Progress in Diabetes Technology: Developments in Insulin Pumps, Continuous Glucose Monitors, and Progress towards the Artificial Pancreas

Forlenza, Gregory P.; Buckingham, Bruce A.; Maahs, David M.

doi:10.1016/j.jpeds.2015.10.015

Cited by 54 publications

(54 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our clinical experience, CGM use can reduce family conflict and hypoglycemia fears by providing greater information about glucose trends and alerting individuals to high-and low-range glucose levels. Remote monitoring, an additional feature of CGM, allows the individual with T1D to share data with a partner using an online platform, thus providing peace of mind even when couples are apart [1]. Some studies about the experience of remote monitoring have highlighted the reduced worry of parents, many of whom wake up on a nightly basis to check that their child with diabetes is not dangerously low [17].…”

Section: Partners and Diabetes Technologymentioning

confidence: 99%

See 1 more Smart Citation

Partner Perspectives on Closed Loop Systems

Iturralde¹,

Tanenbaum²,

Naranjo³

et al. 2016

PLAID

View full text Add to dashboard Cite

Objective: Closed loop automated insulin delivery systems have the potential to transform diabetes management. Partners and relationships will be increasingly affected by these innovations. We examine current understanding of the partner's role in type 1 diabetes (T1D) management and technology, and provide an example of how to elicit partners' perspectives in technology research. Research Design and Methods:We conducted a literature review and a small focus group with the partners of participants enrolled in a 5-day hybrid closed loop (HCL) clinical trial. Couples' questionnaire ratings of diabetes-related distress and hypoglycemia concerns were described.Results: Partners play an integral and often helpful role in managing diabetes. They also report significant diabetes-related distress and fear of hypoglycemia, which have implications for relationships. Closed loop systems offer potential benefits such as hypoglycemia prevention and partners' online access to glucose data ("remote monitoring"). However, disruptive alerts, technical glitches, maintenance tasks, device size, and other drawbacks may strain partners and relationships. A partner focus group elicited several novel themes. Partners gained valuable insights about T1D from remote monitoring and identified hypoglycemia prevention as a major benefit. For all partners, hypoglycemia worries decreased during system use. However, partners also cited vicarious frustrations with the system, concerns about remote monitoring disrupting couple communication, and needs for technology-specific partner education. Conclusion:Closed loop systems stand to affect partners and relationships. As researchers continue to design closed loop systems and devise their integration into standard clinical care, it will be vital to assess partner perspectives to increase satisfaction and success with this technology.

show abstract

Section: Partners and Diabetes Technologymentioning

confidence: 99%

“…Closed loop systems use a computer algorithm to administer insulin via a pump based on data from a continuous glucose monitoring (CGM) system and user inputs [1]. Anticipated benefits for individuals with T1D include better glucose control, reduced self-management burden, and improved quality of life [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Partner Perspectives on Closed Loop Systems

Iturralde¹,

Tanenbaum²,

Naranjo³

et al. 2016

PLAID

View full text Add to dashboard Cite

show abstract

“…Some simulation tools have been successfully developed to design and testing insulin therapies for T1D patients, most of them related to automated control strategies which have been further extensively evaluated in clinical trials [6]. The Food and Drug Administration (FDA) has approved one simulation tool to be used for pre-clinical testing replacing animal experiments [7] which are very time consuming and expensive.…”

Section: Introductionmentioning

confidence: 99%

Glu4Pred: A computational tool for design and testing of insulin therapies for patients with type 1 diabetes based on interval simulation

Maira

Delgado

León-Vargas

2017

VII Latin American Congress on Biomedical Engineering CLAIB 2016, Bucaramanga, Santander, Colombia, October 26th -28th, 2016

View full text Add to dashboard Cite

Abstract-Diabetes management is a key factor in preventing clinical complications in type 1 diabetes (T1D) patients, where the use of manual or automatic insulin therapies are designed and implemented to counteract the effects of diabetes. However, a good glucose control may perform poorly if any therapy condition changes suddenly or over time, without the patient's awareness. This phenomenon can seriously compromise the patient's health and is usually attributed to uncertainty in the T1D models used to this end.Some simulation tools have been successfully designed to develop strategies for automated control in T1D patients; one of them even has the Food and Drug Administration's (FDA) approval to be used for pre-clinical testing replacing animal experiments. However, none have explicitly included uncertainty as part of their simulation results.This work proposes a simulation tool named Glu4Pred that includes different sources of uncertainty as well as intra-patient variability to predict a more comprehensive dynamics of the glucose-insulin system. The Glu4Pred tool allows to define a complex scenario of several days or meals, where the patient's variability and several sources of uncertainty are simulated obtaining as a result an envelope of glucose traces. This is achieved using different mathematical interval models of the glucose-insulin system. Furthermore, the tool includes a risk index outcome that quantifies the risk of experiencing different grades of hypo-or hyperglycemia in the postprandial state from interval simulation. As a result, a new computational tool integrating several sources of uncertainty through interval simulation, that can support the design of decision-aid systems for insulin therapy and glucose control in T1D, was developed.

show abstract

“…Without doubt, novel diabetes technology has already had a major impact on diabetes care and patients' quality of life. However, closed-loop systems and fully artificial pancreas devices still face several technical hurdles that prohibit their widespread application and preclude the goal of physiological metabolic control [7]. These are (1) insufficient accuracy and stability of continuous glucose monitoring systems and unsuitable measuring sites; (2) lack of "ultra-rapid" insulin with the appropriate pharmacokinetics, i.e., fast onset, rapid peak, short duration of action; (3) insufficient algorithms including features for exercise, stress, sleep, and illness; (4) suboptimal user interface (device-user, devicesensor-pump-controller, device-cloud); and (5) inappropriate sites for device application (nonphysiological route of insulin delivery).…”

Section: Introductionmentioning

confidence: 99%

Current Concepts of Using Pigs as a Source for Beta-Cell Replacement Therapy of Type 1 Diabetes

et al. 2016

View full text Add to dashboard Cite

The global prevalence of insulin-dependent diabetes mellitus is rapidly increasing. In spite of major improvements in insulin treatment regimens and diabetes technology (e.g., artificial pancreas devices), glucose control remains problematic in a substantial proportion of diabetic patients. Those patients may benefit from beta-cell replacement therapies. Allotransplantation of pancreas or isolated pancreatic islets is limited by the small number of organ donors. Thus, alternative sources of beta-cells are being developed and tested. These include endocrine progenitor cells or mature beta-cells derived from pluripotent human stem cells and attempts to derive human pancreas tissue in animal hosts by interspecific chimeric complementation experiments. Xenotransplantation of porcine islets is a realistic alternative option. Immune rejection of xenoislets can be prevented by immunosuppression of the recipient or by encapsulation of the islets in microdevices or macrodevices. Using precise and efficient genetic engineering of donor pigs, immune-protected xenoislets with improved functionality can be generated.

show abstract

Progress in Diabetes Technology: Developments in Insulin Pumps, Continuous Glucose Monitors, and Progress towards the Artificial Pancreas

Cited by 54 publications

References 85 publications

Partner Perspectives on Closed Loop Systems

Partner Perspectives on Closed Loop Systems

Glu4Pred: A computational tool for design and testing of insulin therapies for patients with type 1 diabetes based on interval simulation

Current Concepts of Using Pigs as a Source for Beta-Cell Replacement Therapy of Type 1 Diabetes

Contact Info

Product

Resources

About