster, A history of blood glucose meters and their role in self-monitoring of diabetes mellitus, British Journal of Biomedical Science, 2012, volume 69, number 2, pages 83-89
• Heinemann L. The failure of exubera: are we beating a dead horse?. J Diabetes Sci Technol. 2008;2(3):518–529.