title: Closed loop insulin delivery in diabetes.
abstract: The primary goal of type 1 diabetes treatment is attaining near-normal glucose values. This currently remains out of reach for most people with type 1 diabetes despite intensified insulin treatment in the form of insulin analogues, educational interventions, continuous glucose monitoring, and sensor augmented insulin pump. The main remaining problem is risk of hypoglycaemia, which cannot be sufficiently reduced in all patient groups. Additionally, patients' burn-out often develops with years of tedious day-to-day diabetes management, rendering available diabetes-related technology less efficient. Over the past 40 years, several attempts have been made towards computer-programmed insulin delivery in the form of closed loop, with faster developments especially in the past decade. Automated insulin delivery has reduced human error in glycaemic control and considerably lessened the burden of routine self-management. In this chapter, data from randomized controlled trials with closed-loop insulin delivery that included type 1 diabetes population are summarized, and an evidence-based vision for possible routine utilization of closed loop is provided.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, UMC - University Children's Hospital, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia. Electronic address: tadej.battelino@mf.uni-lj.si.
authors.forename: Tadej
authors.initials: T
authors.lastname: Battelino
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, UMC - University Children's Hospital, Ljubljana, Slovenia.
authors.forename: Jasna Šuput
authors.initials: JŠ
authors.lastname: Omladič
authors.affiliation: Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Phillip
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D018670:Monitoring, Ambulatory; D019397:Pancreas, Artificial; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: artificial pancreas; closed loop insulin delivery; continuous glucose monitoring; glucose variability; glycaemic range; hypoglycaemia; mean blood glucose; sensor augmented insulin pump