Closed-loop insulin delivery - what lies between where we are and where we are going?

Expert Opin Drug Deliv. 2005 Mar;2(2):353-62. doi: 10.1517/17425247.2.2.353.

Abstract

Closed-loop insulin delivery in individuals with diabetes can potentially lead to near-normal glucose profiles. To this end, existing subcutaneous glucose sensors and external insulin pumps can be linked with an insulin delivery algorithm to create a completely automated closed-loop system. This paper reviews current research into the development of such a system, with particular emphasis on creating a system emulating the physiological properties of the beta-cell. Issues related to using subcutaneous interstitial fluid for glucose sensing and insulin delivery are reviewed. Criteria for optimising the system are discussed using historical data. Existing strategies for open-loop pump therapy are presented with the objective of defining a path to advance from the existing physician/patient determined insulin therapy to a completely automated system.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Algorithms
  • Animals
  • Biosensing Techniques
  • Blood Glucose
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / physiopathology
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / blood
  • Hypoglycemic Agents / therapeutic use
  • Injections, Subcutaneous
  • Insulin / administration & dosage*
  • Insulin / blood
  • Insulin / therapeutic use
  • Insulin Infusion Systems / standards
  • Insulin Infusion Systems / trends*
  • Insulin-Secreting Cells / physiology

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin