J Korean Diabetes.  2017 Sep;18(3):141-149. 10.4093/jkd.2017.18.3.141.

Artificial Pancreas: A Concise Review

Affiliations
  • 1Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea. jtwoomd@khmc.or.kr

Abstract

Artificial pancreas is a technique developed to automatically control blood glucose in people with diabetes by providing an endocrine function instead of a healthy pancreas. The technique was developed for the replacement of insulin secretion deficiencies among various exocrine and endocrine functions of the pancreas and is mainly used for people with type 1 diabetes or those who need intensive insulin treatment. This review briefly summarizes the working principles, components, recent clinical research, and future perspectives of artificial pancreas.

Keyword

Artificial; Diabetes mellitus; Extracellular fluid; Glucose; Insulin; Pancreas

MeSH Terms

Blood Glucose
Diabetes Mellitus
Extracellular Fluid
Glucose
Insulin
Pancreas
Pancreas, Artificial*
Blood Glucose
Glucose
Insulin

Figure

  • Fig. 1. General concept of the artificial pancreas technique.

  • Fig. 2. The main components of the closed loop artificial pancreas system, and the three key technical limitations that need to be overcome.


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Reference

References

1. Shapiro AM, Lakey JR, Ryan EA, Korbutt GS, Toth E, Warnock GL, Kneteman NM, Rajotte RV. Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med. 2000; 343:230–8.
Article
2. Sutherland DE, Gruessner RW, Gruessner AC. Pancreas transplantation for treatment of diabetes mellitus. World J Surg. 2001; 25:487–96.
Article
3. Humar A, Kandaswamy R, Granger D, Gruessner RW, Gruessner AC, Sutherland DE. Decreased surgical risks of pancreas transplantation in the modern era. Ann Surg. 2000; 231:269–75.
Article
4. Shapiro AM. Islet transplantation in type 1 diabetes: ongoing challenges, refined procedures, and longterm outcome. Rev Diabet Stud. 2012; 9:385–406.
Article
5. Huh KB. Artificial pancreas. Korean J Int Med. 1978; 21:1071–6.
6. Cobelli C, Renard E, Kovatchev B. Artificial pancreas: past, present, future. Diabetes. 2011; 60:2672–82.
Article
7. Kobayashi N. Bioartificial pancreas for the treatment of diabetes. Cell Transplant. 2008; 17:11–7.
Article
8. Ricordi C, Edlund H. Toward a renewable source of pancreatic beta-cells. Nat Biotechnol. 2008; 26:397–8.
9. Farmer TG Jr, Edgar TF, Peppas NA. The future of open- and closed-loop insulin delivery systems. J Pharm Pharmacol. 2008; 60:1–13.
Article
10. Bode BW. Clinical utility of the continuous glucose monitoring system. Diabetes Technol Ther. 2000; 2(Suppl 1):S35–41.
Article
11. Hovorka R. Continuous glucose monitoring and closed-loop systems. Diabet Med. 2006; 23:1–12.
Article
12. Haidar A, Legault L, Messier V, Mitre TM, Leroux C, Rabasa-Lhoret R. Comparison of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy for glycaemic control in patients with type 1 diabetes: an open-label randomised controlled crossover trial. Lancet Diabetes Endocrinol. 2015; 3:17–26.
Article
13. Russell SJ, El-Khatib FH, Sinha M, Magyar KL, McKeon K, Goergen LG, Balliro C, Hillard MA, Nathan DM, Damiano ER. Outpatient glycemic control with a bionic pancreas in type 1 diabetes. N Engl J Med. 2014; 371:313–25.
Article
14. Cobelli C, Man CD, Sparacino G, Magni L, De Nicolao G, Kovatchev BP. Diabetes: models, signals, and control. IEEE Rev Biomed Eng. 2009; 2:54–96.
Article
15. Steil GM, Rebrin K, Darwin C, Hariri F, Saad MF. Feasibility of automating insulin delivery for the treatment of type 1 diabetes. Diabetes. 2006; 55:3344–50.
Article
16. Hovorka R. The future of continuous glucose monitoring: closed loop. Curr Diabetes Rev. 2008; 4:269–79.
Article
17. Rhee SY, Chon S, Koh G, Paeng JR, Oh S, Woo JT, Kim SW, Kim JW, Kim YS. Clinical experience of an iontophoresis based glucose measuring system. J Korean Med Sci. 2007; 22:70–3.
Article
18. Bailey T, Bode BW, Christiansen MP, Klaff LJ, Alva S. The performance and usability of a factory-calibrated flash glucose monitoring system. Diabetes Technol Ther. 2015; 17:787–94.
Article
19. Ólafsdóttir AF, Attvall S, Sandgren U, Dahlqvist S, Pivodic A, Skrtic S, Theodorsson E, Lind M. A clinical trial of the accuracy and treatment experience of the flash glucose monitor freestyle libre in adults with type 1 diabetes. Diabetes Technol Ther. 2017; 19:164–72.
Article
20. Clemens AH, Chang PH, Myers RW. The development of biostator, a glucose controlled insulin infusion system (GCIIS). Horm Metab Res. 1977; (Suppl 7):23–33.
21. LeBlanc H, Chauvet D, Lombrail P, Robert JJ. Glycemic control with closed-loop intraperitoneal insulin in type I diabetes. Diabetes Care. 1986; 9:124–8.
Article
22. Pickup JC, Keen H, Parsons JA, Alberti KG. Continuous subcutaneous insulin infusion: an approach to achieving normoglycaemia. Br Med J. 1978; 1:204–7.
Article
23. Bally L, Thabit H, Kojzar H, Mader JK, Qerimi-Hyseni J, Hartnell S, Tauschmann M, Allen JM, Wilinska ME, Pieber TR, Evans ML, Hovorka R. Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study. Lancet Diabetes Endocrinol. 2017; 5:261–70.
Article
24. Stewart ZA, Wilinska ME, Hartnell S, Temple RC, Rayman G, Stanley KP, Simmons D, Law GR, Scott EM, Hovorka R, Murphy HR. Closed-Loop insulin delivery during pregnancy in women with type 1 diabetes. N Engl J Med. 2016; 375:644–54.
Article
25. Tauschmann M, Allen JM, Wilinska ME, Thabit H, Stewart Z, Cheng P, Kollman C, Acerini CL, Dunger DB, Hovorka R. Day-and-night hybrid closed-loop insulin delivery in adolescents with type 1 diabetes: a free-living, randomized clinical trial. Diabetes Care. 2016; 39:1168–74.
Article
26. Reddy M, Herrero P, Sharkawy ME, Pesl P, Jugnee N, Pavitt D, Godsland IF, Alberti G, Toumazou C, Johnston DG, Georgiou P, Oliver NS. Metabolic control with the Bio-inspired artificial pancreas in adults with type 1 diabetes: a 24-hour randomized controlled crossover study. J Diabetes Sci Technol. 2015; 10:405–13.
27. Cherñavvsky DR, DeBoer MD, Keith-Hynes P, Mize B, McElwee M, Demartini S, Dunsmore SF, Wakeman C, Kovatchev BP, Breton MD. Use of an artificial pancreas among adolescents for a missed snack bolus and an underestimated meal bolus. Pediatr Diabetes. 2016; 17:28–35.
Article
28. Thabit H, Tauschmann M, Allen JM, Leelarathna L, Hartnell S, Wilinska ME, Acerini CL, Dellweg S, Benesch C, Heinemann L, Mader JK, Holzer M, Kojzar H, Exall J, Yong J, Pichierri J, Barnard KD, Kollman C, Cheng P, Hindmarsh PC, Campbell FM, Arnolds S, Pieber TR, Evans ML, Dunger DB, Hovorka R. APCam Consortium; AP@home Consortium. Home use of an artificial beta cell in type 1 diabetes. N Engl J Med. 2015; 373:2129–40.
Article
29. Kropff J, Del Favero S, Place J, Toffanin C, Visentin R, Monaro M, Messori M, Di Palma F, Lanzola G, Farret A, Boscari F, Galasso S, Magni P, Avogaro A, Keith-Hynes P, Kovatchev BP, Bruttomesso D, Cobelli C, DeVries JH, Renard E, Magni L. AP@home consortium. 2 month evening and night closed-loop glucose control in patients with type 1 diabetes under free-living conditions: a randomised crossover trial. Lancet Diabetes Endocrinol. 2015; 3:939–47.
Article
30. Dassau E, Brown SA, Basu A, Pinsker JE, Kudva YC, Gondhalekar R, Patek S, Lv D, Schiavon M, Lee JB, Dalla Man C, Hinshaw L, Castorino K, Mallad A, Dadlani V, McCrady-Spitzer SK, McElwee-Malloy M, Wakeman CA, Bevier WC, Bradley PK, Kovatchev B, Cobelli C, Zisser HC, Doyle FJ 3rd. Adjustment of open-loop settings to improve closed-loop results in type 1 diabetes: a multicenter randomized trial. J Clin Endocrinol Metab. 2015; 100:3878–86.
Article
31. Ly TT, Roy A, Grosman B, Shin J, Campbell A, Monirabbasi S, Liang B, von Eyben R, Shanmugham S, Clinton P, Buckingham BA. Day and night closed-loop control using the integrated medtronic hybrid closed-loop system in type 1 diabetes at diabetes camp. Diabetes Care. 2015; 38:1205–11.
Article
32. Brown SA, Kovatchev BP, Breton MD, Anderson SM, Keith-Hynes P, Patek SD, Jiang B, Ben Brahim N, Vereshchetin P, Bruttomesso D, Avogaro A, Del Favero S, Boscari F, Galasso S, Visentin R, Monaro M, Cobelli C. Multinight "bedside" closed-loop control for patients with type 1 diabetes. Diabetes Technol Ther. 2015; 17:203–9.
Article
33. Thabit H, Elleri D, Leelarathna L, Allen JM, Lubina-Solomon A, Stadler M, Walkinshaw E, Iqbal A, Choudhary P, Wilinska ME, Barnard KD, Heller SR, Amiel SA, Evans ML, Dunger DB, Hovorka R. Unsupervised home use of an overnight closed-loop system over 3–4 weeks: a pooled analysis of randomized controlled studies in adults and adolescents with type 1 diabetes. Diabetes Obes Metab. 2015; 17:452–8.
Article
34. Nimri R, Muller I, Atlas E, Miller S, Fogel A, Bratina N, Kordonouri O, Battelino T, Danne T, Phillip M. MD-Logic overnight control for 6 weeks of home use in patients with type 1 diabetes: randomized crossover trial. Diabetes Care. 2014; 37:3025–32.
Article
35. Leelarathna L, Dellweg S, Mader JK, Allen JM, Benesch C, Doll W, Ellmerer M, Hartnell S, Heinemann L, Kojzar H, Michalewski L, Nodale M, Thabit H, Wilinska ME, Pieber TR, Arnolds S, Evans ML, Hovorka R. AP@ home Consortium. Day and night home closed-loop insulin delivery in adults with type 1 diabetes: three-center randomized crossover study. Diabetes Care. 2014; 37:1931–7.
Article
36. Thabit H, Lubina-Solomon A, Stadler M, Leelarathna L, Walkinshaw E, Pernet A, Allen JM, Iqbal A, Choudhary P, Kumareswaran K, Nodale M, Nisbet C, Wilinska ME, Barnard KD, Dunger DB, Heller SR, Amiel SA, Evans ML, Hovorka R. Home use of closed-loop insulin delivery for overnight glucose control in adults with type 1 diabetes: a 4-week, multicentre, randomised crossover study. Lancet Diabetes Endocrinol. 2014; 2:701–9.
Article
37. Voelker R. "Artificial pancreas" is approved. JAMA. 2016; 316:1957.
Article
38. DeVries JH. The artificial pancreas-ready for prime time? Lancet Diabetes Endocrinol. 2017; 5:238–9.
Article
39. Lewis D, Leibrand S. #OpenAPS Community. Real-world use of open source artificial pancreas systems. J Diabetes Sci Technol. 2016; 10:1411.
Article
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