Abstract
Since the discovery of insulin, alleviation of the burden of insulin therapy has been a constant worry. In The Lancet today, Roman Hovorka and colleagues 1 Hovorka R Allen JM Elleri D et al. Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial. Lancet. 2010; (published online February 5.)https://doi.org/10.1016/S0140-6736(09)61998-X Summary Full Text Full Text PDF PubMed Scopus (397) Google Scholar report a milestone in the quest for an artificial pancreatic β cell that started almost 50 years ago. Restoration of missing β-cell function by an automated, glucose-modulated, insulin-delivery system was initially supported by reports of glucose swings in patients treated with insulin injections, resulting in extreme cases of so-called brittle diabetes. The Diabetes Control and Complications Trial 2 The Diabetes Control and Complications Trial Research GroupThe effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993; 329: 977-986 Crossref PubMed Scopus (22519) Google Scholar later underscored the need for sustained near-normal glucose concentrations to prevent long-term diabetes-related body damage. Although technology applied to insulin delivery and glucose monitoring for the past 20 years has allowed substantial improvements in glucose control, for patients with diabetes and their caregivers the quest for the artificial β cell has remained similar to that of the holy grail for King Arthur's knights. Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trialClosed-loop systems could reduce risk of nocturnal hypoglycaemia in children and adolescents with type 1 diabetes. Full-Text PDF Open Access
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