Automated blood glucose control in type 1 diabetes: A review of progress and challenges

Arthur Bertachi; Charrise M Ramkissoon; Jorge Bondia; Josep Vehí

doi:10.1016/j.endinu.2017.10.011

Automated blood glucose control in type 1 diabetes: A review of progress and challenges

Endocrinol Diabetes Nutr (Engl Ed). 2018 Mar;65(3):172-181. doi: 10.1016/j.endinu.2017.10.011. Epub 2017 Dec 24.

[Article in English, Spanish]

Authors

Arthur Bertachi¹, Charrise M Ramkissoon², Jorge Bondia³, Josep Vehí⁴

Affiliations

¹ Institute of Informatics and Applications, University of Girona, Campus de Montilivi, s/n, Edifici P4, 17071 Girona, Spain; Federal University of Technology - Paraná (UTFPR), Guarapuava, Avenida Professora Laura Pacheco Bastos 800, 85053-525 Guarapuava, Paraná, Brazil.
² Institute of Informatics and Applications, University of Girona, Campus de Montilivi, s/n, Edifici P4, 17071 Girona, Spain.
³ Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Camino de Vera, s/n, Edificio 8G, 46022 Valencia, Spain.
⁴ Institute of Informatics and Applications, University of Girona, Campus de Montilivi, s/n, Edifici P4, 17071 Girona, Spain. Electronic address: [email protected].

PMID: 29279252
DOI: 10.1016/j.endinu.2017.10.011

Abstract

Since the 2000s, research teams worldwide have been working to develop closed-loop (CL) systems able to automatically control blood glucose (BG) levels in patients with type 1 diabetes. This emerging technology is known as artificial pancreas (AP), and its first commercial version just arrived in the market. The main objective of this paper is to present an extensive review of the clinical trials conducted since 2011, which tested various implementations of the AP for different durations under varying conditions. A comprehensive table that contains key information from the selected publications is provided, and the main challenges in AP development and the mitigation strategies used are discussed. The development timelines for different AP systems are also included, highlighting the main evolutions over the clinical trials for each system.

Keywords: Artificial pancreas; Automated insulin delivery; Closed-loop glucose control; Control de glucosa en lazo cerrado; Diabetes mellitus tipo 1; Infusión automática de insulina; Páncreas artificial; Type 1 diabetes mellitus.

Publication types

Review

MeSH terms

Automation
Blood Glucose / analysis*
Blood Glucose Self-Monitoring / instrumentation
Blood Glucose Self-Monitoring / methods
Blood Glucose Self-Monitoring / statistics & numerical data*
Clinical Trials as Topic
Diabetes Mellitus, Type 1 / blood*
Diabetes Mellitus, Type 1 / drug therapy
Equipment Design
Exercise
Forecasting
Humans
Hyperglycemia / blood
Hyperglycemia / drug therapy
Hypoglycemia / blood
Hypoglycemia / chemically induced
Hypoglycemia / prevention & control
Hypoglycemic Agents / administration & dosage
Hypoglycemic Agents / therapeutic use
Infusion Pumps, Implantable
Insulin / administration & dosage
Insulin / therapeutic use
Insulin Infusion Systems
Pancreas, Artificial*

Substances

Blood Glucose
Hypoglycemic Agents
Insulin