Recent advances in closed-loop insulin delivery
Since the discovery of insulin 100 years ago, we have seen considerable advances across diabetes therapies. The more recent advent of glucose-responsive automated insulin delivery has started to revolutionise the management of type 1 diabetes in children and adults. Evolution of closed-loop insulin...
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| Veröffentlicht in: | Metabolism, clinical and experimental clinical and experimental, 2022-02, Vol.127, p.154953-154953, Article 154953 |
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| container_title | Metabolism, clinical and experimental |
| container_volume | 127 |
| creator | Ware, Julia Hovorka, Roman |
| description | Since the discovery of insulin 100 years ago, we have seen considerable advances across diabetes therapies. The more recent advent of glucose-responsive automated insulin delivery has started to revolutionise the management of type 1 diabetes in children and adults. Evolution of closed-loop insulin delivery from research to clinical practice has been rapid, and multiple systems are now commercially available. In this review, we summarise key evidence on currently available closed-loop systems and those in development. We comment on dual-hormone and do-it-yourself systems, as well as reviewing clinical evidence in special populations such as very young children, older adults and in pregnancy. We identify future directions for research and barriers to closed-loop adoption, including how these might be addressed to ensure equitable access to this novel therapy.
•Type 1 diabetes is a lifelong condition with high management burden.•Glucose-responsive automated insulin delivery improves glycaemic outcomes and quality of life.•Multiple closed-loop systems are commercially available, offering increased choice for users.•Working towards a fully closed-loop system and addressing barriers to adoption should be the focus of future research. |
| doi_str_mv | 10.1016/j.metabol.2021.154953 |
| format | Article |
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•Type 1 diabetes is a lifelong condition with high management burden.•Glucose-responsive automated insulin delivery improves glycaemic outcomes and quality of life.•Multiple closed-loop systems are commercially available, offering increased choice for users.•Working towards a fully closed-loop system and addressing barriers to adoption should be the focus of future research.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age of Onset</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Artificial pancreas</subject><subject>Blood Glucose - analysis</subject><subject>Blood Glucose - drug effects</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Closed loop insulin delivery</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes Mellitus, Type 1 - epidemiology</subject><subject>Diabetes technology</subject><subject>Female</subject><subject>Humans</subject><subject>Insulin - administration & dosage</subject><subject>Insulin Infusion Systems - trends</subject><subject>Middle Aged</subject><subject>Pancreas, Artificial - trends</subject><subject>Pregnancy</subject><subject>Type 1 diabetes</subject><subject>Young Adult</subject><issn>0026-0495</issn><issn>1532-8600</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE9rwzAMxc3YWLtuH2Gjx12Syo7juqcxyv5BYTB6N46tQIoTd3ZS6LefS7pddxJ6etJDP0LuKeQUqFjs8hZ7XXmXM2A0pyVflcUFmdKyYJkUAJdkCsBEBmkwITcx7gBguZTimkwKLlcguJySxRca7Pq5tgfdGYzzppsb5yPazHm_T20cXNIsuuaA4XhLrmrtIt6d64xsX1-26_ds8_n2sX7eZIZT1mdLWxtjCs5LSTE1haFYFTUzeBJXMqkls6xALSsGnAnNOFsBWC4lpEdm5HE8uw_-e8DYq7aJBp3THfohKiYoFYIxypK1HK0m-BgD1mofmlaHo6KgTqjUTp1RqRMqNaJKew_niKFq0f5t_bJJhqfRgOnPQ4NBRdNggmSbgKZX1jf_RPwA2417WQ</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Ware, Julia</creator><creator>Hovorka, Roman</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202202</creationdate><title>Recent advances in closed-loop insulin delivery</title><author>Ware, Julia ; Hovorka, Roman</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-7dfccc344581e7df3c1eb3f2cec3449881e52d23ea8b20426a242900d4880953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age of Onset</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Artificial pancreas</topic><topic>Blood Glucose - analysis</topic><topic>Blood Glucose - drug effects</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Closed loop insulin delivery</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetes Mellitus, Type 1 - epidemiology</topic><topic>Diabetes technology</topic><topic>Female</topic><topic>Humans</topic><topic>Insulin - administration & dosage</topic><topic>Insulin Infusion Systems - trends</topic><topic>Middle Aged</topic><topic>Pancreas, Artificial - trends</topic><topic>Pregnancy</topic><topic>Type 1 diabetes</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ware, Julia</creatorcontrib><creatorcontrib>Hovorka, Roman</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Metabolism, clinical and experimental</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ware, Julia</au><au>Hovorka, Roman</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recent advances in closed-loop insulin delivery</atitle><jtitle>Metabolism, clinical and experimental</jtitle><addtitle>Metabolism</addtitle><date>2022-02</date><risdate>2022</risdate><volume>127</volume><spage>154953</spage><epage>154953</epage><pages>154953-154953</pages><artnum>154953</artnum><issn>0026-0495</issn><eissn>1532-8600</eissn><abstract>Since the discovery of insulin 100 years ago, we have seen considerable advances across diabetes therapies. The more recent advent of glucose-responsive automated insulin delivery has started to revolutionise the management of type 1 diabetes in children and adults. Evolution of closed-loop insulin delivery from research to clinical practice has been rapid, and multiple systems are now commercially available. In this review, we summarise key evidence on currently available closed-loop systems and those in development. We comment on dual-hormone and do-it-yourself systems, as well as reviewing clinical evidence in special populations such as very young children, older adults and in pregnancy. We identify future directions for research and barriers to closed-loop adoption, including how these might be addressed to ensure equitable access to this novel therapy.
•Type 1 diabetes is a lifelong condition with high management burden.•Glucose-responsive automated insulin delivery improves glycaemic outcomes and quality of life.•Multiple closed-loop systems are commercially available, offering increased choice for users.•Working towards a fully closed-loop system and addressing barriers to adoption should be the focus of future research.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34890648</pmid><doi>10.1016/j.metabol.2021.154953</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0026-0495 1532-8600 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Age of Onset Aged Aged, 80 and over Artificial pancreas Blood Glucose - analysis Blood Glucose - drug effects Child Child, Preschool Closed loop insulin delivery Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - drug therapy Diabetes Mellitus, Type 1 - epidemiology Diabetes technology Female Humans Insulin - administration & dosage Insulin Infusion Systems - trends Middle Aged Pancreas, Artificial - trends Pregnancy Type 1 diabetes Young Adult |
| title | Recent advances in closed-loop insulin delivery |
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