Closed-loop control in insulin pumps for type-1 diabetes mellitus: safety and efficacy. (2nd July 2020)

• Record Type: Journal Article
• Authors: Fuchs, Julia; Hovorka, Roman
• Is Part Of: Expert review of medical devices. Volume 17:Number 7(2020)
• Page Start: 707
• Page End: 720
• Publication Date: 2020-07-02
• Subjects: Artificial pancreas -- automated insulin delivery -- closed-loop -- continuous glucose monitoring -- insulin pump -- type 1 diabetes; Medical instruments and apparatus -- Periodicals; 610.28
• DOI: 10.1080/17434440.2020.1784724
• Languages: English
• ISSNs: 1743-4440

Abstract

ABSTRACT: Introduction: Type 1 diabetes is a lifelong disease with high management burden. The majority of people with type 1 diabetes fail to achieve glycemic targets. Algorithm-driven automated insulin delivery (closed-loop) systems aim to address these challenges. This review provides an overview of commercial and emerging closed-loop systems. Areas covered: We review safety and efficacy of commercial and emerging hybrid closed-loop systems. A literature search was conducted and clinical trials using day-and-night closed-loop systems during free-living conditions were used to report on safety data. We comment on efficacy where robust randomized controlled trial data for a particular system are available. We highlight similarities and differences between commercial systems. Expert opinion: Study data shows that hybrid closed-loop systems are safe and effective, consistently improving glycemic control when compared to standard therapy. While a fully closed-loop system with minimal burden remains the end-goal, these hybrid closed-loop systems have transformative potential in diabetes care.