New technologies in diabetology. How far are we from a closed loop?

Abstract

Today, assistive technologies are highly important in the treatment of diabetes, especially in the therapy of type 1 diabetes. The use of insulin pumps, for example, has become an established form of treatment. Modern insulin pumps offer various functions, such as different basal rate profiles, split delivery of the meal bolus, and integrated bolus calculators. Some pumps are additionally connected to a blood glucose meter or a continuous glucose-monitoring sensor. Several minimally invasive needle-type sensor systems for continuous tissue glucose monitoring are already available. Recent developments aim at increasing the functionality of insulin pumps and the improvements of sensors for continuous glucose monitoring. In addition, many research groups are working on closing the loop between these two components and thus developing an artificial pancreas, which automatically regulates insulin delivery. The first steps have already been taken and bolus calculators or sensor-augmented insulin pumps with suspension of insulin delivery are now available. Many experimental models show promising results. Prior to the implementation of a fully automated system for everyday use, however, partially automated systems that require user input are to be expected. This article aims at giving an overview of the current state of development in the field of diabetes technology.