What is the role of artificial pancreases in the treatment of type 1 diabetes mellitus (DM)?

Updated: Oct 13, 2020
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Closed-loop systems, also known as artificial pancreases, are in development for use in improving glycemic control in type 1 diabetes. These systems include a CGM that is in constant communication with an infusion pump, with a blood glucose device (eg, a glucose meter) utilized for CGM calibration. An external processor, such as a cell phone, runs control algorithm software, receiving data from the CGM. The data is used to perform a series of calculations, producing dosing instructions that are sent to the infusion pump. [113]

The artificial pancreases are being developed to administer either insulin or glucagon or a combination of the two agents. [114] A 1-month study in 20 patients indicated that, with regard to keeping blood glucose levels in the target range over a 24-hour period, round-the-clock use of closed-loop glucose control is more effective than use of a patient-controlled sensor-augmented pump. [115, 116]

In September 2016, the FDA approved the first artificial pancreas, Medtronic's MiniMed 670G, for persons aged 14 years or older with type 1 diabetes. A hybrid closed-loop system, it still requires patients to determine the number of carbohydrates in their food and input that data into the system, manually requesting the insulin dose needed for meals. [117]  In June 2018, the FDA extended the MiniMed 670G’s approval to children aged 7-13 years with type 1 diabetes. [118]


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