Artificial Pancreas: Current Progress and Future Outlook in the Treatment of Type 1 Diabetes

@article{Ramli2019ArtificialPC,
  title={Artificial Pancreas: Current Progress and Future Outlook in the Treatment of Type 1 Diabetes},
  author={Rozana Ramli and Monika Reddy and Nick S. Oliver},
  journal={Drugs},
  year={2019},
  pages={1-13}
}
Type 1 diabetes is characterised by insulin deficiency caused by autoimmune destruction of the pancreatic beta cells. The treatment of type 1 diabetes is exogenous insulin in the form of multiple daily injections or continuous subcutaneous insulin infusion. Advances in diabetes technology have been exponential in the past few decades, culminating in studies to develop an automated artificial pancreas, also known as the closed-loop system. This has recently led to a commercially available… 
Study of blood glucose and insulin infusion rate in real-time in diabetic rats using an artificial pancreas system
TLDR
A rat APS may be used as a powerful tool not only to study alterations of glucose and insulin homeostasis in real-time caused by diet, exercise, hormones, or antidiabetic agents, but also to test mathematical and engineering models of blood glucose prediction or new algorithms for closed-loop APS.
Closed-loop bioelectronic medicine for diabetes management
TLDR
An overview of the state-of-the-art for closed-loop neuromodulation systems in relation to diabetes is presented and future related opportunities for management of this chronic disease are discussed.
Therapeutic Advances in Diabetes, Autoimmune, and Neurological Diseases
TLDR
This review focuses on nine diseases in three major therapeutics areas, diabetes, autoimmune, and neurological disorders, and provides a comprehensive overview of current and emerging therapeutic modalities developed in the recent years.
Diabetic neuropathy and neuropathic pain: a (con)fusion of pathogenic mechanisms?
TLDR
An overview of current understanding of potential initiating lesions for diabetic neuropathy and the multiple downstream mechanisms identified in cell and animal models of diabetes that may contribute to the pathogenesis of diabetic Neuropathy and neuropathic pain is provided.
Artificial pancreas with carbohydrate suggestion performance for unannounced and announced exercise in Type 1 Diabetes.
TLDR
MCL with automatic carbohydrate recommendation performed well and was safe during and after both unannounced and announced exercise maintaining glucose mostly within the target range and reducing the risk of hypoglycemia despite of less amount of carbohydrate intake.
Advanced Diabetes Management Using Artificial Intelligence and Continuous Glucose Monitoring Sensors
TLDR
The state-of-the-art methodologies using AI and CGM sensors for decision support in advanced T1D management are reviewed, including techniques for personalized insulin bolus calculation, adaptive tuning of bolus calculator parameters and glucose prediction.
Efficacy and safety of closed-loop insulin delivery versus sensor-augmented pump in the treatment of adults with type 1 diabetes: a systematic review and meta-analysis of randomized-controlled trials
TLDR
CL insulin delivery appears to be a better treatment method than SAP therapy for adults with T1D because of its increased BG control efficacy and decreased number of hypoglycemic events.
Fault Tolerant Strategies for Automated Insulin Delivery Considering the Human Component: Current and Future Perspectives
TLDR
An analysis of potential faults introduced by AID users when the system is under normal operation is presented, followed by a review of current fault tolerant control (FTC) approaches to identify missing areas of research.
...
...

References

SHOWING 1-10 OF 94 REFERENCES
A Review of the Current Challenges Associated with the Development of an Artificial Pancreas by a Double Subcutaneous Approach
TLDR
Although using a double SC AP leads to significant improvements in glucose control, the SC approach has severe limitations that hamper further progress towards a robust AP.
Artificial Pancreas as an Effective and Safe Alternative in Patients with Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis
TLDR
Artificial pancreas might be considered an effective and safe alternative to be used during a 24-h basis in patients with T1DM.
Artificial Pancreas: Past, Present, Future
TLDR
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 that has proved the feasibility of external glucose control and stimulated further technology development.
Artificial Pancreas Device Systems for the Closed-Loop Control of Type 1 Diabetes
TLDR
There are around 18 closed-loop artificial pancreas device systems progressing through early stages of clinical development, but only a few of these are currently in phase 3 trials and in settings that replicate real life.
Performance of an Artificial Pancreas System for Young Children with Type 1 Diabetes.
TLDR
Use of an AP in young children was safe and resulted in improved mean BG without increased hypoglycemia, which suggests that AP use in youngChildren is safe and improves overall diabetes control.
Performance of an Artificial Pancreas System for Young Children with Type 1 Diabetes
TLDR
Evaluated the safety and performance of an artificial pancreas (AP) system among young children with type 1 diabetes and found that the AP admission admission resu...
Patients' Perception and Future Acceptance of an Artificial Pancreas
TLDR
Investigating future acceptance of an artificial pancreas and its determinants found the overall attitude on the AP was positive, and intention to use was dependent on trust in the AP, which was related to the quality of glucose control provided by the AP.
A Bio-Inspired Glucose Controller Based on Pancreatic β-Cell Physiology
TLDR
Very good glucose control in a virtual population with type 1 diabetes mellitus using a controller based on a subcellular β-cell model is shown for the first time.
...
...