Artificial pancreas: the past and the future.

Area of Science:

• Endocrinology
• Biomedical Engineering
• Diabetes Technology

Background:

• Continuous insulin infusion and continuous glucose monitoring are key to managing diabetes.
• Advances have led to sensor-augmented pump therapy and hybrid closed-loop systems.
• Fully automated insulin delivery systems are now emerging for enhanced glucose regulation.

Purpose of the Study:

• To review the evolution and applications of artificial pancreas systems.
• To discuss the transition from manual to automated insulin delivery.
• To explore the potential of integrating wearable and bedside artificial pancreas technologies.

Main Methods:

• Review of advancements in insulin pump and continuous glucose monitoring technologies.
• Analysis of the development of sensor-augmented, hybrid closed-loop, and fully automated systems.
• Comparison of wearable and bedside artificial pancreas system functionalities.

Main Results:

• Artificial pancreas systems effectively prevent blood glucose fluctuations and hypoglycemia.
• Hybrid closed-loop systems automate basal insulin delivery, improving upon manual adjustments.
• Fully automated systems offer more dynamic insulin adjustments for meals and exercise.
• Both wearable and bedside systems show promise for specific patient populations.

Conclusions:

• Artificial pancreas technology is expanding beyond type 1 diabetes to all insulin-dependent patients.
• Wearable systems are suitable for ambulatory management, while bedside systems cater to perioperative and critically ill patients.
• Future research should focus on integrating the strengths of both wearable and bedside artificial pancreas systems for comprehensive glucose management.