Moving Toward a Unified Platform for Insulin Delivery and Sensing of Inputs Relevant to an Artificial Pancreas

Abstract

Advances in insulin pump and continuous glucose monitoring technology have primarily focused on optimizing glycemic control for people with type 1 diabetes. There remains a need to identify ways to minimize the physical burden of this technology. A unified platform with closely positioned or colocalized interstitial fluid glucose sensing and hormone delivery components is a potential solution. Present challenges to combining these components are interference of glucose sensing from proximate insulin delivery and the large discrepancy between the life span of current insulin infusion sets and glucose sensors. Addressing these concerns is of importance given that the future physical burden of this technology is likely to be even greater with the ongoing development of the artificial pancreas, potentially incorporating multiple hormone delivery, glucose sensing redundancy, and sensing of other clinically relevant nonglucose biochemical inputs.

Strengths and Challenges of Closed-Loop Insulin Delivery During Exercise in People With Type 1 Diabetes: Potential Future Directions

“…Research is in progress for the development of wearable sensors that measure analytes such as glucose, lactate, accelerometry, and ketones. [58][59][60][61][63][64][65] Subsequent in silico mathematical modeling and evaluation of the performance of CL algorithms incorporating these signals is then required to inform advances in next-generation CL systems. However, the impact of any additional signals influencing HCL insulin delivery would remain subject to the downstream influence of the pharmacokinetics of subcutaneous insulin.…”

“…Research is in progress for the development of wearable sensors that measure analytes such as glucose, lactate, accelerometry, and ketones. 58-61,63-65…”

‘Smart’ insulin-delivery technologies and intrinsic glucose-responsive insulin analogues

“…Insulin stability in closed-loop systems Ultra-miniaturisation of sensors and improved accuracy of pumps [36,57,58] have encouraged reconsideration of i.p. delivery of insulin via i.p.…”

Design Considerations for Macroencapsulation Devices for Stem Cell Derived Islets for the Treatment of Type 1 Diabetes

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