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Cited by 600Diabetes Management and ResearchPancreatic function and diabetesDiabetes Treatment and Management

Artificial Pancreas: Past, Present, Future

Open access
Cobelli, Claudio, Renard, Eric, Kovatchev, Boris·2011·Diabetes
DOI 10.2337/db11-0654PMC PMC3198099
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Abstract

The artificial pancreas (AP), known as closed-loop control of blood glucose in diabetes, is a system combining a glucose sensor, a control algorithm, and an insulin infusion device. AP developments can be traced back 50 years to when the possibility for external blood glucose regulation was established by studies in individuals with type 1 diabetes using intravenous glucose measurement and infusion of insulin and glucose. After the pioneering work by Kadish (1) in 1964, expectations for effectively closing the loop were inspired by the nearly simultaneous work of five teams reporting closed-loop control results between 1974 and 1978: Albisser et al. (2), Pfeiffer et al. (3), Mirouze et al. (4), Kraegen et al. (5), and Shichiri et al. (6). In 1977, one of these realizations (3) resulted in the first commercial device—the Biostator (7; Fig. 1), followed by another inpatient system, the Nikkiso STG-22 Blood Glucose Controller, now in use in Japan (8). FIG. 1. The Biostator (courtesy of William Clarke, University of Virginia). Although the intravenous route of glucose sensing and insulin infusion is unsuitable for outpatient use, these devices proved the feasibility of external glucose control and stimulated further technology development. Figure 2 presents key milestones in the timeline of AP progress. FIG. 2. Key milestones in the timeline of AP progress. EU, Europe; IP, intraperitoneal; NIH, National Institutes of Health; SC, subcutaneous. In 1979, landmark studies by Pickup et al. (9) and Tamborlane et al. (10) showed that the subcutaneous route was feasible for continuous insulin delivery. Three years later, Shichiri et al. (11) tested a prototype of a wearable AP, which was further developed in subsequent studies (12,13). In the late 1980s, an implantable system was introduced using intravenous glucose sensing and intraperitoneal insulin infusion (14). This technology was further developed, leading to clinical trials and …

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  • The development of artificial pancreas control algorithms in the past few years has been accelerated by computer simulation.

    “The development of artificial pancreas control algorithms in the past few years has been accelerated by computer simulation; for example, in silico testing has provided directions for clinical studies and ruling out of ineffective control scenarios in a cost-effective manner. 1,2”

    From The UVA/PADOVA Type 1 Diabetes Simulator: New Features (2014) · cites this paper as [2]

    In “A step forward: in silico experiments replacing animal trials” (page unavailable), the paper says simulation is already used to test control algorithms efficiently and at a fraction of the time and cost of animal trials. But it says simulation *will* greatly accelerate future artificial-pancreas development; it does not establish that algorithm development had already accelerated in the past few years. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • In silico testing has provided directions for clinical studies and ruling out of ineffective control scenarios in a cost-effective manner.

    “in silico testing has provided directions for clinical studies and ruling out of ineffective control scenarios in a cost-effective manner. 1,2”

    From The UVA/PADOVA Type 1 Diabetes Simulator: New Features (2014) · cites this paper as [2]

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Research works printed but not linked: 1

  1. [119]Micheletto F, Dalla Man C, Vella A, Cobelli C. A model of glucagon secretion and action in healthy subjects. Proceedings of the 10th Diabetes Technology Meeting, Bethesda, MD, 2010, A105

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Authors
Cobelli, C., Renard, E., & Kovatchev, B.
Affiliations
  • University of Padua (IT)
  • Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
  • University of Virginia (US)
Corresponding author
Cobelli, Claudio
ORCID
Venue
Diabetes
Publisher
American Diabetes Association
Published
2011-10-17
Volume
60
Issue
11
Pages
2672-2682
ISSN
  • 0012-1797 (ISSN-L)
  • 1939-327X
DOI
10.2337/db11-0654
PMC
PMC3198099
OpenAlex
W2162557622
Cited by
600
References
123
Citations by year
2026: 23 · 2025: 31 · 2024: 37 · 2023: 28 · 2022: 32 · 2021: 29 · 2020: 45 · 2019: 47 · 2018: 56 · 2017: 58 · 2016: 34 · 2015: 50 · 2014: 57 · 2013: 43 · 2012: 29
FWCI
5.73
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Funders
  • Juvenile Diabetes Research Foundation International
  • Ministero dell'Università e della Ricerca
  • National Institutes of Health
  • University of California, Santa Barbara
  • U.S. Public Health Service (R01 085623)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK085623)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
artificial pancreas, closed-loop glucose control, type 1 diabetes, insulin infusion, continuous glucose monitoring, subcutaneous insulin administration, intraperitoneal insulin infusion, Biostator
MeSH terms
Animals, Blood Chemical Analysis, Blood Glucose, Computer Simulation, Diabetes Mellitus, Type 1, Humans, Insulin, Insulin Infusion Systems, Pancreas, Artificial

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