The artificial pancreas: a digital-age treatment for diabetes

Abstract

The artificial pancreas—the commonly accepted term for closed-loop glucose control—combines a continuous glucose monitor, insulin pump, and control algorithm into a system that automates insulin delivery. In The Lancet Diabetes & Endocrinology, Hood Thabit and colleagues' 1 Thabit H Lubina-Solomon A Stadler M et al. Home use of closed-loop insulin delivery for overnight glucose control in adults with type 1 diabetes: a 4-week, multicentre, randomised crossover study. Lancet Diabetes Endocrinol. 2014; (published online June 16.)http://dx.doi.org/10.1016/S2213-8587(14)70114-7 Google Scholar multicentre, randomised crossover study assesses home-based use of overnight closed-loop insulin delivery for improvement of glucose control in 25 participants with type 1 diabetes. Extending previous work by the same group, 2 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; 375: 743-751 Summary Full Text Full Text PDF PubMed Scopus (396) Google Scholar the artificial pancreas system in the present study was automated, rather than manual, and was used by patients at home for 4 weeks. At-home use is a particularly notable aspect because in other outpatient trials the device was used in a controlled environment, 3 Kovatchev BP Renard E Cobelli C et al. Feasibility of outpatient fully integrated closed-loop control: first studies of wearable artificial pancreas. Diabetes Care. 2013; 36: 1851-1858 Crossref PubMed Scopus (153) Google Scholar , 4 Phillip M Battelino T Atlas E et al. Nocturnal glucose control with an artificial pancreas at a diabetes camp. N Engl J Med. 2013; 368: 824-833 Crossref PubMed Scopus (337) Google Scholar and only one trial 5 Nimri R Muller I Atlas E et al. Night glucose control with MD-Logic artificial pancreas in home setting: a single blind, randomized crossover trial-interim analysis. Pediatr Diabetes. 2014; 15: 91-99 Crossref PubMed Scopus (83) Google Scholar reported overnight closed-loop glucose control at home. Home use of closed-loop insulin delivery for overnight glucose control in adults with type 1 diabetes: a 4-week, multicentre, randomised crossover studyUnsupervised overnight closed-loop insulin delivery at home is feasible and could improve glucose control in adults with type 1 diabetes. Full-Text PDF Open Access