Toward Automation of Insulin Delivery - Management Solutions for Type 1 Diabetes

In the past decade, the field of type 1 diabetes was characterized by the efforts to integrate technology into the daily management of diabetes. Automated insulin delivery systems have emerged followed by the improvements in technology of pumps and sensors and automated close-loop systems that were developed around the world for overnight as well as for day and night use. Initially, these closed-loop systems were tested clinically in research centers, then at diabetes camps or hotels, and recently at patients' homes. The systems were tested in a wide range of populations of patients with type 1 diabetes: children, adolescents, adults, newly diagnosed, well and suboptimally controlled patients, the critically ill and pregnant women. The extensive clinical evaluation found these close-loop systems to be safe and efficient in controlling blood glucose levels. Now is the time to take these systems from research to industry and to get a regulatory approval of convenient devices for the use at home. Automated insulin delivery systems have the potential to change the way diabetes is treated and managed for the benefit of patients. This chapter summarizes the recent advances in this field.