1
|
Ghanim R, Kaushik A, Park J, Abramson A. Communication Protocols Integrating Wearables, Ingestibles, and Implantables for Closed-Loop Therapies. DEVICE 2023; 1:100092. [PMID: 38465200 PMCID: PMC10923538 DOI: 10.1016/j.device.2023.100092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Body-conformal sensors and tissue interfacing robotic therapeutics enable the real-time monitoring and treatment of diabetes, wound healing, and other critical conditions. By integrating sensors and drug delivery devices, scientists and engineers have developed closed-loop drug delivery systems with on-demand therapeutic capabilities to provide just-in-time treatments that correspond to chemical, electrical, and physical signals of a target morbidity. To enable closed-loop functionality in vivo, engineers utilize various low-power means of communication that reduce the size of implants by orders of magnitude, increase device lifetime from hours to months, and ensure the secure high-speed transfer of data. In this review, we highlight how communication protocols used to integrate sensors and drug delivery devices, such as radio frequency communication (e.g., Bluetooth, near-field communication), in-body communication, and ultrasound, enable improved treatment outcomes.
Collapse
Affiliation(s)
- Ramy Ghanim
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Anika Kaushik
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Jihoon Park
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Alex Abramson
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
- Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA 30322, USA
| |
Collapse
|
2
|
Preoperative optimization of diabetes. Int Anesthesiol Clin 2022; 60:8-15. [PMID: 34897217 DOI: 10.1097/aia.0000000000000351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
3
|
Bozkurt E, Atay E, Bilir A, Ertekin A, Buğra Koca H, Cem Sabaner M. A novel model of early type 1 diabetes mellitus: The chick embryo air sack model. Saudi J Biol Sci 2021; 28:5538-5546. [PMID: 34588863 PMCID: PMC8459128 DOI: 10.1016/j.sjbs.2021.08.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 11/18/2022] Open
Abstract
Diabetes Mellitus (DM) is a metabolic disease characterized by hyperglycemia. Chronic hyperglycemia is associated with long-term dysfunction such as retinopathy, nephropathy, neuropathy and cardiovascular diseases. These complications increase rates of death and disability worldwide. Due to the negative effects of DM on the quality of life, the mechanism and treatments of the disease should be investigated in more detail. Most of the research in diabetes is performed in experimental animals. Experimental animal models contributed to the advancement of clinical research, the development of new therapeutic approaches, the discovery of insulin and the purification of insulin. There are many animal models of DM in the literature. But there are a few DM model studies created with chick embryos. In these studies, it was seen that there were differences in STZ doses and STZ administration techniques. The objective of this study was to create a more acceptable and easier DM model. 180 specific pathogen free (SPF) fertilized chicken eggs (White Leghorn chicken) were used in this study. STZ was administered to 160 SPF eggs for an induced DM model. The remaining 20 SPF eggs were separated as a control group. We used two different DM models (Air sack model (ASM) and Chorioallantoic membrane model (CAMM)) and blood sampling technique in our study. 160 SPF eggs were divided into two groups with 80 eggs in each group, according to the model in which STZ was administered. When the relationship between blood glucose and blood insulin levels were examined, it was determined that there was a significantly strong negative correlation in the control group and ASM 1 group; and a significantly very strong negative correlation was found in the ASM 2 group and ASM 3 group. Our data indicate that the optimal STZ dose to create a DM model was 0.45 mg/egg and the best DM model was ASM. The second technique to be the best blood sampling technique for determining blood glucose levels. We believe that ASM can be used in DM studies and anti-DM drug studies in terms of its easebly, applicability, reproducibility and low cost.
Collapse
Affiliation(s)
- Erhan Bozkurt
- Department of Internal Medicine, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Emre Atay
- Department of Anatomy, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Abdülkadir Bilir
- Department of Anatomy, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ayşe Ertekin
- Department of Emergency Medicine, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Halit Buğra Koca
- Department of Medical Biochemistry, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | | |
Collapse
|
4
|
Li H, Zhou R, He J, Zhang M, Liu J, Sun X, Ni P. Glucose-Sensitive Core-Cross-Linked Nanoparticles Constructed with Polyphosphoester Diblock Copolymer for Controlling Insulin Delivery. Bioconjug Chem 2021; 32:2095-2107. [PMID: 34469130 DOI: 10.1021/acs.bioconjchem.1c00390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This work aims to construct biocompatible, biodegradable core-cross-linked and insulin-loaded nanoparticles which are sensitive to glucose and release insulin via cleavage of the nanoparticles in a high-concentration blood glucose environment. First, a polyphosphoester-based diblock copolymer (PBYP-g-Gluc)-b-PEEP was prepared via ring-opening copolymerization (ROP) and the copper(I)-catalyzed azide-alkyne cycloaddition (CuAAC) in which PBYP and PEEP represent the polymer segments from 2-(but-3-yn-1-yloxy)-2-oxo-1,3,2-dioxaphospholane and 2-ethoxy-2-oxo-1,3,2-dioxaphospholane, respectively, and Gluc comes from 2-azidoethyl-β-d-glucopyranoside (Gluc-N3) that grafted with PBYP. The structure and molecular weight of the copolymer were characterized by 1H NMR, 31P NMR, GPC, FT-IR, and UV-vis measurements. The amphiphilic copolymer could self-assemble into core-shell uncore-cross-linked nanoparticles (UCCL NPs) in aqueous solutions and form core-cross-linked nanoparticles (CCL NPs) after adding cross-linking agent adipoylamidophenylboronic acid (AAPBA). Dynamic light scattering (DLS) and transmission electron microscopy (TEM) were used to study the self-assembly behavior of the two kinds of NPs and the effect of different Gluc group contents on the size of NPs further to verify the stability and glucose sensitivity of CCL NPs. The ability of NPs to load fluorescein isothiocyanate-labeled insulin (FITC-insulin) and their glucose-triggered release behavior were detected by a fluorescence spectrophotometer. The results of methyl thiazolyl tetrazolium (MTT) assay and hemolysis activity experiments showed that the CCL NPs had good biocompatibility. An in vivo hypoglycemic study has shown that FITC-insulin-loaded CCL NPs could reduce blood glucose and have a protective effect on hypoglycemia. This research provides a new method for constructing biodegradable and glucose-sensitive core-cross-linked nanomedicine carriers for controlled insulin release.
Collapse
Affiliation(s)
- Hongping Li
- College of Chemistry, Chemical Engineering and Materials Science, State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, Jiangsu Key Laboratory of Advanced Functional Polymer Design and Application, Suzhou Key Laboratory of Macromolecular Design and Precision Synthesis, Soochow University, Suzhou 215123, P. R. China
| | - Ru Zhou
- College of Chemistry, Chemical Engineering and Materials Science, State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, Jiangsu Key Laboratory of Advanced Functional Polymer Design and Application, Suzhou Key Laboratory of Macromolecular Design and Precision Synthesis, Soochow University, Suzhou 215123, P. R. China
| | - Jinlin He
- College of Chemistry, Chemical Engineering and Materials Science, State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, Jiangsu Key Laboratory of Advanced Functional Polymer Design and Application, Suzhou Key Laboratory of Macromolecular Design and Precision Synthesis, Soochow University, Suzhou 215123, P. R. China
| | - Mingzu Zhang
- College of Chemistry, Chemical Engineering and Materials Science, State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, Jiangsu Key Laboratory of Advanced Functional Polymer Design and Application, Suzhou Key Laboratory of Macromolecular Design and Precision Synthesis, Soochow University, Suzhou 215123, P. R. China
| | - Jian Liu
- Institute of Functional Nano and Soft Materials (FUNSOM), Soochow University, Suzhou 215123, P. R. China
| | - Xingwei Sun
- Intervention Department, The Second Affiliated Hospital of Soochow University, Suzhou 215004, P. R. China
| | - Peihong Ni
- College of Chemistry, Chemical Engineering and Materials Science, State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, Jiangsu Key Laboratory of Advanced Functional Polymer Design and Application, Suzhou Key Laboratory of Macromolecular Design and Precision Synthesis, Soochow University, Suzhou 215123, P. R. China
| |
Collapse
|
5
|
Tejedor M, Woldaregay AZ, Godtliebsen F. Reinforcement learning application in diabetes blood glucose control: A systematic review. Artif Intell Med 2020; 104:101836. [DOI: 10.1016/j.artmed.2020.101836] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/03/2019] [Accepted: 02/19/2020] [Indexed: 10/25/2022]
|
6
|
Wang J, Wang Z, Yu J, Kahkoska AR, Buse JB, Gu Z. Glucose-Responsive Insulin and Delivery Systems: Innovation and Translation. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2020; 32:e1902004. [PMID: 31423670 PMCID: PMC7141789 DOI: 10.1002/adma.201902004] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/09/2019] [Indexed: 05/18/2023]
Abstract
Type 1 and advanced type 2 diabetes treatment involves daily injections or continuous infusion of exogenous insulin aimed at regulating blood glucose levels in the normoglycemic range. However, current options for insulin therapy are limited by the risk of hypoglycemia and are associated with suboptimal glycemic control outcomes. Therefore, a range of glucose-responsive components that can undergo changes in conformation or show alterations in intermolecular binding capability in response to glucose stimulation has been studied for ultimate integration into closed-loop insulin delivery or "smart insulin" systems. Here, an overview of the evolution and recent progress in the development of molecular approaches for glucose-responsive insulin delivery systems, a rapidly growing subfield of precision medicine, is presented. Three central glucose-responsive moieties, including glucose oxidase, phenylboronic acid, and glucose-binding molecules are examined in detail. Future opportunities and challenges regarding translation are also discussed.
Collapse
Affiliation(s)
- Jinqiang Wang
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095, USA
| | - Zejun Wang
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095, USA
| | | | - Anna R. Kahkoska
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - John B. Buse
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Zhen Gu
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095, USA
- Zenomics Inc., Durham, NC 27709, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA 90095, USA
- Center for Minimally Invasive Therapeutics, University of California, Los Angeles, CA 90095, USA
| |
Collapse
|
7
|
|
8
|
Agazzi ML, Herrera SE, Cortez ML, Marmisollé WA, Tagliazucchi M, Azzaroni O. Insulin Delivery from Glucose‐Responsive, Self‐Assembled, Polyamine Nanoparticles: Smart “Sense‐and‐Treat” Nanocarriers Made Easy. Chemistry 2020; 26:2456-2463. [DOI: 10.1002/chem.201905075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Maximiliano L. Agazzi
- Instituto de Investigaciones Fisicoquímicas Teóricas y, Aplicadas Facultad de Ciencias ExactasUniversidad Nacional de La, Plata-CONICET Sucursal 4, Casilla de Correo 16 1900 La Plata Argentina
| | - Santiago E. Herrera
- Instituto de Investigaciones Fisicoquímicas Teóricas y, Aplicadas Facultad de Ciencias ExactasUniversidad Nacional de La, Plata-CONICET Sucursal 4, Casilla de Correo 16 1900 La Plata Argentina
| | - M. Lorena Cortez
- Instituto de Investigaciones Fisicoquímicas Teóricas y, Aplicadas Facultad de Ciencias ExactasUniversidad Nacional de La, Plata-CONICET Sucursal 4, Casilla de Correo 16 1900 La Plata Argentina
| | - Waldemar A. Marmisollé
- Instituto de Investigaciones Fisicoquímicas Teóricas y, Aplicadas Facultad de Ciencias ExactasUniversidad Nacional de La, Plata-CONICET Sucursal 4, Casilla de Correo 16 1900 La Plata Argentina
| | - Mario Tagliazucchi
- Departamento de Química Inorgánica, Analítica y Química FísicaINQUIMAE-CONICETFacultad de Ciencias Exactas y NaturalesCiudad Universitaria Pabellón 2 Buenos Aires C1428EHA Argentina
| | - Omar Azzaroni
- Instituto de Investigaciones Fisicoquímicas Teóricas y, Aplicadas Facultad de Ciencias ExactasUniversidad Nacional de La, Plata-CONICET Sucursal 4, Casilla de Correo 16 1900 La Plata Argentina
| |
Collapse
|
9
|
|
10
|
Oroojeni Mohammad Javad M, Agboola SO, Jethwani K, Zeid A, Kamarthi S. A Reinforcement Learning-Based Method for Management of Type 1 Diabetes: Exploratory Study. JMIR Diabetes 2019; 4:e12905. [PMID: 31464196 PMCID: PMC6737889 DOI: 10.2196/12905] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 06/24/2019] [Accepted: 07/19/2019] [Indexed: 01/17/2023] Open
Abstract
Background Type 1 diabetes mellitus (T1DM) is characterized by chronic insulin deficiency and consequent hyperglycemia. Patients with T1DM require long-term exogenous insulin therapy to regulate blood glucose levels and prevent the long-term complications of the disease. Currently, there are no effective algorithms that consider the unique characteristics of T1DM patients to automatically recommend personalized insulin dosage levels. Objective The objective of this study was to develop and validate a general reinforcement learning (RL) framework for the personalized treatment of T1DM using clinical data. Methods This research presents a model-free data-driven RL algorithm, namely Q-learning, that recommends insulin doses to regulate the blood glucose level of a T1DM patient, considering his or her state defined by glycated hemoglobin (HbA1c) levels, body mass index, engagement in physical activity, and alcohol usage. In this approach, the RL agent identifies the different states of the patient by exploring the patient’s responses when he or she is subjected to varying insulin doses. On the basis of the result of a treatment action at time step t, the RL agent receives a numeric reward, positive or negative. The reward is calculated as a function of the difference between the actual blood glucose level achieved in response to the insulin dose and the targeted HbA1c level. The RL agent was trained on 10 years of clinical data of patients treated at the Mass General Hospital. Results A total of 87 patients were included in the training set. The mean age of these patients was 53 years, 59% (51/87) were male, 86% (75/87) were white, and 47% (41/87) were married. The performance of the RL agent was evaluated on 60 test cases. RL agent–recommended insulin dosage interval includes the actual dose prescribed by the physician in 53 out of 60 cases (53/60, 88%). Conclusions This exploratory study demonstrates that an RL algorithm can be used to recommend personalized insulin doses to achieve adequate glycemic control in patients with T1DM. However, further investigation in a larger sample of patients is needed to confirm these findings.
Collapse
Affiliation(s)
- Mahsa Oroojeni Mohammad Javad
- Department of Information Technology and Analytics, Kogod School of Business, American University, Washington, DC, United States
| | - Stephen Olusegun Agboola
- Department of Dermatology, Harvard Medical School, Boston, MA, United States.,Partners HealthCare, Boston, MA, United States
| | - Kamal Jethwani
- Department of Dermatology, Harvard Medical School, Boston, MA, United States
| | - Abe Zeid
- Mechanical and Industrial Engineering Department, College of Engineering, Northeastern University, Boston, MA, United States
| | - Sagar Kamarthi
- Mechanical and Industrial Engineering Department, College of Engineering, Northeastern University, Boston, MA, United States
| |
Collapse
|
11
|
Huang Q, Wang L, Yu H, Ur-Rahman K. Advances in phenylboronic acid-based closed-loop smart drug delivery system for diabetic therapy. J Control Release 2019; 305:50-64. [DOI: 10.1016/j.jconrel.2019.05.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 02/05/2023]
|
12
|
Lim ZW, Ping Y, Miserez A. Glucose-Responsive Peptide Coacervates with High Encapsulation Efficiency for Controlled Release of Insulin. Bioconjug Chem 2018; 29:2176-2180. [DOI: 10.1021/acs.bioconjchem.8b00369] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Zhi Wei Lim
- Centre for Biomimetic Sensor Science, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Drive, 637553 Singapore
| | - Yuan Ping
- Centre for Biomimetic Sensor Science, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Drive, 637553 Singapore
| | - Ali Miserez
- Centre for Biomimetic Sensor Science, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Drive, 637553 Singapore
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, 637551 Singapore
| |
Collapse
|
13
|
Temporal case-based reasoning for type 1 diabetes mellitus bolus insulin decision support. Artif Intell Med 2018; 85:28-42. [DOI: 10.1016/j.artmed.2017.09.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 08/22/2017] [Accepted: 09/13/2017] [Indexed: 11/23/2022]
|
14
|
Matsumoto A, Tanaka M, Matsumoto H, Ochi K, Moro-oka Y, Kuwata H, Yamada H, Shirakawa I, Miyazawa T, Ishii H, Kataoka K, Ogawa Y, Miyahara Y, Suganami T. Synthetic "smart gel" provides glucose-responsive insulin delivery in diabetic mice. SCIENCE ADVANCES 2017; 3:eaaq0723. [PMID: 29202033 PMCID: PMC5706739 DOI: 10.1126/sciadv.aaq0723] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 10/27/2017] [Indexed: 05/20/2023]
Abstract
Although previous studies have attempted to create "electronics-free" insulin delivery systems using glucose oxidase and sugar-binding lectins as a glucose-sensing mechanism, no successful clinical translation has hitherto been made. These protein-based materials are intolerant of long-term use and storage because of their denaturing and/or cytotoxic properties. We provide a solution by designing a protein-free and totally synthetic material-based approach. Capitalizing on the sugar-responsive properties of boronic acid, we have established a synthetic polymer gel-based insulin delivery device confined within a single catheter, which exhibits an artificial pancreas-like function in vivo. Subcutaneous implantation of the device in healthy and diabetic mice establishes a closed-loop system composed of "continuous glucose sensing" and "skin layer"-regulated insulin release. As a result, glucose metabolism was controlled in response to interstitial glucose fluctuation under both insulin-deficient and insulin-resistant conditions with at least 3-week durability. Our "smart gel" technology could offer a user-friendly and remarkably economic (disposable) alternative to the current state of the art, thereby facilitating availability of effective insulin treatment not only to diabetic patients in developing countries but also to those patients who otherwise may not be strongly motivated, such as the elderly, infants, and patients in need of nursing care.
Collapse
Affiliation(s)
- Akira Matsumoto
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
- Corresponding author. (A.M.); (T.S.)
| | - Miyako Tanaka
- Department of Molecular Medicine and Metabolism, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
| | - Hiroko Matsumoto
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kozue Ochi
- Department of Molecular Medicine and Metabolism, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
| | - Yuki Moro-oka
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirohito Kuwata
- Department of Molecular Medicine and Metabolism, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
- Department of Diabetology, Nara Medical University, Nara, Japan
| | - Hironori Yamada
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ibuki Shirakawa
- Department of Organ Network and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taiki Miyazawa
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hitoshi Ishii
- Department of Diabetology, Nara Medical University, Nara, Japan
| | - Kazunori Kataoka
- Innovation Center of NanoMedicine, Kawasaki Institute of Industrial Promotion, Kawasaki, Japan
- Policy Alternatives Research Institute, University of Tokyo, Tokyo, Japan
| | - Yoshihiro Ogawa
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (CREST), Tokyo, Japan
| | - Yuji Miyahara
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayoshi Suganami
- Department of Molecular Medicine and Metabolism, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
- Corresponding author. (A.M.); (T.S.)
| |
Collapse
|
15
|
Oroval M, Díez P, Aznar E, Coll C, Marcos MD, Sancenón F, Villalonga R, Martínez-Máñez R. Self-Regulated Glucose-Sensitive Neoglycoenzyme-Capped Mesoporous Silica Nanoparticles for Insulin Delivery. Chemistry 2016; 23:1353-1360. [DOI: 10.1002/chem.201604104] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Mar Oroval
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico; Unidad Mixta Universitat Politècnica de València; Universitat de València; Camino de Vera s/n 46022 Valencia Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN); Spain
| | - Paula Díez
- Nanosensors & Nanomachines Group; Department of Analytical Chemistry; Faculty of Chemistry; Complutense University of Madrid; 28040 Madrid Spain
| | - Elena Aznar
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN); Spain
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico; Unidad Mixta Universitat Politècnica de València; Universitat de València; Camino de Vera s/n 46022 Valencia Spain
| | - Carmen Coll
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico; Unidad Mixta Universitat Politècnica de València; Universitat de València; Camino de Vera s/n 46022 Valencia Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN); Spain
| | - María Dolores Marcos
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico; Unidad Mixta Universitat Politècnica de València; Universitat de València; Camino de Vera s/n 46022 Valencia Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN); Spain
- Departamento de Química; Universitat Politècnica de València; Camino de Vera s/n 46022 València Spain
| | - Félix Sancenón
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico; Unidad Mixta Universitat Politècnica de València; Universitat de València; Camino de Vera s/n 46022 Valencia Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN); Spain
- Departamento de Química; Universitat Politècnica de València; Camino de Vera s/n 46022 València Spain
| | - Reynaldo Villalonga
- Nanosensors & Nanomachines Group; Department of Analytical Chemistry; Faculty of Chemistry; Complutense University of Madrid; 28040 Madrid Spain
| | - Ramón Martínez-Máñez
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico; Unidad Mixta Universitat Politècnica de València; Universitat de València; Camino de Vera s/n 46022 Valencia Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN); Spain
- Departamento de Química; Universitat Politècnica de València; Camino de Vera s/n 46022 València Spain
| |
Collapse
|
16
|
Taylor M, Gregory R, Tomlins P, Jacob D, Hubble J, Sahota T. Closed-loop glycaemic control using an implantable artificial pancreas in diabetic domestic pig ( Sus scrofa domesticus ). Int J Pharm 2016; 500:371-8. [DOI: 10.1016/j.ijpharm.2015.12.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 11/30/2015] [Accepted: 12/09/2015] [Indexed: 01/30/2023]
|
17
|
Siegel RA. Stimuli sensitive polymers and self regulated drug delivery systems: a very partial review. J Control Release 2014; 190:337-51. [PMID: 24984012 PMCID: PMC4142101 DOI: 10.1016/j.jconrel.2014.06.035] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 06/18/2014] [Accepted: 06/21/2014] [Indexed: 10/25/2022]
Abstract
Since the early days of the Journal of Controlled Release, there has been considerable interest in materials that can release drug on an "on-demand" basis. So called "stimuli-responsive" and "intelligent" systems have been designed to deliver drug at various times or at various sites in the body, according to a stimulus that is either endogenous or externally applied. In the past three decades, research along these lines has taken numerous directions, and each new generation of investigators has discovered new physicochemical principles and chemical schemes by which the release properties of materials can be altered. No single review could possibly do justice to all of these approaches. In this article, some general observations are made, and a partial history of the field is presented. Both open loop and closed loop systems are discussed. Special emphasis is placed on stimuli-responsive hydrogels, and on systems that can respond repeatedly. It is argued that the most success at present and in the foreseeable future is with systems in which biosensing and actuation (i.e. drug delivery) are separated, with a human and/or cybernetic operator linking the two.
Collapse
Affiliation(s)
- Ronald A Siegel
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN 55455 USA; Department Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455 USA.
| |
Collapse
|
18
|
Lin KY, Lo JH, Consul N, Kwong GA, Bhatia SN. Self-titrating anticoagulant nanocomplexes that restore homeostatic regulation of the coagulation cascade. ACS NANO 2014; 8:8776-85. [PMID: 25119520 PMCID: PMC4174090 DOI: 10.1021/nn501129q] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Antithrombotic therapy is a critical portion of the treatment regime for a number of life-threatening conditions, including cardiovascular disease, stroke, and cancer; yet, proper clinical management of anticoagulation remains a challenge because existing agents increase the propensity for bleeding in patients. Here, we describe the development of a bioresponsive peptide-polysaccharide nanocomplex that utilizes a negative feedback mechanism to self-titrate the release of anticoagulant in response to varying levels of coagulation activity. This nanoscale self-titrating activatable therapeutic, or nanoSTAT, consists of a cationic thrombin-cleavable peptide and heparin, an anionic polysaccharide and widely used clinical anticoagulant. Under nonthrombotic conditions, nanoSTATs circulate inactively, neither releasing anticoagulant nor significantly prolonging bleeding time. However, in response to life-threatening pulmonary embolism, nanoSTATs locally release their drug payload and prevent thrombosis. This autonomous negative feedback regulator may improve antithrombotic therapy by increasing the therapeutic window and decreasing the bleeding risk of anticoagulants.
Collapse
Affiliation(s)
- Kevin Y. Lin
- Department of Chemical Engineering and Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Justin H. Lo
- Department of Chemical Engineering and Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Medical Scientist Training Program, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Nikita Consul
- Department of Chemical Engineering and Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Gabriel A. Kwong
- Department of Chemical Engineering and Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Sangeeta N. Bhatia
- Department of Chemical Engineering and Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02142, United States
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts 02115, United States
- Electrical Engineering and Computer Science, David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, Massachusetts 02139, United States
- Howard Hughes Medical Institute, Chevy Chase, Maryland 20815, United States
- Address correspondence to
| |
Collapse
|
19
|
Srinivasan A, Lee JB, Dassau E, Doyle FJ. Novel insulin delivery profiles for mixed meals for sensor-augmented pump and closed-loop artificial pancreas therapy for type 1 diabetes mellitus. J Diabetes Sci Technol 2014; 8:957-68. [PMID: 25049364 PMCID: PMC4455363 DOI: 10.1177/1932296814543660] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Maintaining euglycemia for people with type 1 diabetes is highly challenging, and variations in glucose absorption rates with meal composition require meal type specific insulin delivery profiles for optimal blood glucose control. Traditional basal/bolus therapy is not fully optimized for meals of varied fat contents. Thus, regimens for low- and high-fat meals were developed to improve current insulin pump therapy. Simulations of meals with varied fat content demonstrably replicated published data. Subsequently, an insulin profile library with optimized delivery regimens under open and closed loop for various meal compositions was constructed using particle swarm optimization. Calculations showed that the optimal basal bolus insulin profiles for low-fat meals comprise a normal bolus or a short wave. The preferred delivery for high-fat meals is typically biphasic, but can extend to multiple phases depending on meal characteristics. Results also revealed that patients that are highly sensitive to insulin could benefit from biphasic deliveries. Preliminary investigations of the optimal closed-loop regimens also display bi- or multiphasic patterns for high-fat meals. The novel insulin delivery profiles present new waveforms that provide better control of postprandial glucose excursions than existing schemes. Furthermore, the proposed novel regimens are also more or similarly robust to uncertainties in meal parameter estimates, with the closed-loop schemes demonstrating superior performance and robustness.
Collapse
Affiliation(s)
- Asavari Srinivasan
- Department of Chemical Engineering, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Joon Bok Lee
- Department of Chemical Engineering, University of California, Santa Barbara, Santa Barbara, CA, USA Sansum Diabetes Research Institute, Santa Barbara, CA, USA
| | - Eyal Dassau
- Department of Chemical Engineering, University of California, Santa Barbara, Santa Barbara, CA, USA Sansum Diabetes Research Institute, Santa Barbara, CA, USA
| | - Francis J Doyle
- Department of Chemical Engineering, University of California, Santa Barbara, Santa Barbara, CA, USA Sansum Diabetes Research Institute, Santa Barbara, CA, USA
| |
Collapse
|
20
|
Jiang T, Jiang G, Wang X, Dong Y, Wei Z, Li X, Tang B. Facile one-pot synthesis of fluorescent hyperbranched polymers for optical detection of glucose. Des Monomers Polym 2014. [DOI: 10.1080/15685551.2014.907610] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Tengteng Jiang
- Department of Materials Engineering, College of Materials and Textile, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
- Key Laboratory of Advanced Textile Materials and Manufacturing Technology (ATMT), Ministry of Education, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
| | - Guohua Jiang
- Department of Materials Engineering, College of Materials and Textile, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
- Key Laboratory of Advanced Textile Materials and Manufacturing Technology (ATMT), Ministry of Education, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
| | - Xiaohong Wang
- Department of Materials Engineering, College of Materials and Textile, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
- Key Laboratory of Advanced Textile Materials and Manufacturing Technology (ATMT), Ministry of Education, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
| | - Yue Dong
- Department of Materials Engineering, College of Materials and Textile, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
| | - Zhen Wei
- Department of Materials Engineering, College of Materials and Textile, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
- Key Laboratory of Advanced Textile Materials and Manufacturing Technology (ATMT), Ministry of Education, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
| | - Xia Li
- Department of Materials Engineering, College of Materials and Textile, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
- Key Laboratory of Advanced Textile Materials and Manufacturing Technology (ATMT), Ministry of Education, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
| | - Bolin Tang
- Department of Materials Engineering, College of Materials and Textile, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
- Key Laboratory of Advanced Textile Materials and Manufacturing Technology (ATMT), Ministry of Education, Zhejiang Sci-Tech University, Hangzhou 310018, P.R. China
| |
Collapse
|
21
|
Taylor MJ, Gregory R, Mitchell H, Alblihed M, Alsabih A, Tomlins P, Sahota TS. Insulin pump users would not rule out using an implantable artificial pancreas. PRACTICAL DIABETES 2014. [DOI: 10.1002/pdi.1822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
22
|
Bothe MK, Dickens L, Reichel K, Tellmann A, Ellger B, Westphal M, Faisal AA. The use of reinforcement learning algorithms to meet the challenges of an artificial pancreas. Expert Rev Med Devices 2014; 10:661-73. [PMID: 23972072 DOI: 10.1586/17434440.2013.827515] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Melanie K Bothe
- Fresenius Kabi Deutschland GmbH, Else-Kröner-Strasse 1, 61352 Bad Homburg, Germany
| | | | | | | | | | | | | |
Collapse
|
23
|
Artificial Pancreas Coupled Vital Signs Monitoring for Improved Patient Safety. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2013. [DOI: 10.1007/s13369-012-0456-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
24
|
|
25
|
|
26
|
Chu MKL, Chen J, Gordijo CR, Chiang S, Ivovic A, Koulajian K, Giacca A, Wu XY, Sun Y. In vitro and in vivo testing of glucose-responsive insulin-delivery microdevices in diabetic rats. LAB ON A CHIP 2012; 12:2533-2539. [PMID: 22565220 DOI: 10.1039/c2lc40139h] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We have developed glucose-responsive implantable microdevices for closed-loop delivery of insulin and conducted in vivo testing of these devices in diabetic rats. The microdevices consist of an albumin-based bioinorganic membrane that utilizes glucose oxidase (GOx), catalase (CAT) and manganese dioxide (MnO(2)) nanoparticles to convert a change in the environmental glucose level to a pH stimulus, which regulates the volume of pH-sensitive hydrogel nanoparticles and thereby the permeability of the membrane. The membrane is integrated with microfabricated PDMS (polydimethylsiloxane) structures to form compact, stand-alone microdevices, which do not require tethering wires or tubes. During in vitro testing, the microdevices showed glucose-responsive insulin release over multiple cycles at clinically relevant glucose concentrations. In vivo, the microdevices were able to counter hyperglycemia in diabetic rats over a one-week period. The in vitro and in vivo testing results demonstrated the efficacy of closed-loop biosensing and rapid response of the 'smart' insulin delivery devices.
Collapse
Affiliation(s)
- Michael K L Chu
- Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Bratlie KM, York RL, Invernale MA, Langer R, Anderson DG. Materials for diabetes therapeutics. Adv Healthc Mater 2012; 1:267-84. [PMID: 23184741 PMCID: PMC3899887 DOI: 10.1002/adhm.201200037] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Indexed: 11/10/2022]
Abstract
This review is focused on the materials and methods used to fabricate closed-loop systems for type 1 diabetes therapy. Herein, we give a brief overview of current methods used for patient care and discuss two types of possible treatments and the materials used for these therapies-(i) artificial pancreases, comprised of insulin producing cells embedded in a polymeric biomaterial, and (ii) totally synthetic pancreases formulated by integrating continuous glucose monitors with controlled insulin release through degradable polymers and glucose-responsive polymer systems. Both the artificial and the completely synthetic pancreas have two major design requirements: the device must be both biocompatible and be permeable to small molecules and proteins, such as insulin. Several polymers and fabrication methods of artificial pancreases are discussed: microencapsulation, conformal coatings, and planar sheets. We also review the two components of a completely synthetic pancreas. Several types of glucose sensing systems (including materials used for electrochemical, optical, and chemical sensing platforms) are discussed, in addition to various polymer-based release systems (including ethylene-vinyl acetate, polyanhydrides, and phenylboronic acid containing hydrogels).
Collapse
Affiliation(s)
- Kaitlin M. Bratlie
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 32 Vassar St., Cambridge, MA 02142, USA
- Department of Anesthesiology, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Roger L. York
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 32 Vassar St., Cambridge, MA 02142, USA
- Department of Anesthesiology, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Michael A. Invernale
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 32 Vassar St., Cambridge, MA 02142, USA
- Department of Anesthesiology, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Robert Langer
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 32 Vassar St., Cambridge, MA 02142, USA
- Department of Anesthesiology, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
- Harvard-MIT Division of Health Science Technology, Massachusetts Institute of Technology, 45 Carleton Street, Building E25-342, Cambridge, MA 02142, USA
| | - Daniel G. Anderson
- The Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 32 Vassar St., Cambridge, MA 02142, USA
- Department of Anesthesiology, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
- Harvard-MIT Division of Health Science Technology, Massachusetts Institute of Technology, 45 Carleton Street, Building E25-342, Cambridge, MA 02142, USA
| |
Collapse
|
28
|
|
29
|
Taylor MJ, Tanna S, Sahota T. In Vivo Study of a Polymeric Glucose-Sensitive Insulin Delivery System Using a Rat Model. J Pharm Sci 2010; 99:4215-27. [DOI: 10.1002/jps.22138] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
30
|
Siegel RA, Gu Y, Lei M, Baldi A, Nuxoll EE, Ziaie B. Hard and soft micro- and nanofabrication: An integrated approach to hydrogel-based biosensing and drug delivery. J Control Release 2009; 141:303-13. [PMID: 20036310 DOI: 10.1016/j.jconrel.2009.12.012] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 12/09/2009] [Indexed: 11/16/2022]
Abstract
We review efforts to produce microfabricated glucose sensors and closed-loop insulin delivery systems. These devices function due to the swelling and shrinking of glucose-sensitive microgels that are incorporated into silicon-based microdevices. The glucose response of the hydrogel is due to incorporated phenylboronic acid (PBA) side chains. It is shown that in the presence of glucose, these polymers alter their swelling properties, either by ionization or by formation of glucose-mediated reversible crosslinks. Swelling pressures impinge on microdevice structures, leading either to a change in resonant frequency of a microcircuit, or valving action. Potential areas for future development and improvement are described. Finally, an asymmetric nano-microporous membrane, which may be integrated with the glucose-sensitive devices, is described. This membrane, formed using photolithography and block polymer assembly techniques, can be functionalized to enhance its biocompatibility and solute size selectivity. The work described here features the interplay of design considerations at the supramolecular, nano, and micro scales.
Collapse
Affiliation(s)
- Ronald A Siegel
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN 55455, USA.
| | | | | | | | | | | |
Collapse
|
31
|
Kumareswaran K, Evans ML, Hovorka R. Artificial pancreas: an emerging approach to treat Type 1 diabetes. Expert Rev Med Devices 2009; 6:401-10. [PMID: 19572795 DOI: 10.1586/erd.09.23] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Intensive insulin therapy aimed at achieving normal glucose levels significantly reduces the complications that are associated with diabetes but is also associated with an increased risk of low glucose levels (hypoglycemia). The growing use of continuous glucose monitors has stimulated the development of the artificial pancreas, a closed-loop insulin-delivery system aimed at restoring near-normal glucose levels while reducing the risk of hypoglycemia. The artificial pancreas comprises three components: a continuous glucose monitor, an insulin infusion pump and a control algorithm delivering insulin according to real-time glucose readings. In this article, we review closed-loop glucose control, including its components, development, testing and clinical application.
Collapse
Affiliation(s)
- Kavita Kumareswaran
- Institute of Metabolic Science, University of Cambridge, Metabolic Research Laboratories, Box 289, Level 4, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
| | | | | |
Collapse
|
32
|
A Review of Closed-Loop Algorithms for Glycemic Control in the Treatment of Type 1 Diabetes. ALGORITHMS 2009. [DOI: 10.3390/a2010518] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
33
|
Autonomous Rhythmic Drug Delivery Systems Based on Chemical and Biochemomechanical Oscillators. CHEMOMECHANICAL INSTABILITIES IN RESPONSIVE MATERIALS 2009. [DOI: 10.1007/978-90-481-2993-5_7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|