Is an artificial pancreas (closed‐loop system) for Type 1 diabetes effective?
Year: 2018
Type: review
Abstract: The artificial pancreas is now a viable treatment option for people with Type 1 diabetes and has demonstrated improved glycaemic outcomes while also reducing the onus of self‐management of Type 1 diabetes. Closed‐loop glucose‐responsive insulin delivery guided by real‐time sensor glucose readings can accommodate highly variable day‐to‐day insulin requirements and reduce the hypoglycaemia risk observed with tight glycaemic control in Type 1 diabetes. In 2011, the James Lind Alliance research priorities for Type 1 diabetes were produced and priority 3 was to establish whether an artificial pancreas (closed‐loop system) for Type 1 diabetes is effective. This review focuses on the progress that has been made in the evolution of closed‐loop systems as an effective treatment option for Type 1 diabetes. Development of closed‐loop systems has advanced from feasibility evaluations in highly supervised settings over short periods, to clinical studies in free‐living, unsupervised conditions lasting several months. The approval in the USA of the first hybrid closed‐loop system (MiniMed® 670G pump, Medtronic, Northridge, CA, USA) in 2016 for use in Type 1 diabetes reflects these advancements. We discuss the evidence from clinical studies that closed‐loop systems are effective with improved glycaemic outcomes, reduced hypoglycaemia and had positive end‐user acceptance in children, adolescents, adults and pregnant women with Type 1 diabetes. We also present the outlook for future closed‐loop systems in the treatment of Type 1 diabetes and identify the challenges facing the wide‐spread clinical adoption of this technology.
Source: Diabetic Medicine
DOI: 10.1111/dme.13816
Authors: C. K. Boughton, R. Hovorka
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Juvenile Diabetes Research Foundation International, Leona M. and Harry B. Helmsley Charitable Trust, Wellcome Trust, National Institute for Health and Care Research, Diabetes UK, Cambridge University Hospitals, National Institute of Diabetes and Digestive and Kidney Diseases, NIHR Evaluation Trials and Studies Coordinating Centre
Awards: Institute of Metabolic Science., 24/7 closed-loop in older subjects with type 1 diabetes, One year day-and-night home closed loop in young people with type 1 diabetes, Effect of closed loop insulin delivery from onset of diabetes in youth on progression of type 1 diabetes, G8585681489, G8589133502
OpenAlex ID: W2891785890