The artificial pancreas.
Journal
Current opinion in organ transplantation
ISSN: 1531-7013
Titre abrégé: Curr Opin Organ Transplant
Pays: United States
ID NLM: 9717388
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
pubmed:
4
7
2020
medline:
29
1
2021
entrez:
4
7
2020
Statut:
ppublish
Résumé
Advances in diabetes technologies have enabled the development of artificial pancreas (closed-loop) systems for people with diabetes. We review the key studies which have led to the adoption of the artificial pancreas in clinical practice and consider ongoing challenges and areas for future enhancements. Studies have demonstrated safety and efficacy of closed-loop insulin delivery systems in free-living settings over periods of up to 6 months for children and adults with type 1 diabetes. Since 2017, four hybrid closed-loop systems have been approved by regulatory bodies worldwide, but these systems are not entirely automated, requiring user interaction to deliver mealtime insulin boluses. Improving usability of these devices in the real-world setting is an important challenge. The artificial pancreas has become the gold standard for the treatment of type 1 diabetes. First-generation systems are increasingly being adopted in clinical practice, however further work is required, developing advanced systems and faster acting insulin analogues to allow complete automation and further reduce the burden of type 1 diabetes.
Identifiants
pubmed: 32618719
doi: 10.1097/MOT.0000000000000786
pii: 00075200-202008000-00006
doi:
Substances chimiques
Hypoglycemic Agents
0
Insulin
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
336-342Références
Nathan DM, Genuth S, Lachin J, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329 (14):977–986.
Foster NC, Beck RW, Miller KM, et al. State of type 1 diabetes management and outcomes from the T1D Exchange in 2016–2018. Diab Techn Ther 2019; 21 (2):66–72.
Garg SK, Weinzimer SA, Tamborlane WV, et al. Glucose outcomes with the in-home use of a hybrid closed-loop insulin delivery system in adolescents and adults with Type 1 diabetes. Diab Techn Ther 2017; 19 (3):155–163.
Bekiari E, Kitsios K, Thabit H, et al. Artificial pancreas treatment for outpatients with type 1 diabetes: systematic review and meta-analysis. Br Med J 2018; 361.
Benhamou PY, Franc S, Reznik Y, et al. Closed-loop insulin delivery in adults with type 1 diabetes in real-life conditions: a 12-week multicentre, open-label randomised controlled crossover trial. Lancet Digital Health 2019; 1 (1):E17–E25.
Tauschmann M, Thabit H, Bally L, et al. Closed-loop insulin delivery in suboptimally controlled type 1 diabetes: a multicentre, 12-week randomised trial. Lancet 2018; 392 (10155):1321–1329.
Brown SA, Kovatchev BP, Raghinaru D, et al. Six-month randomized, multicenter trial of closed-loop control in type 1 diabetes. N Engl J Med 2019; 381 (18):1707–1717.
Dovc K, Boughton C, Tauschmann M, et al. Young children have higher variability of insulin requirements: observations during hybrid closed-loop insulin delivery. Diabetes Care 2019; 42 (7):1344–1347.
Tauschmann M, Allen JM, Nagl K, et al. Home use of day-and-night hybrid closed-loop insulin delivery in very young children: a multicenter, 3-week, randomized trial. Diabetes Care 2019; 42 (4):594–600.
Musolino G, Dovc K, Boughton CK, et al. Reduced burden of diabetes and improved quality of life: experiences from unrestricted day-and-night hybrid closed-loop use in very young children with type 1 diabetes. Pediatr Diabetes 2019; 20 (6):794–799.
Murphy HR, Rayman G, Duffield K, et al. Changes in the glycemic profiles of women with type 1 and type 2 diabetes during pregnancy. Diabetes Care 2007; 30 (11):2785–2791.
Stewart ZA, Wilinska ME, Hartnell S, et al. Closed-loop insulin delivery during pregnancy in women with type 1 diabetes. N Engl J Med 2016; 375 (7):644–654.
Haidar A, Messier V, Legault L, et al. Outpatient 60-hour day-and-night glucose control with dual-hormone artificial pancreas, single-hormone artificial pancreas, or sensor-augmented pump therapy in adults with type 1 diabetes: an open-label, randomised, crossover, controlled trial. Diabetes Obes Metab 2017; 19 (5):713–720.
El-Khatib FH, Balliro C, Hillard MA, et al. Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial. Lancet 2017; 389 (10067):369–380.
Haidar A, Tsoukas MA, Bernier-Twardy S, et al. A novel dual-hormone insulin-and-pramlintide artificial pancreas for type 1 diabetes: a randomized controlled crossover trial. Diabetes Care 2020; 43 (3):597–606.
Lal RA, Basina M, Maahs DM, et al. One year clinical experience of the first commercial hybrid closed-loop system. Diabetes Care 2019; 42 (12):2190–2196.
Messer LH, Berget C, Vigers T, et al. Real world hybrid closed-loop discontinuation: predictors and perceptions of youth discontinuing the 670G system in the first 6 months. Pediatric Diabetes 2020; 21 (2):319–327.
Lewis DM. Do-It-Yourself artificial pancreas system and the OpenAPS movement. Endocrinol Metab Clin North Am 2020; 49 (1):203–213.
McDonnell ME, Umpierrez GE. Insulin therapy for the management of hyperglycemia in hospitalized patients. Endocrinol Metab Clin North Am 2012; 41 (1):175–201.
Bally L, Thabit H, Hartnell S, et al. Closed-loop insulin delivery for glycemic control in noncritical care. N Engl J Med 2018; 379 (6):547–556.
Boughton CK, Bally L, Martignoni F, et al. Fully closed-loop insulin delivery in inpatients receiving nutritional support: a two-centre, open-label, randomised controlled trial. Lancet Diabetes Endocrinol 2019; 7 (5):368–377.