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Progress of artificial pancreas devices towards clinical use

the first outpatient studies

Russell, Steven J.

Current Opinion in Endocrinology, Diabetes and Obesity: April 2015 - Volume 22 - Issue 2 - p 106–111
doi: 10.1097/MED.0000000000000142
DIABETES AND THE ENDOCRINE PANCREAS I: Edited by David M. Harlan
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Purpose of review This article describes recent progress in the automated control of glycemia in type 1 diabetes with artificial pancreas devices that combine continuous glucose monitoring with automated decision-making and insulin delivery.

Recent findings After a gestation period of closely supervised feasibility studies in research centers, the last 2 years have seen publication of studies testing these devices in outpatient environments, and many more such studies are ongoing. The most basic form of automation, suspension of insulin delivery for actual or predicted hypoglycemia, has been shown to be effective and well tolerated, and a first-generation device has actually reached the market. Artificial pancreas devices that actively dose insulin fall into two categories, those that dose insulin alone and those that also use glucagon to prevent and treat hypoglycemia (bihormonal artificial pancreas). Initial outpatient clinical trials have shown that both strategies can improve glycemic management in comparison with patient-controlled insulin pump therapy, but only the bihormonal strategy has been tested without restrictions on exercise.

Summary Artificial pancreas technology has the potential to reduce acute and chronic complications of diabetes and mitigate the burden of diabetes self-management. Successful outpatient studies bring these technologies one step closer to availability for patients.

Massachusetts General Hospital Diabetes Research Center, Boston, Massachusetts, USA

Correspondence to Steven J. Russell, Massachusetts General Hospital Diabetes Research Center, 50 Staniford Street, Suite 301, Boston, MA 02114, USA. Tel: +1 617 726 1848; e-mail: sjrussell@mgh.harvard.edu

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.