Can We Really Close the Loop and How Soon? Accelerating the Availability of an Artificial Pancreas: A Roadmap to Better Diabetes Outcomes
- 2 June 2009
- journal article
- research article
- Published by Mary Ann Liebert Inc in Diabetes Technology & Therapeutics
- Vol. 11 (S1), S113-113
- https://doi.org/10.1089/dia.2009.0031
Abstract
Development of a closed-loop artificial pancreas has been a long-time goal that could transform diabetes management. The primary limitation until recent years was the lack of a robust and portable continuous glucose sensor. There has been significant progress over the past 5 years in the development and commercialization of continuous glucose monitoring (CGM) devices. Used adjunctively, CGM has been demonstrated to add significant value in improving diabetes management by increasing time spent in glycemic targets and improving overall glycemic control. However, these benefits are limited by the human user's finite capacity to respond to the data provided by the device. By automating even a portion of the insulin delivery functionality of combined sensor/pump systems via computer algorithm, impending excursions could be handled more quickly and effectively. This review will describe very promising preliminary closed-loop studies, describe a potential roadmap to an artificial pancreas that will be safe and effective, and propose a solution—a hypo- and hyperglycemia minimizing control-to-range approach—that may allow for near-term delivery of a semiautomated system to people with diabetes.Keywords
This publication has 22 references indexed in Scilit:
- Effect of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump TherapyDiabetes Care, 2009
- The Barrier of Hypoglycemia in DiabetesDiabetes, 2008
- Continuous Glucose Monitoring and Intensive Treatment of Type 1 DiabetesThe New England Journal of Medicine, 2008
- Fully Automated Closed-Loop Insulin Delivery Versus Semiautomated Hybrid Control in Pediatric Patients With Type 1 Diabetes Using an Artificial PancreasDiabetes Care, 2008
- Continuous Glucose Monitoring in Children with Type 1 DiabetesThe Journal of Pediatrics, 2007
- Improved Glycemic Control in Poorly Controlled Patients with Type 1 Diabetes Using Real-Time Continuous Glucose MonitoringDiabetes Care, 2006
- Feasibility of Automating Insulin Delivery for the Treatment of Type 1 DiabetesDiabetes, 2006
- Closing the loop: combining insulin pumps and glucose sensors in children with type 1 diabetes mellitusPediatric Diabetes, 2006
- Improvement in Glycemic Excursions With a Transcutaneous, Real-Time Continuous Glucose SensorDiabetes Care, 2006
- Continuous glucose monitoring and closed‐loop systemsDiabetic Medicine, 2005