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Diabetologia
Published in: Diabetologia 9/2016

Open Access 01-09-2016 | Review

Coming of age: the artificial pancreas for type 1 diabetes

Authors: Hood Thabit, Roman Hovorka

Published in: Diabetologia | Issue 9/2016

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Abstract

The artificial pancreas (closed-loop system) addresses the unmet clinical need for improved glucose control whilst reducing the burden of diabetes self-care in type 1 diabetes. Glucose-responsive insulin delivery above and below a preset insulin amount informed by sensor glucose readings differentiates closed-loop systems from conventional, threshold-suspend and predictive-suspend insulin pump therapy. Insulin requirements in type 1 diabetes can vary between one-third–threefold on a daily basis. Closed-loop systems accommodate these variations and mitigate the risk of hypoglycaemia associated with tight glucose control. In this review we focus on the progress being made in the development and evaluation of closed-loop systems in outpatient settings. Randomised transitional studies have shown feasibility and efficacy of closed-loop systems under supervision or remote monitoring. Closed-loop application during free-living, unsupervised conditions by children, adolescents and adults compared with sensor-augmented pumps have shown improved glucose outcomes, reduced hypoglycaemia and positive user acceptance. Innovative approaches to enhance closed-loop performance are discussed and we also present the outlook and strategies used to ease clinical adoption of closed-loop systems.
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Metadata
Title
Coming of age: the artificial pancreas for type 1 diabetes
Authors
Hood Thabit
Roman Hovorka
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 9/2016
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-016-4022-4

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