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Artificial pancreas

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https://www.readbyqxmd.com/read/29202033/synthetic-smart-gel-provides-glucose-responsive-insulin-delivery-in-diabetic-mice
#1
Akira Matsumoto, Miyako Tanaka, Hiroko Matsumoto, Kozue Ochi, Yuki Moro-Oka, Hirohito Kuwata, Hironori Yamada, Ibuki Shirakawa, Taiki Miyazawa, Hitoshi Ishii, Kazunori Kataoka, Yoshihiro Ogawa, Yuji Miyahara, Takayoshi Suganami
Although previous studies have attempted to create "electronics-free" insulin delivery systems using glucose oxidase and sugar-binding lectins as a glucose-sensing mechanism, no successful clinical translation has hitherto been made. These protein-based materials are intolerant of long-term use and storage because of their denaturing and/or cytotoxic properties. We provide a solution by designing a protein-free and totally synthetic material-based approach. Capitalizing on the sugar-responsive properties of boronic acid, we have established a synthetic polymer gel-based insulin delivery device confined within a single catheter, which exhibits an artificial pancreas-like function in vivo...
November 2017: Science Advances
https://www.readbyqxmd.com/read/29188429/spike-in-glucose-levels-after-reperfusion-during-aortic-surgery-assessment-by-continuous-blood-glucose-monitoring-using-artificial-endocrine-pancreas
#2
Koji Kawahito, Hirotaka Sato, Mamoru Kadosaki, Atsushi Egawa, Yoshio Misawa
OBJECTIVES: Although strict blood glucose control during cardiovascular surgery is essential to avoid postoperative complications, the various changes in glucose levels that occur during surgery have not been investigated in detail. In this study, we continuously monitored blood glucose changes during aortic surgery using the STG-55Ⓡ artificial endocrine pancreas (Nikkiso Inc., Tokyo). METHODS: Between December 2015 and 2016, we performed continuous blood glucose monitoring in 22 patients (14 men and 8 women, 72 ± 11 years old), who required hypothermic circulatory arrest during an ascending/aortic arch surgery, at the Jichi Medical University Hospital...
November 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29188386/the-shifting-paradigm-of-a-cure-for-type-1-diabetes-is-technology-replacing-immune-based-therapies
#3
Jeremy Pettus, Matthias Von Herrath
Nearly 50 years after the autoimmune nature of type 1 diabetes was discovered, no therapy has been approved to alter the course of the disease at any stage. However, during that same period, technology has been delivering tools to help patients achieve better glycemic control and reduce the burden of the disease. With the imminent arrival of fully automated artificial pancreas systems that will continue to improve control and quality of life, it appears that we are on the verge of a major technological breakthrough that will significantly impact diabetes care...
November 29, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/29174479/practical-implementation-education-and-interpretation-guidelines-for-continuous-glucose-monitoring-a-french-position-statement
#4
S Borot, P Y Benhamou, C Atlan, E Bismuth, E Bonnemaison, B Catargi, G Charpentier, A Farret, N Filhol, S Franc, D Gouet, B Guerci, I Guilhem, C Guillot, N Jeandidier, M Joubert, V Melki, E Merlen, A Penfornis, S Picard, E Renard, Y Reznik, J P Riveline, S Rudoni, P Schaepelynck, A Sola-Gazagnes, N Tubiana-Rufi, O Verier-Mine, H Hanaire
The use by diabetes patients of real-time continuous interstitial glucose monitoring (CGM) or the FreeStyle Libre® (FSL) flash glucose monitoring (FGM) system is becoming widespread and has changed diabetic practice. The working group bringing together a number of French experts has proposed the present practical consensus. Training of professionals and patient education are crucial for the success of CGM. Also, institutional recommendations must pay particular attention to the indications for and reimbursement of CGM devices in populations at risk of hypoglycaemia...
November 11, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29060152/personalization-of-a-compartmental-physiological-model-for-an-artificial-pancreas-through-integration-of-patient-s-state-estimation
#5
P Jallon, S Lachal, C Franco, G Charpentier, E Huneker, M Doron, Sylvia Franc, Pierre-Yves Benhamou, Sophie Borot, Bruno Guerci, He le Ne Hanaire, Nathalie Jeandidier, Alfred Penfornis, Eric Renard, Yves Reznik, Pauline Schaepelynck, Chantal Simon
Artificial Pancreas (AP) are developed for patients with Type 1 diabetes. This medical device system consists in the association of a subcutaneous continuous glucose monitor (CGM) providing a proxy of the patient's glycaemia and a control algorithm offering the real-time modification of the insulin delivery with an automatic command of the subcutaneous insulin pump. The most complex algorithms are based on a compartmental model of the glucoregulatory system of the patient coupled to an approach of MPC (Model-Predictive-Control) for the command...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29045172/real-world-challenges-of-controller-adaptation-with-the-artificial-pancreas
#6
Lia Bally, Hood Thabit
No abstract text is available yet for this article.
October 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29039207/stochastic-seasonal-models-for-glucose-prediction-in-the-artificial-pancreas
#7
Eslam Montaser, José-Luis Díez, Jorge Bondia
BACKGROUND: Linear empirical dynamic models have been widely used for glucose prediction. The extension of the concept of seasonality, characteristic of other domains, is explored here for the improvement of prediction accuracy. METHODS: Twenty time series of 8-hour postprandial periods (PP) for a same 60g-carbohydrate meal were collected from a closed-loop controller validation study. A single concatenated time series was produced representing a collection of data from similar scenarios, resulting in seasonality...
November 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29030383/twelve-week-24-7-ambulatory-artificial-pancreas-with-weekly-adaptation-of-insulin-delivery-settings-effect-on-hemoglobin-a1c-and-hypoglycemia
#8
Eyal Dassau, Jordan E Pinsker, Yogish C Kudva, Sue A Brown, Ravi Gondhalekar, Chiara Dalla Man, Steve Patek, Michele Schiavon, Vikash Dadlani, Isuru Dasanayake, Mei Mei Church, Rickey E Carter, Wendy C Bevier, Lauren M Huyett, Jonathan Hughes, Stacey Anderson, Dayu Lv, Elaine Schertz, Emma Emory, Shelly K McCrady-Spitzer, Tyler Jean, Paige K Bradley, Ling Hinshaw, Alejandro J Laguna Sanz, Ananda Basu, Boris Kovatchev, Claudio Cobelli, Francis J Doyle
OBJECTIVE: Artificial pancreas (AP) systems are best positioned for optimal treatment of type 1 diabetes (T1D) and are currently being tested in outpatient clinical trials. Our consortium developed and tested a novel adaptive AP in an outpatient, single-arm, uncontrolled multicenter clinical trial lasting 12 weeks. RESEARCH DESIGN AND METHODS: Thirty adults with T1D completed a continuous glucose monitor (CGM)-augmented 1-week sensor-augmented pump (SAP) period...
December 2017: Diabetes Care
https://www.readbyqxmd.com/read/28992720/accuracy-and-time-delay-of-glucose-measurements-of-continuous-glucose-monitoring-and-bedside-artificial-pancreas-during-hyperglycemic-and-euglycemic-hyperinsulinemic-glucose-clamp-study
#9
Akio Kuroda, Satoshi Taniguchi, Yuko Akehi, Hiroyasu Mori, Motoyuki Tamaki, Reiko Suzuki, Yinhua Otsuka, Munehide Matsuhisa
BACKGROUND: Glucose values of continuous glucose monitoring (CGM) have time delays compared with plasma glucose (PG) values. The artificial pancreas (STG-55, Nikkiso, Japan) (AP), which measures venous blood glucose directly, also has a time delay because of the long tubing lines from sampling vessel to the glucose sensor. We investigate accuracy and time delay of CGM and AP in comparison with PG values during 2-step glucose clamp study. METHODS: Seven patients with type 2 diabetes and 2 healthy volunteers were included in this study...
November 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28970466/induction-of-artificial-pancreas-in-liver-transplant-recipients-preliminary-experience-with-an-insightful-message
#10
Hironori Hayashi, Hiroyuki Takamura, Ryosuke Gabata, Isamu Makino, Yoshinao Ohbatake, Shinichi Nakanuma, Tomoharu Miyashita, Hidehiro Tajima, Kazuhiro Hanazaki, Tetsuo Ohta
BACKGROUND We investigated the impact of using an artificial pancreas for glycemic control in liver transplant recipients. MATERIAL AND METHODS Between January 2014 and December 2016, glycemic control using an artificial pancreas was performed 13 times. The target blood glucose level was set at 80-110 mg/dL. We retrospectively analyzed the clinical course, including achievement rate of the target blood glucose range. RESULTS For perioperative glycemic control, an artificial pancreas was used 9 times. The total insulin dose and achievement rate of the target blood glucose level were 113...
October 3, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28942594/keeping-up-with-the-diabetes-technology-2016-endocrine-society-guidelines-of-insulin-pump-therapy-and-continuous-glucose-monitor-management-of-diabetes
#11
REVIEW
Alfonso Galderisi, Elise Schlissel, Eda Cengiz
PURPOSE OF REVIEW: Decades after the invention of insulin pump, diabetes management has encountered a technology revolution with the introduction of continuous glucose monitoring, sensor-augmented insulin pump therapy and closed-loop/artificial pancreas systems. In this review, we discuss the significance of the 2016 Endocrine Society Guidelines for insulin pump therapy and continuous glucose monitoring and summarize findings from relevant diabetes technology studies that were conducted after the publication of the 2016 Endocrine Society Guidelines...
September 23, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28929796/a-coordinated-control-strategy-for-insulin-and-glucagon-delivery-in-type-1-diabetes
#12
Pau Herrero, Jorge Bondia, Nick Oliver, Pantelis Georgiou
Type 1 diabetes is an autoimmune condition characterised by a pancreatic insulin secretion deficit, resulting in high blood glucose concentrations, which can lead to micro- and macrovascular complications. Type 1 diabetes also leads to impaired glucagon production by the pancreatic α-cells, which acts as a counter-regulatory hormone to insulin. A closed-loop system for automatic insulin and glucagon delivery, also referred to as an artificial pancreas, has the potential to reduce the self-management burden of type 1 diabetes and reduce the risk of hypo- and hyperglycemia...
October 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28918653/setting-expectations-for-successful-artificial-pancreas-hybrid-closed-loop-automated-insulin-delivery-adoption
#13
Dana Lewis
Hybrid closed loop (or automated insulin delivery systems) and artificial pancreas technology will dramatically change the quality of life for people living with diabetes. However, this technology is not a cure. Without having expectations set, patients may assume that APs will replace critical self-care behaviors. It is important for patients to understand several key things before choosing to adopt and switching to APs for diabetes management. Like any technology, APs will have a learning curve. But like switching from MDI to standard pump therapy, it is not insurmountable...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28898340/-from-insulin-pump-and-continuous-glucose-monitoring-to-the-artificial-pancreas
#14
REVIEW
Pamela Apablaza, Néstor Soto, Ethel Codner
Technology for diabetes care has undergone major development during recent decades. These technological advances include continuous subcutaneous insulin infusion (CSII), also known as insulin pumps, and real-time continuous glucose monitoring system (RT-CGMS). The integration of CSII and RT-CGMS into a single device has led to sensor-augmented pump therapy and more recently, a technology that has automated delivery of basal insulin therapy, known as hybrid system. These new technologies have led to benefits in attaining better metabolic control and decreasing the incidence of severe hypoglycemia, especially in patients with type 1 diabetes...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28887408/erratum-application-of-zone-model-predictive-control-artificial-pancreas-during-extended-use-of-infusion-set-and-sensor-a-randomized-crossover-controlled-home-use-trial-diabetes-care-2017-40-1096-1102
#15
Gregory P Forlenza, Sunil Deshpande, Trang T Ly, Daniel P Howsmon, Faye Cameron, Nihat Baysal, Eric Mauritzen, Tatiana Marcal, Lindsey Towers, B Wayne Bequette, Lauren M Huyett, Jordan E Pinsker, Ravi Gondhalekar, Francis J Doyle, David M Maahs, Bruce A Buckingham, Eyal Dassau
No abstract text is available yet for this article.
November 2017: Diabetes Care
https://www.readbyqxmd.com/read/28880188/a-review-of-safety-and-hazards-associated-with-the-artificial-pancreas
#16
Charrise M Ramkissoon, Brian Aufderheide, B Wayne Bequette, Josep Vehi
The artificial pancreas (AP) is a closed-loop (CL) device with the potential to reduce the complications associated with type 1 diabetes mellitus (T1DM) by maintaining euglycemia in patients. The AP encompasses an algorithm that determines the amount of insulin (and other hormones) to be administered to the patient via a continuous subcutaneous insulin infusion (CSII) pump using information provided by a continuous glucose monitor (CGM) and other sensors. As the AP approaches commercialization special attention must be given to safety within all the individual components, including physiological changes in the patient, as well as, safety issues that can arise when these components are combined into a single system...
September 4, 2017: IEEE Reviews in Biomedical Engineering
https://www.readbyqxmd.com/read/28867311/distal-technologies-and-type-1-diabetes-management
#17
REVIEW
Danny C Duke, Samantha Barry, David V Wagner, Jane Speight, Pratik Choudhary, Michael A Harris
Type 1 diabetes requires intensive self-management to avoid acute and long-term health complications. In the past two decades, substantial advances in technology have enabled more effective and convenient self-management of type 1 diabetes. Although proximal technologies (eg, insulin pumps, continuous glucose monitors, closed-loop and artificial pancreas systems) have been the subject of frequent systematic and narrative reviews, distal technologies have received scant attention. Distal technologies refer to electronic systems designed to provide a service remotely and include heterogeneous systems such as telehealth, mobile health applications, game-based support, social platforms, and patient portals...
August 31, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28855239/closed-loop-control-during-intense-prolonged-outdoor-exercise-in-adolescents-with-type-1-diabetes-the-artificial-pancreas-ski-study
#18
Marc D Breton, Daniel R Cherñavvsky, Gregory P Forlenza, Mark D DeBoer, Jessica Robic, R Paul Wadwa, Laurel H Messer, Boris P Kovatchev, David M Maahs
OBJECTIVE: Intense exercise is a major challenge to the management of type 1 diabetes (T1D). Closed-loop control (CLC) systems (artificial pancreas) improve glycemic control during limited intensity and short duration of physical activity (PA). However, CLC has not been tested during extended vigorous outdoor exercise common among adolescents. RESEARCH DESIGN AND METHODS: Skiing presents unique metabolic challenges: intense prolonged PA, cold, altitude, and stress/fear/excitement...
December 2017: Diabetes Care
https://www.readbyqxmd.com/read/28854339/improving-the-safety-and-functionality-of-an-artificial-pancreas-system-for-use-in-younger-children-input-from-parents-and-physicians
#19
Rachel Gildersleeve, Sara L Riggs, Daniel R Cherñavvsky, Marc D Breton, Mark D DeBoer
BACKGROUND: Artificial pancreas (AP) systems have initially been designed for and tested in teens and adults, but there is evidence that an AP system with additional support and safety systems could greatly benefit younger children with type 1 diabetes (T1D). SUBJECTS AND METHODS: Five pediatric endocrinologists and 15 parents of children aged 5-8 years with T1D participated in a total of four focus groups. Focus groups investigated current diabetes technology use and acceptance, as well as possible modifications to the current adult AP system, which would allow for safe and successful use in younger children...
November 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28853168/a-novel-three-compartmental-model-for-artificial-pancreas-development-and-validation
#20
Vincenzo Piemonte, Mauro Capocelli, Luca De Santis, Anna Rita Maurizi, Paolo Pozzilli
Closed-loop insulin delivery system, also known as artificial pancreas (AP), provides the blood glucose control in diabetic patients, enabling the automatic blood-sugar management and reducing the risks and improving the lives of people with diabetes. A new three-compartmental model of glucose-insulin interaction for AP is presented and tested in this paper. The glucose and insulin "spaces" are split into a plasma compartment and interstitial fluids compartment, respectively. The model includes an additional subcutaneous compartment and provides three explicit delays and three parameters influencing the regulatory system and correlating with the physiopathology of the patients...
August 29, 2017: Artificial Organs
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