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Closed-loop insulin delivery systems in children and adolescents with type 1 diabetes

Klemen Dovc1,2, Tadej Battelino1,2

  • 1Department of Paediatric Endocrinology, Diabetes and Metabolic Diseases, UMC - University Children's Hospital, Ljubljana, Slovenia.

Expert Opinion on Drug Delivery
|February 21, 2020
PubMed

Insights

Closed-loop systems improve glycemic control in children with type 1 diabetes. Recent advances show significant time in target range and reduced hypoglycemia in real-world settings.

Area of Science:

  • Endocrinology
  • Biomedical Engineering

Background:

  • Type 1 diabetes management in children requires optimal glycemic control, which is difficult due to insulin variability.
  • Glucose-responsive insulin delivery systems offer a potential solution.

Purpose of the Study:

  • To review recent advances in closed-loop systems for pediatric type 1 diabetes.
  • To assess outcomes like time in target glucose range and hypoglycemia.

Main Methods:

  • Review of single- and dual-hormone closed-loop systems.
  • Analysis of unsupervised, free-living randomized controlled trials.
  • Focus on time in target range (70-180 mg/dl) and hypoglycemia (<70 mg/dl).

Main Results:

  • Significant progress has been made in translating experimental findings to home settings.
  • The first hybrid closed-loop system has been approved for pediatric use.
  • Several advanced devices are in development.

Conclusions:

  • Closed-loop systems demonstrate clinically meaningful improvements in glycemic control for children with type 1 diabetes.
  • Ongoing trials aim to facilitate wider clinical adoption of these advanced systems.

Keywords:
Artificial pancreaschildrenclosed-loopcontinuous glucose monitoringtechnologytype 1 diabetes

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