The pathway to the closed-loop artificial pancreas: research and commercial perspectives.
BACKGROUND
Over the past decades, insulin pumps (CSII) and continuous glucose monitoring (CGM) systems have been combined in sensor augmented pump therapy. In addition, artificial pancreas (AP) research has progressed to clinical studies, using combinations of commercially available devices.


OBJECTIVE
Sensor augmented pump therapy has been evaluated in a number of clinical trials. These studies have been designed to show glycemic outcomes. The low glucose suspend (LGS) feature of the Medtronic Paradigm Veo (Medtronic MiniMed, Northridge, CA) pump allows CGM to suspend insulin delivery if preset hypoglycemic thresholds are achieved. Evaluation of the AP has been conducted to show effect on time in target, and has involved a variety of algorithms, pumps and CGM systems.


RESULTS
Multiple studies have shown that more time is spent in the target range for glucose levels and that there is less hypoglycemia with sensor augmented pump, LGS and early AP platforms.


CONCLUSIONS
Current research shows that progress has been made in the iterative steps required to develop the AP.
Keenan
D Barry
DB
Medtronic MiniMed Northridge CA 91325, USA. barry.keenan@medtronic.com
Cartaya
Raymond
R
Mastrototaro
John J
JJ
D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D007332:Insulin Infusion Systems; D018670:Monitoring, Ambulatory / Q000379:methods; D019397:Pancreas, Artificial