The artificial pancreas: current status and future prospects in the management of diabetes
Abstract
Recent advances in insulins, insulin pumps, continuous glucose‐monitoring systems, and control algorithms have resulted in an acceleration of progress in the development of artificial pancreas devices. This review discusses progress in the development of external systems that are based on subcutaneous drug delivery and subcutaneous continuous glucose monitoring. There are two major system‐level approaches to achieving closed‐loop control of blood glucose in diabetic individuals. The unihormonal approach uses insulin to reduce blood glucose and relies on complex safety mitigation algorithms to reduce the risk of hypoglycemia. The bihormonal approach uses both insulin to lower blood glucose and glucagon to raise blood glucose, and also relies on complex algorithms to provide for safety of the user. There are several major strategies for the design of control algorithms and supervision control for application to the artificial pancreas: proportional–integral–derivative, model predictive control, fuzzy logic, and safety supervision designs. Advances in artificial pancreas research in the first decade of this century were based on the ongoing computer revolution and miniaturization of electronic technology. The advent of modern smartphones has created the ability to utilize smartphone technology as the engineering centerpiece of an artificial pancreas. With these advances, an artificial or bionic pancreas is within reach.
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Advanced device technology, including continuous glucose monitors (CGMs) and continuous subcutaneous insulin infusion (CSII) pumps, improves care for patients living with type 1 diabetes and has recently moved to closed-loop artificial pancreas (AP) systems.
“Advanced device technology, including continuous glucose monitors (CGMs) and continuous subcutaneous insulin infusion (CSII) pumps, improves care for patients living with type 1 diabetes and has recently moved to closed-loop artificial pancreas (AP) systems.”
From Real-Time Detection of Infusion Site Failures in a Closed-Loop Artificial Pancreas (2018) · cites this paper as [2]
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“Developments in technology such as continuous glucose monitors and dose-adjusted insulin pumps offer the possibility of closed-loop control over blood glucose levels via their integration into an artificial pancreas [32,33].”
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Self-citationReal-Time Detection of Infusion Site Failures in a Closed-Loop Artificial Pancreas
Howsmon, D. P., Baysal, N., Buckingham, B. A., Forlenza, G. P., Ly, T. T., Maahs, D. M., Marcal, T., Towers, L., Mauritzen, E., Deshpande, S., et al. (2018) · Journal of Diabetes Science and Technology · doi:10.1177/1932296818755173 · Cited by 32 · see citing works
Self-citationA comparison among three maximal mathematical models of the glucose-insulin system
Pompa, M., Panunzi, S., Borri, A., & De Gaetano, A. (2021) · PLOS ONE · doi:10.1371/journal.pone.0257789 · Cited by 24 · see citing works
- Authors
- Peyser, T., Dassau, E., Breton, M., & Skyler, J. S.
- Affiliations
- Dexcom, Inc San Diego California
- Department of Chemical Engineering and the Institute for Collaborative Biotechnologies University of California, Santa Barbara Santa Barbara California
- Department of Psychiatry and Neurobehavioral Sciences University of Virginia Charlottesville Virginia
- Diabetes Research Institute University of Miami Miami Florida
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 2014-04
- Volume
- 1311
- Issue
- 1
- Pages
- 102-123
- ISSN
- 0077-8923
- 1749-6632
- Cited by
- 144
- References
- 5
- Language
- en
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