Year: 2017
Type: editorial
Abstract: BACKGROUND: Rapid progress over the past decade has been made with the development of the 'Artificial Pancreas', also known as the closed-loop system, which emulates the feedback glucose-responsive functionality of the pancreatic beta cell. The recent FDA approval of the first hybrid closed-loop system makes the Artificial Pancreas a realistic therapeutic option for people with type 1 diabetes. In anticipation of its advent into clinical care, we provide a primer and appraisal of this novel therapeutic approach in type 1 diabetes for healthcare professionals and non-specialists in the field. DISCUSSION: Randomised clinical studies in outpatient and home settings have shown improved glycaemic outcomes, reduced risk of hypoglycaemia and positive user attitudes. User input and interaction with existing closed-loop systems, however, are still required. Therefore, management of user expectations, as well as training and support by healthcare providers are key to ensure optimal uptake, satisfaction and acceptance of the technology. An overview of closed-loop technology and its clinical implications are discussed, complemented by our extensive hands-on experience with closed-loop system use during free daily living. CONCLUSIONS: The introduction of the artificial pancreas into clinical practice represents a milestone towards the goal of improving the care of people with type 1 diabetes. There remains a need to understand the impact of user interaction with the technology, and its implication on current diabetes management and care.
Source: BMC Medicine
Authors: Lia Bally, Hood Thabit, Roman Hovorka
Institutions: University of Bern, University of Cambridge, University Hospital of Bern, Cambridge University Hospitals NHS Foundation Trust, Wellcome/MRC Institute of Metabolic Science, Addenbrooke's Hospital, NIHR Cambridge Biomedical Research Centre, National Institute for Health and Care Research, Wellcome Trust
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,190
Funders: National Science Foundation, Eli Lilly and Company, Juvenile Diabetes Research Foundation United States of America, Wellcome Trust, National Institute for Health and Care Research, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Novo Nordisk, Horizon 2020 Framework Programme, NIHR Cambridge Biomedical Research Centre, National Institute of Diabetes and Digestive and Kidney Diseases, H2020 Societal Challenges, NIHR Evaluation Trials and Studies Coordinating Centre
Awards: G2018687014, G2166940007, Firing modes and synaptic transmission in the forebrain., G3320221261, Institute of Metabolic Science., G4577803176, Institute of Metabolic Science., 24/7 closed-loop in older subjects with type 1 diabetes, G4903748289, One year day-and-night home closed loop in young people with type 1 diabetes, G5246447471, Closing the loop - towards the artificial pancreas in adults with type 1 diabetes, G6049260834, G6351477851, Effect of closed loop insulin delivery from onset of diabetes in youth on progression of type 1 diabetes, G8589133502
OpenAlex ID: W2582902716