Abstract
Improvements in accuracy of real-time continuous glucose monitoring facilitate the development of closed-loop systems consisting of a continuous glucose monitor, a control algorithm, and an insulin pump. Closedloop systems can be divided according to the way meal delivery is handled as “fully closed-loop” or “closed-loop” with meal announcement systems. Depending on the subcutaneous (sc) or intravenous (iv) body interface, three major types of closed-loop systems are recognised, (i) sc sensing and sc delivery system, (ii) the iv sensing and intraperitoneal delivery system, and (iii) the iv glucose sensing and iv insulin delivery system. Given the current research focus, this review centres on the sc-sc closed-loop approach, which has the greatest potential for a near-future commercial exploitation as recognised by the JDRF Artificial Pancreas Project. Other approaches utilising intraperitoneal or intravenous sensing/delivery are also discussed. Closed-loop systems may revolutionise diabetes management but their introduction is likely to be gradual starting from simpler applications such as hypoglycaemia prevention or overnight glucose control progressing to more complex approaches such as 24/7 glucose control. The most important question is what is achievable with existing technologies and when the first generation of closed-loop systems will find its way into clinical practice.
Keywords: Automated insulin delivery, Artificial pancreas, Insulin pump, Control algorithm, Model-predictive control, PID control, Type 1 diabetes
Current Diabetes Reviews
Title: The Future of Continuous Glucose Monitoring: Closed Loop
Volume: 4 Issue: 3
Author(s): Roman Hovorka
Affiliation:
Keywords: Automated insulin delivery, Artificial pancreas, Insulin pump, Control algorithm, Model-predictive control, PID control, Type 1 diabetes
Abstract: Improvements in accuracy of real-time continuous glucose monitoring facilitate the development of closed-loop systems consisting of a continuous glucose monitor, a control algorithm, and an insulin pump. Closedloop systems can be divided according to the way meal delivery is handled as “fully closed-loop” or “closed-loop” with meal announcement systems. Depending on the subcutaneous (sc) or intravenous (iv) body interface, three major types of closed-loop systems are recognised, (i) sc sensing and sc delivery system, (ii) the iv sensing and intraperitoneal delivery system, and (iii) the iv glucose sensing and iv insulin delivery system. Given the current research focus, this review centres on the sc-sc closed-loop approach, which has the greatest potential for a near-future commercial exploitation as recognised by the JDRF Artificial Pancreas Project. Other approaches utilising intraperitoneal or intravenous sensing/delivery are also discussed. Closed-loop systems may revolutionise diabetes management but their introduction is likely to be gradual starting from simpler applications such as hypoglycaemia prevention or overnight glucose control progressing to more complex approaches such as 24/7 glucose control. The most important question is what is achievable with existing technologies and when the first generation of closed-loop systems will find its way into clinical practice.
Export Options
About this article
Cite this article as:
Hovorka Roman, The Future of Continuous Glucose Monitoring: Closed Loop, Current Diabetes Reviews 2008; 4 (3) . https://dx.doi.org/10.2174/157339908785294479
DOI https://dx.doi.org/10.2174/157339908785294479 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
Call for Papers in Thematic Issues
Advancing Diabetic Wound Healing: Mechanisms and Interventions
In recent years, diabetic wounds have become a global health concern with the increase in the incidence of diabetes. Diabetic wounds are a kind of chronic and refractory ulcer. It is generally due to the microcirculatory disturbances and the reduced levels of endogenous growth factors. Delayed cutaneous wound healing is ...read more
Oxidative and inflammatory responses in the development of secondary diabetic complications
Diabetes, along with its associated secondary complications, represents a significant global health challenge, contributing significantly to morbidity and mortality. Unhealthy lifestyle habits, reduced physical activity, environmental pollutants, and stress are pivotal factors in the onset of diabetes, particularly type-2 diabetes. Poorly managed hyperglycemia can lead to various complications, including neuropathy, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
X-ray Crystallography and Computational Docking for the Detection and Development of Protein–Ligand Interactions
Current Medicinal Chemistry Nanomulsion as a Carrier for Efficient Delivery of Metformin
Current Drug Delivery PiWi RNA in Neurodevelopment and Neurodegenerative Disorders
Current Molecular Pharmacology Potential Therapeutic Relevance of Adenosine A2B and A2A Receptors in the Central Nervous System
CNS & Neurological Disorders - Drug Targets Pathogens and Chronic or Long-Term Neurologic Disorders
Cardiovascular & Hematological Disorders-Drug Targets Over-nutrition, Obesity and Insulin Resistance in the Development of β-Cell Dysfunction
Current Diabetes Reviews Role of Methylene Blue in Trauma Neuroprotection and Neuropsychiatric Diseases
CNS & Neurological Disorders - Drug Targets Neurodegenerative Diseases and Flavonoids: Special Reference to Kaempferol
CNS & Neurological Disorders - Drug Targets Superoxide Dismutases: Anti- Versus Pro- Oxidants?
Anti-Cancer Agents in Medicinal Chemistry Subject Index To Volume 1
Recent Patents on CNS Drug Discovery (Discontinued) Insulin Therapy for Improving Cardiac Surgical Outcomes
Current Drug Targets Riluzole, Neuroprotection and Amyotrophic Lateral Sclerosis
Current Medicinal Chemistry Exploring Rat Plasmatic Proteomes: What Triggered the Liver Regeneration?
Protein & Peptide Letters Abietane Diterpenes as Potential Candidates for the Management of Type 2 Diabetes
Current Pharmaceutical Design Can't Always Get What you Want? Try an Indirect Route you Just Might Get What you Need: A Study on Access to Genetic Data by Canadian Life Insurers
Current Pharmacogenomics and Personalized Medicine Management of Inflammation by Natural Polyphenols: A Comprehensive Mechanistic Update
Current Medicinal Chemistry Subfractions and Subpopulations of HDL: An Update
Current Medicinal Chemistry The Role of local Insulin-like Growth Factor-1 Isoforms in the Pathophysiology of Skeletal Muscle
Current Genomics Diabetes, Cognitive Function, and the Blood-Brain Barrier
Current Pharmaceutical Design Vascular Pharmacotherapy and Dementia
Current Vascular Pharmacology