Glucose-responsive insulin delivery for type 1 diabetes: The artificial pancreas story.

Bally, Lia; Thabit, Hood; Hovorka, Roman (2018). Glucose-responsive insulin delivery for type 1 diabetes: The artificial pancreas story. International journal of pharmaceutics, 544(2), pp. 309-318. Elsevier 10.1016/j.ijpharm.2017.12.022

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Insulin replacement therapy is integral to the management of type 1 diabetes, which is characterised by absolute insulin deficiency. Optimal glycaemic control, as assessed by glycated haemoglobin, and avoidance of hyper- and hypoglycaemic excursions have been shown to prevent diabetes-related complications. Insulin pump use has increased considerably over the past decade with beneficial effects on glycaemic control, quality of life and treatment satisfaction. The advent and progress of ambulatory glucose sensor technology has enabled continuous glucose monitoring based on real-time glucose levels to be integrated with insulin therapy. Low glucose and predictive low glucose suspend systems are currently used in clinical practice to mitigate against hypoglycaemia, and provide the first step towards feedback glucose control. The more advanced technology approach, an artificial pancreas or a closed-loop system, gradually increases and decreases insulin delivery in a glucose-responsive fashion to mitigate against hyper- and hypoglycaemia. Randomised outpatient clinical trials over the past 5 years have demonstrated the feasibility, safety and efficacy of the approach, and the recent FDA approval of the first single hormone closed-loop system establishes a new standard of care for people with type 1 diabetes.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Bally, Lia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0378-5173

Publisher:

Elsevier

Language:

English

Submitter:

Jacques Donzé

Date Deposited:

26 Mar 2018 14:43

Last Modified:

25 Oct 2019 16:25

Publisher DOI:

10.1016/j.ijpharm.2017.12.022

PubMed ID:

29258910

Uncontrolled Keywords:

Artificial pancreas Closed-loop Continuous glucose monitoring Control algorithm Insulin pump therapy

BORIS DOI:

10.7892/boris.111466

URI:

https://boris.unibe.ch/id/eprint/111466

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