title: Smart approaches to glucose-responsive drug delivery.
abstract: A grand challenge in the field of "smart" drug delivery has been the quest to create formulations that can sense glucose and respond by delivering an appropriate dose of insulin. This approach, referred to as the "fully synthetic pancreas", envisions closed-loop insulin therapy. The strategies for incorporating glucose sensing into formulations can be broadly categorized into three subsets: enzymatic sensing, natural glucose-binding proteins and synthetic molecular recognition. Here, we highlight some examples of each of these approaches. The challenges remaining en route to the realization of closed-loop insulin therapy are substantial, and include improved response time, more authentic fidelity in glycemic control, improved biocompatibility for delivery materials and assurance of both safety and efficacy. The ubiquitous existence of glucose, combined with the unstable and toxic properties of insulin, further compound efforts towards the generation of a fully synthetic pancreas. However, given the growing incidence of both type-1 and type-2 diabetes, there is significant potential impact from the realization of such an approach on improving therapeutic management of the disease.
authors.affiliation: a David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology , Cambridge , MA , USA .|b Department of Anesthesiology , Boston Children's Hospital , Boston , MA , USA .
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Webber
authors.affiliation: a David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology , Cambridge , MA , USA .|b Department of Anesthesiology , Boston Children's Hospital , Boston , MA , USA .|c Department of Chemical Engineering .|d Institute for Medical Engineering and Science , and.|e Harvard-MIT Division of Health Science and Technology, Massachusetts Institute of Technology , Cambridge , MA , USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Anderson
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000187:drug effects; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology; D016503:Drug Delivery Systems; D015195:Drug Design; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D005947:Glucose
keywords: Artificial pancreas; diabetes; insulin; smart drug delivery