Closed loop insulin delivery–Opportunities and limitations

In females, insulin sensitivity and action may be affected by the phase of the menstrual cycle, which can be identified using physiological measures such as body temperature or patient-controlled apps. Subcutaneous insulin absorption is a major limitation to HCLs as the time lag between insulin delivery and insulin action is significantly longer in comparison to the rate of carbohydrate absorption from the gastrointestinal tract into the bloodstream. [...]the markedly longer half-life of subcutaneously administered insulin leaves a long active amount of insulin in the circulation following its delivery. In addition to the biochemical properties of the insulin itself, the transdermal catheters of insulin pumps suffer from their own limitations. [...]repeated insertion of catheters in the same vicinity, as commonly observed in many patients using insulin pumps, results in local lipohypertrophy that hampers insulin absorption even more. [...]the use of HCLs should be considered standard of care for patients with T1DM regardless of their age.