Endocrine Reviews Journal Article

Realizing a Closed-Loop (Artificial Pancreas) System for the Treatment of Type 1 Diabetes

July 05, 2019

Rayhan A Lal, Laya Ekhlaspour, Korey Hood, Bruce Buckingham
Endocrine Reviews, Volume 40, Issue 6, December 2019, Pages 1521–1546
https://doi.org/10.1210/er.2018-00174

Abstract

Recent, rapid changes in the treatment of type 1 diabetes have allowed for commercialization of an “artificial pancreas” that is better described as a closed-loop controller of insulin delivery. This review presents the current state of closed-loop control systems and expected future developments with a discussion of the human factor issues in allowing automation of glucose control. The goal of these systems is to minimize or prevent both short-term and long-term complications from diabetes and to decrease the daily burden of managing diabetes. The closed-loop systems are generally very effective and safe at night, have allowed for improved sleep, and have decreased the burden of diabetes management overnight. However, there are still significant barriers to achieving excellent daytime glucose control while simultaneously decreasing the burden of daytime diabetes management. These systems use a subcutaneous continuous glucose sensor, an algorithm that accounts for the current glucose and rate of change of the glucose, and the amount of insulin that has already been delivered to safely deliver insulin to control hyperglycemia, while minimizing the risk of hypoglycemia. The future challenge will be to allow for full closed-loop control with minimal burden on the patient during the day, alleviating meal announcements, carbohydrate counting, alerts, and maintenance. The human factors involved with interfacing with a closed-loop system and allowing the system to take control of diabetes management are significant. It is important to find a balance between enthusiasm and realistic expectations and experiences with the closed-loop system.

Read the article


You may also like...

Endocrinology

Search underway for the next Editor-in-Chief

The Endocrine Society seeks the next Editor-in-Chief (EIC) of Endocrinology, the Society’s premier basic science journal, publishing continuously online on basic and translational research at molecular, biochemical, cellular, genomic, comparative, and organismal levels.

The Endocrine Society seeks the next Editor-in-Chief (EIC) of Endocrinology, the Society’s premier basic science journal, publishing continuously online on basic and translational research at molecular, biochemical, cellular, genomic, comparative, and organismal levels.

Thematic Issue

Immuno-endocrinology 2020

immuno-endocrinology
Read our special collection of journal articles, published in 2018-2019, focused on immuno-endocrinology! Curation of the collection was guided by Altmetric Attention Scores and Featured Article designations.

Read our special collection of journal articles, published in 2018-2019, focused on immuno-endocrinology! Curation of the collection was guided by Altmetric Attention Scores and Featured Article designations.

Back to top
Short on time?

We'll come to you...

Get updates on the latest breakthroughs, clinical practice guidelines, and career development opportunities, straight to your inbox

Then take the next step: Set up your free website account and get exclusive access to even more great tools & content!