scholarly journals Automated Insulin Delivery: How Artificial Pancreas “Closed Loop” Systems Can Aid You in Living With Diabetes

2020 ◽  
Vol 38 (1) ◽  
pp. 117-118
Author(s):  
Keyword(s):  
Closed Loop ◽  
Artificial Pancreas ◽  
Insulin Delivery ◽  
Closed Loop Systems

scholarly journals Progress in Development of an Artificial Pancreas

2009 ◽  
Vol 3 (5) ◽  
pp. 1002-1004 ◽  
Author(s):  
David C. Klonoff ◽  
Claudio Cobelli ◽  
Boris Kovatchev ◽  
Howard C. Zisser
Keyword(s):  
Closed Loop ◽  
Artificial Pancreas ◽  
Insulin Delivery ◽  
The Novel ◽  
Closed Loop System ◽  
Time Activity ◽  
Glucose Levels ◽  
Closed Loop Systems ◽  
Patients With Diabetes ◽  
Novel Approaches

This issue of Journal of Diabetes Science and Technology contains a collection of 12 original articles describing the latest advances in the development of algorithms for controlling insulin delivery in an artificial pancreas. Algorithms presented in this issue are affected by numerous quantifiable factors, including insulin pharmacokinetics, timing of meal carbohydrate appearance, meal size, amount of exercise, presence of stress, day-to-day variations in insulin sensitivity, insulin time-activity profiles, accuracy of glucose monitor calibration, metabolic profiles of both adults and neonates, and risks of hypoglycemia/hyperglycemia. These articles present theoretical advances in insulin delivery algorithms from modeled in silico patients, as well as clinical data from actual patients who have used closed loop systems. The novel approaches described in these articles are expected to bring us much closer to realization of a commercially available closed loop system for controlling glucose levels in patients with diabetes.

scholarly journals Women’s Experiences of Day-and-Night Closed-Loop Insulin Delivery During Type 1 Diabetes Pregnancy

2018 ◽  
Vol 12 (6) ◽  
pp. 1125-1131 ◽  
Author(s):  
Conor Farrington ◽  
Zoe Stewart ◽  
Roman Hovorka ◽  
Helen Murphy
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Control ◽  
Closed Loop ◽  
Insulin Delivery ◽  
Peace Of Mind ◽  
Women’S Experiences ◽  
Closed Loop Systems ◽  
Women's Experiences

Aims: Closed-loop insulin delivery has the potential to improve day-to-day glucose control in type 1 diabetes pregnancy. However, the psychosocial impact of day-and-night usage of automated closed-loop systems during pregnancy is unknown. Our aim was to explore women’s experiences and relationships between technology experience and levels of trust in closed-loop therapy. Methods: We recruited 16 pregnant women with type 1 diabetes to a randomized crossover trial of sensor-augmented pump therapy compared to automated closed-loop therapy. We conducted semistructured qualitative interviews at baseline and follow-up. Findings from follow-up interviews are reported here. Results: Women described benefits and burdens of closed-loop systems during pregnancy. Feelings of improved glucose control, excitement and peace of mind were counterbalanced by concerns about technical glitches, CGM inaccuracy, and the burden of maintenance requirements. Women expressed varied but mostly high levels of trust in closed-loop therapy. Conclusions: Women displayed complex psychosocial responses to day-and-night closed-loop therapy in pregnancy. Clinicians should consider closed-loop therapy not just in terms of its potential impact on biomedical outcomes but also in terms of its impact on users’ lives.

scholarly journals The road from intermittently scanned continuous glucose monitoring to hybrid closed-loop systems. Part B: results from randomized controlled trials

2019 ◽  
Vol 10 ◽  
pp. 204201881987190 ◽  
Author(s):  
Francesca De Ridder ◽  
Marieke den Brinker ◽  
Christophe De Block
Keyword(s):  
Randomized Controlled Trials ◽  
Continuous Glucose Monitoring ◽  
Closed Loop ◽  
Glucose Monitoring ◽  
Insulin Delivery ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Closed Loop Systems ◽  
Adults And Children

Background: Advances in diabetes technology have been exponential in the last few decades. With evolution in continuous glucose monitoring (CGM) systems and its progressive automation in control of insulin delivery, these advances have changed type 1 diabetes mellitus (T1DM) management. These novel technologies have the potential to improve glycated haemoglobin (HbA1c), reduce hypoglycaemic events, increase time spent in range and improve quality of life (QoL). Our aim was to evaluate the sustained effects in free-living unsupervised conditions of CGM systems (intermittently scanned and real time) and insulin delivery [from multiple daily injections, via sensor-augmented pump therapy and (predictive) low-glucose insulin suspension to hybrid closed-loop systems] on glucose control and QoL in adults and children with T1DM. Methods: We performed a systematic review of randomized controlled trials (RCTs), using PubMed and the Cochrane library up to 30 May 2019. Inclusion of RCTs was based on type of intervention (comparing glucose-monitoring devices and insulin-delivery devices), population (nonpregnant adults and children with T1DM), follow-up (outpatient setting for at least 8 weeks) and relevant outcomes [HbA1c, time in range (TIR), time in target, time in hypoglycaemia and QoL]. Exclusion of RCTs was based on intervention (exercise, only overnight use). The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were used to score the quality of the papers and for the final selection of the articles. Results: Our search resulted in 214 articles, of which 19 were eligible. Studies on advanced use in adults and children with T1DM reported increased TIR (all 9 studies); decreased time in hypoglycaemia (13 out of 15 studies); lowered HbA1c levels (5 out of 15 studies); improved QoL (10 of 16 studies) and treatment satisfaction (7 studies). Conclusions: Recent technologies have dramatically changed the course of T1DM. They are proving useful in controlling glycaemia in patients with T1DM, without increasing the treatment burden.

scholarly journals Fully Automated Closed-Loop Insulin Delivery Versus Semiautomated Hybrid Control in Pediatric Patients With Type 1 Diabetes Using an Artificial Pancreas

Diabetes Care ◽  
2008 ◽  
Vol 31 (5) ◽  
pp. 934-939 ◽  
Author(s):  
S. A. Weinzimer ◽  
G. M. Steil ◽  
K. L. Swan ◽  
J. Dziura ◽  
N. Kurtz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Pediatric Patients ◽  
Hybrid Control ◽  
Artificial Pancreas ◽  
Insulin Delivery

Closing the Loop

2014 ◽  
Vol 3 (1) ◽  
pp. 269-272
Author(s):  
Keith Karn ◽  
Kathryn Rieger ◽  
Eric Bergman ◽  
Bruce Hallbert ◽  
Andrew W. Gellatly ◽  
...  
Keyword(s):  
Human Factors ◽  
Medical Technology ◽  
Closed Loop ◽  
Artificial Pancreas ◽  
Subject Matter Experts ◽  
Aircraft Control ◽  
Closed Loop Systems ◽  
Power Plant Control ◽  
Closing The Loop

There has been considerable study and discussion regarding the appropriate role of the human operator in automated systems. Closed-loop systems are commonplace in manufacturing, power plant control, and aircraft control, and there is a growing body of research and public discussion related to automobile control. Closed-loop systems are less common in healthcare with some notable exceptions. The Artificial Pancreas Project is an example of a medical technology where system designers are facing difficult decisions related to removing the human from the control loop. This panel presented an opportunity for open, professional discussion on such closed-loop systems in healthcare that included subject matter experts not only from healthcare human factors, but also from the nuclear, automotive, and aviation human factors domains.

scholarly journals Progress with Closed-loop Systems in Type 1 Diabetes

2010 ◽  
Vol 06 (01) ◽  
pp. 58
Author(s):  
Lalantha Leelarathna ◽  
Roman Hovorka ◽  
◽  
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Diabetes Management ◽  
Insulin Delivery ◽  
Glucose Measurement ◽  
Target Range ◽  
Advantages And Disadvantages ◽  
Closed Loop Systems ◽  
Interstitial Glucose

Automated insulin delivery by means of a glucose-responsive closed-loop system has often been cited as the ‘holy grail’ of type 1 diabetes management. Reflecting the technological advances in interstitial glucose measurements and wider use of continuous glucose monitoring, recent research in closed-loop glucose control has focused on the subcutaneous route for glucose measurements and insulin delivery. The primary aim of such systems is to keep blood glucose within the target range while minimizing the risk of hypoglycemia with minimal input from the user. This article examines recent developments in the field of interstitial glucose measurement, limitations of the current generation of devices and implications on the performance of closed-loop systems. Clinical results and the advantages and disadvantages of different closed-loop configurations are summarized. Potential future advances in closed-loop systems are highlighted.

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