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Real-Time Proxy-Control of Re-Parameterized Peripheral Signals using a Close-Loop Interface
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[The Way to Closed Loop - Dream and Reality].

Torben Biester, Thomas Danne, Olga Kordonouri

    Deutsche Medizinische Wochenschrift (1946)
    |May 18, 2017
    PubMed
    Summary

    Fully automated insulin therapy is a goal for type 1 diabetes management. Hybrid closed-loop systems, approved in the US, improve metabolic status but require patient education for safe use.

    Area of Science:

    • Endocrinology
    • Biomedical Engineering
    • Diabetes Technology

    Background:

    • Type 1 diabetes management aims for fully automated insulin therapy, a long-standing patient and medical goal.
    • Current sensor-augmented insulin pumps can reduce insulin doses but do not offer full automation.
    • Development focuses on algorithms to integrate pump and sensor for automated insulin dose regulation.

    Purpose of the Study:

    • To evaluate the potential and current status of automated insulin therapy systems for type 1 diabetes.
    • To assess the efficacy and safety of hybrid closed-loop systems in outpatient settings.

    Main Methods:

    • Review of current advancements in insulin pump and continuous glucose monitoring (CGM) integration.
    • Analysis of approved hybrid closed-loop systems and their operational principles.

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  • Assessment of clinical outcomes and safety profiles associated with these systems.

    • Main Results:

    • Hybrid closed-loop systems have been approved in the US, representing a step towards automated insulin therapy.
    • These systems demonstrate an improvement in the metabolic status of patients with type 1 diabetes.
    • Identified risks are comparable to those associated with existing sensor-augmented insulin pump therapy.

    Conclusions:

    • Fully closed-loop systems are not yet available for widespread outpatient use.
    • Hybrid closed-loop systems offer improved glycemic control for type 1 diabetes.
    • Comprehensive patient education remains critical for the successful and safe implementation of these advanced therapies.