Steil GM, Rebrin K. Closed-loop insulin delivery – what lies between where we are and where we are going?
Expert Opin Drug Deliv 2005;
2:353-62. [PMID:
16296759 DOI:
10.1517/17425247.2.2.353]
[Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Closed-loop insulin delivery in individuals with diabetes can potentially lead to near-normal glucose profiles. To this end, existing subcutaneous glucose sensors and external insulin pumps can be linked with an insulin delivery algorithm to create a completely automated closed-loop system. This paper reviews current research into the development of such a system, with particular emphasis on creating a system emulating the physiological properties of the beta-cell. Issues related to using subcutaneous interstitial fluid for glucose sensing and insulin delivery are reviewed. Criteria for optimising the system are discussed using historical data. Existing strategies for open-loop pump therapy are presented with the objective of defining a path to advance from the existing physician/patient determined insulin therapy to a completely automated system.
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