Automated insulin delivery systems: from early research to routine care of type 1 diabetes

Renard, Éric

doi:10.1007/s00592-022-01929-5

Cited by 25 publications

(9 citation statements)

References 78 publications

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“…According to differences in the pathogenic mechanisms, DM is divided into type I and type II (Fan W. et al, 2022). It has been demonstrated that immunocytes and autoimmune antibodies-triggered destruction of pancreatic βcells and concomitant insulin insufficiency are deeply associated with the onset of type I DM (Renard, 2022). Previous studies have determined the importance of insulin resistance in the Frontiers in Pharmacology frontiersin.org development of type II DM.…”

Section: Dysglycemia-related Injurymentioning

confidence: 99%

Advances in the therapeutic application and pharmacological properties of kinsenoside against inflammation and oxidative stress-induced disorders

et al. 2022

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Extensive research has implicated inflammation and oxidative stress in the development of multiple diseases, such as diabetes, hepatitis, and arthritis. Kinsenoside (KD), a bioactive glycoside component extracted from the medicinal plant Anoectochilus roxburghii, has been shown to exhibit potent anti-inflammatory and anti-oxidative abilities. In this review, we summarize multiple effects of KD, including hepatoprotection, pro-osteogenesis, anti-hyperglycemia, vascular protection, immune regulation, vision protection, and infection inhibition, which are partly responsible for suppressing inflammation signaling and oxidative stress. The protective action of KD against dysfunctional lipid metabolism is also associated with limiting inflammatory signals, due to the crosstalk between inflammation and lipid metabolism. Ferroptosis, a process involved in both inflammation and oxidative damage, is potentially regulated by KD. In addition, we discuss the physicochemical properties and pharmacokinetic profiles of KD. Advances in cultivation and artificial synthesis techniques are promising evidence that the shortage in raw materials required for KD production can be overcome. In addition, novel drug delivery systems can improve the in vivo rapid clearance and poor bioavailability of KD. In this integrated review, we aim to offer novel insights into the molecular mechanisms underlying the therapeutic role of KD and lay solid foundations for the utilization of KD in clinical practice.

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Section: Dysglycemia-related Injurymentioning

confidence: 99%

Advances in the therapeutic application and pharmacological properties of kinsenoside against inflammation and oxidative stress-induced disorders

et al. 2022

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“…Despite technological advances including continuous glucose monitoring (CGM) and insulin pump therapy, most people with T1D do not attain glycaemic targets,1 exposing them to risk of acute and chronic complications. Automated insulin delivery (AID) systems, also termed closed loop or artificial pancreas systems combine insulin pump technology, CGM and control algorithms, to automatically adjust insulin delivery based on interstitial fluid glucose sensor readings 2. Multiple AID systems have become commercially available following large randomised controlled trials (RCTs) demonstrating improved glycaemia in people with T1D when compared with sensor-augmented pump therapy (SAPT) 3–7.…”

Section: Introductionmentioning

confidence: 99%

Study protocol for a randomised open-label clinical trial examining the safety and efficacy of the Android Artificial Pancreas System (AAPS) with advanced bolus-free features in adults with type 1 diabetes: the ‘CLOSE IT’ (Closed Loop Open SourcE In Type 1 diabetes) trial

Wilkinson,

Tomic,

Boyle

et al. 2024

BMJ Open

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IntroductionMultiple automated insulin delivery (AID) systems have become commercially available following randomised controlled trials demonstrating benefits in people with type 1 diabetes (T1D). However, their real-world utility may be undermined by user-associated burdens, including the need to carbohydrate count and deliver manual insulin boluses. There is an important need for a ‘fully automated closed loop’ (FCL) AID system, without manual mealtime boluses. The (Closed Loop Open SourcE In Type 1 diabetes) trial is a randomised trial comparing an FCL AID system to the same system used as a hybrid closed loop (HCL) in people with T1D, in an outpatient setting over an extended time frame.Methods and analysisRandomised, open-label, parallel, non-inferiority trial comparing the Android Artificial Pancreas System (AAPS) AID algorithm used as FCL to the same algorithm used as HCL. Seventy-five participants aged 18–70 will be randomised (1:1) to one of two treatment arms for 12 weeks: (a) FCL—participants will be advised not to bolus for meals and (b) HCL—participants will use the AAPS AID algorithm as HCL with announced meals. The primary outcome is the percentage of time in target sensor glucose range (3.9–10.0 mmol/L). Secondary outcomes include other glycaemic metrics, safety, psychosocial factors, platform performance and user dietary factors. Twenty FCL arm participants will participate in a 4-week extension phase comparing glycaemic and dietary outcomes using NovoRapid (insulin aspart) to Fiasp (insulin aspart and niacinamide).Ethics and disseminationApprovals are by the Alfred Health Ethics Committee (615/22) (Australia) and Health and Disability Ethics Committees (2022 FULL 13832) (New Zealand). Each participant will provide written informed consent. Data protection and confidentiality will be ensured. Study results will be disseminated by publications, conferences and patient advocacy groups.Trial registration numbersACTRN12622001400752 and ACTRN12622001401741.

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“…Hybrid closed-loop insulin delivery improves glycemic control in people with type 1 diabetes mellitus (T1D) compared with sensor augmented pump therapy, leading to clinically significant improvements in time in range, reduction in hemoglobin A1C, and lower risk of hypoglycemia. 1 -5 Hybrid closed-loop control continuously adjusts basal insulin delivery in response to measurements of the blood glucose concentration (BGC) levels, with premeal boluses and exercise-related insulin dosing adjustments addressed through manual interventions by the user. 6 -10 The burden on users to manually enter premeal boluses and modulate insulin dosing to accommodate physical activity (PA) limits the safety and efficacy of hybrid closed-loop insulin delivery.…”

Section: Introductionmentioning

confidence: 99%

Multivariable Automated Insulin Delivery System for Handling Planned and Spontaneous Physical Activities

Askari,

Ahmadasas,

Shahidehpour

et al. 2023

J Diabetes Sci Technol

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Background: Hybrid closed-loop control of glucose levels in people with type 1 diabetes mellitus (T1D) is limited by the requirements on users to manually announce physical activity (PA) and meals to the artificial pancreas system. Multivariable automated insulin delivery (mvAID) systems that can handle unannounced PAs and meals without any manual announcements by the user can improve glycemic control by modulating insulin dosing in response to the occurrence and intensity of spontaneous physical activities. Methods: An mvAID system is developed to supplement the glucose measurements with additional physiological signals from a wristband device, with the signals analyzed using artificial intelligence algorithms to automatically detect the occurrence of PA and estimate its intensity. This additional information gained from the physiological signals enables more proactive insulin dosing adjustments in response to both planned exercise and spontaneous unanticipated physical activities. Results: In silico studies of the mvAID illustrate the safety and efficacy of the system. The mvAID is translated to pilot clinical studies to assess its performance, and the clinical experiments demonstrate an increased time in range and reduced risk of hypoglycemia following unannounced PA and meals. Conclusions: The mvAID systems can increase the safety and efficacy of insulin delivery in the presence of unannounced physical activities and meals, leading to improved lives and less burden on people with T1D.

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Automated insulin delivery systems: from early research to routine care of type 1 diabetes

Cited by 25 publications

References 78 publications

Advances in the therapeutic application and pharmacological properties of kinsenoside against inflammation and oxidative stress-induced disorders

Advances in the therapeutic application and pharmacological properties of kinsenoside against inflammation and oxidative stress-induced disorders

Study protocol for a randomised open-label clinical trial examining the safety and efficacy of the Android Artificial Pancreas System (AAPS) with advanced bolus-free features in adults with type 1 diabetes: the ‘CLOSE IT’ (Closed Loop Open SourcE In Type 1 diabetes) trial

Multivariable Automated Insulin Delivery System for Handling Planned and Spontaneous Physical Activities

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