Artificial pancreas: the bridge to a cure for type 1 diabetes

Abstract

Tight glycaemic control in type 1 diabetes mellitus has been shown to be important for the prevention of long-term microvascular complications. Consequently, intensive insulin treatment has been advocated in the attempt to achieve normal glycaemia. This has proven challenging mainly due to an increased risk of hypoglycaemia associated with the intensive insulin regimen. Closed-loop systems for glucose control, designed to mimic the endocrine action of the healthy pancreas without human intervention, may provide a solution.

The vital component of a closed-loop system, often referred to as an artificial pancreas, is a computer-based algorithm. Other components include a real-time continuous glucose monitor and an infusion pump to titrate and deliver insulin. The role of the control algorithm is to translate, in real-time, the information it receives from the glucose monitor and to compute the amount of insulin to be delivered by the pump.

This review article describes the individual components of the artificial pancreas, and aims to highlight existing clinical evidence from studies performed on available artificial pancreas prototypes. Current limitations and obstacles facing this technology are reviewed, together with its potential direction in the future. By achieving normal glycaemia and reducing the risk of hypoglycaemia, the artificial pancreas could potentially improve the lives of patients with type 1 diabetes and act as a ‘bridge’ until a cure for type 1 diabetes is found.

Keywords:

• type 1 diabetes mellitus
• artificial pancreas
• closed-loop insulin delivery