Biostator Glucose Controller: A Building Block of the Future

Young, Alma H.; Herf, Steven M.

doi:10.1177/014572178401000203

Cited by 10 publications

(2 citation statements)

References 2 publications

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“…Because the Biostator was bulky, intricate, and required the patient to be connected to a blood withdrawal catheter in one arm and an infusion line in the other arm, its use was largely limited to research. It was also employed as an investigative tool to study an individual’s glycemic patterns over a 24–36 hour hospital admission, in order to help determine their ideal insulin dosage ( 13 ). The Biostator was used extensively in research throughout the 1980s and 1990s, with over 200 publications based upon its use ( 14 ).…”

Section: Early Closed-loop Systemsmentioning

confidence: 99%

Closed-Loop Insulin Delivery Systems: Past, Present, and Future Directions

Templer

2022

Front. Endocrinol.

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Closed-loop (artificial pancreas) systems for automated insulin delivery have been likened to the holy grail of diabetes management. The first iterations of glucose-responsive insulin delivery were pioneered in the 1960s and 1970s, with the development of systems that used venous glucose measurements to dictate intravenous infusions of insulin and dextrose in order to maintain normoglycemia. Only recently have these bulky, bedside technologies progressed to miniaturized, wearable devices. These modern closed-loop systems use interstitial glucose sensing, subcutaneous insulin pumps, and increasingly sophisticated algorithms. As the number of commercially available hybrid closed-loop systems has grown, so too has the evidence supporting their efficacy. Future challenges in closed-loop technology include the development of fully closed-loop systems that do not require user input for meal announcements or carbohydrate counting. Another evolving avenue in research is the addition of glucagon to mitigate the risk of hypoglycemia and allow more aggressive insulin dosing.

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Section: Early Closed-loop Systemsmentioning

confidence: 99%

Closed-Loop Insulin Delivery Systems: Past, Present, and Future Directions

Templer

2022

Front. Endocrinol.

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“…It was also impractical to use this large device on a daily basis. 17 Most of the Biostators are now used for early pharmacokinetics/pharmacodynamics studies of developing insulin analogs. Between 1965 and1980, several companies made different devices for insulin delivery and blood glucose measurements.…”

Section: History Of the Artificial Pancreas (Cl System)mentioning

confidence: 99%

Closed-Loop System in the Management of Diabetes: Past, Present, and Future

Shah

Shoskes

Tawfik

et al. 2014

Diabetes Technology & Therapeutics

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Intensive insulin therapy (IIT) has been shown to reduce micro- and macrovascular complications in patients with type 1 diabetes mellitus (T1DM). However, IIT is associated with a significant increase in severe hypoglycemic events, resulting in increased morbidity and mortality. Optimization of glycemic control without hypoglycemia (especially nocturnal) should be the next major goal for subjects on insulin treatment. The use of insulin pumps along with continuous glucose monitors (CGMs) has made it easier but requires significant resources and patient education. Research is ongoing to close the loop by integrating the pump and the CGM using different algorithms. The currently available closed-loop system is the threshold suspend. Steps needed to achieve a near-perfect closed-loop are (1) a control-to-range system that will reduce the incidence and/or severity of hyper- and/or hypoglycemia by adjusting the insulin dose and (2) a control-to-target system, a fully automated or hybrid system that sets target glucose levels to individual needs and maintains glucose levels throughout the day using insulin (unihormonal) alone or with other hormones such as glucagon or possibly pramlintide (bihormonal). Future research is also focusing on better insulin delivery devices (pumps), more accurate CGMs, better predictive algorithms, and ultra-rapid-acting insulin analogs to make the closed-loop system as physiological as possible.

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