Closed-loop insulin delivery: from bench to clinical practice
- 22 February 2011
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Endocrinology
- Vol. 7 (7), 385-395
- https://doi.org/10.1038/nrendo.2011.32
Abstract
Automated closed-loop insulin delivery, also referred to as the 'artificial pancreas', has been an important but elusive goal of diabetes treatment for many decades. Research milestones include the conception of continuous glucose monitoring in the early 1960s, followed by the production of the first commercial hospital-based artificial pancreas in the late 1970s that combined intravenous glucose sensing and insulin delivery. In the past 10 years, research into the artificial pancreas has gained substantial momentum and focused on the subcutaneous route for glucose measurement and insulin delivery, which reflects technological advances in interstitial glucose monitoring and the increasing use of the continuous subcutaneous insulin infusion. This Review discusses the design of an artificial pancreas, its components and clinical results, as well as the advantages and disadvantages of different types of automated closed-loop systems and potential future advances. The introduction of the artificial pancreas into clinical practice will probably occur gradually, starting with simpler approaches, such as overnight control of blood glucose concentration and temporary pump shut-off, that are adapted to more complex situations, such as glycemic control during meals and exercise.Keywords
This publication has 118 references indexed in Scilit:
- MD-Logic Artificial Pancreas SystemDiabetes Care, 2010
- Measurement delay associated with the Guardian® RT continuous glucose monitoring systemDiabetic Medicine, 2010
- Use of the Site of Subcutaneous Insulin Administration for the Measurement of Glucose in Patients With Type 1 DiabetesDiabetes Care, 2009
- Closed-Loop Insulin Delivery Using a Subcutaneous Glucose Sensor and Intraperitoneal Insulin DeliveryDiabetes Care, 2009
- Tight glycemic control and computerized decision-support systems: a systematic reviewIntensive Care Medicine, 2009
- Is an Automatic Pump Suspension Feature Safe for Children with Type 1 Diabetes? An Exploratory Analysis with a Closed-Loop SystemDiabetes Technology & Therapeutics, 2009
- Duration of Nocturnal Hypoglycemia Before SeizuresDiabetes Care, 2008
- A novel insulin formulation with a more rapid onset of actionDiabetologia, 2008
- A simulation model of glucose regulation in the critically illPhysiological Measurement, 2008
- Prevention of Hypoglycemia During Exercise in Children With Type 1 Diabetes by Suspending Basal InsulinDiabetes Care, 2006