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Clinical experience with an implanted closed-loop insulin delivery system.

Eric Renard1

  • 1Endocrinology Department, Lapeyronie Hospital, Montpellier, France. e-renard@chu-montpellier

Arquivos Brasileiros De Endocrinologia E Metabologia
|April 29, 2008
PubMed
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This study explored an implanted artificial beta-cell for glucose control in type 1 diabetes patients. While feasible, sensor longevity and meal-time glucose control require further improvement.

Area of Science:

  • Biomedical Engineering
  • Endocrinology
  • Diabetes Technology

Background:

  • Type 1 diabetes management requires continuous glucose monitoring and insulin delivery.
  • Artificial beta-cell systems aim to automate glucose regulation.
  • Previous systems faced challenges with sensor longevity and control accuracy.

Purpose of the Study:

  • To evaluate the initial clinical performance of a prototype fully implanted artificial beta-cell.
  • To assess the feasibility of closed-loop glucose control using implanted devices.

Main Methods:

  • A Long-Term Sensor System project involved 10 type 1 diabetes patients (2000-2007).
  • Combined peritoneal insulin pump and central intravenous glucose sensor implantation.
  • Proportional-Integral-Derivative (PID) algorithms for functional connection and control.

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Main Results:

  • No serious complications from implants were observed.
  • Insulin delivery experienced reversible pump slowdowns due to precipitation.
  • Intravenous sensors showed good correlation with meter values (r=0.83-0.93) for ~9 months.
  • Closed-loop insulin delivery trials were successfully conducted in-patients.

Conclusions:

  • The fully implantable artificial beta-cell concept is feasible.
  • Improvements needed for sensor longevity and reduced delay, especially for meal-time control.