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Artificial pancreas

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https://www.readbyqxmd.com/read/29669716/artificial-pancreas-treatment-for-outpatients-with-type-1-diabetes-systematic-review-and-meta-analysis
#1
Eleni Bekiari, Konstantinos Kitsios, Hood Thabit, Martin Tauschmann, Eleni Athanasiadou, Thomas Karagiannis, Anna-Bettina Haidich, Roman Hovorka, Apostolos Tsapas
OBJECTIVE: To evaluate the efficacy and safety of artificial pancreas treatment in non-pregnant outpatients with type 1 diabetes. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase, Cochrane Library, and grey literature up to 2 February 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials in non-pregnant outpatients with type 1 diabetes that compared the use of any artificial pancreas system with any type of insulin based treatment...
April 18, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29658779/fully-closed-loop-multiple-model-probabilistic-predictive-controller-artificial-pancreas-performance-in-adolescents-and-adults-in-a-supervised-hotel-setting
#2
Gregory P Forlenza, Faye M Cameron, Trang T Ly, David Lam, Daniel P Howsmon, Nihat Baysal, Georgia Kulina, Laurel Messer, Paula Clinton, Camilla Levister, Stephen D Patek, Carol J Levy, R Paul Wadwa, David M Maahs, B Wayne Bequette, Bruce A Buckingham
BACKGROUND: Initial Food and Drug Administration-approved artificial pancreas (AP) systems will be hybrid closed-loop systems that require prandial meal announcements and will not eliminate the burden of premeal insulin dosing. Multiple model probabilistic predictive control (MMPPC) is a fully closed-loop system that uses probabilistic estimation of meals to allow for automated meal detection. In this study, we describe the safety and performance of the MMPPC system with announced and unannounced meals in a supervised hotel setting...
April 16, 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29617192/optical-clearing-of-the-pancreas-for-visualization-of-mature-%C3%AE-cells-and-vessels-in-mice
#3
Wataru Nishimura, Asako Sakaue-Sawano, Satoru Takahashi, Atsushi Miyawaki, Kazuki Yasuda, Yasuko Noda
Glucose metabolism is regulated by insulin, which is produced from β-cells in the pancreas. Because insulin is secreted into vessels in response to blood glucose, vascular structures of the pancreas, especially the relationship between vessels and β-cells, are important for physiological and pathological glucose metabolism. Here, we developed a system to visualize vessels surrounding mature β-cells expressing transcription factor MafA in a three-dimensional manner. Optical clearing of the pancreas prevented light scattering of fluorescence driven by the bacterial artificial chromosome (BAC)-mafA promoter in β-cells...
April 4, 2018: Islets
https://www.readbyqxmd.com/read/29608335/assessment-of-mitigation-methods-to-reduce-the-risk-of-hypoglycemia-for-announced-exercise-in-a-uni-hormonal-artificial-pancreas
#4
Arthur Bertachi, Aleix Beneyto, Charrise M Ramkissoon, Josep Vehí
BACKGROUND: Moderate physical activity improves overall health conditions in subjects with type 1 diabetes. However, insulin management during and after exercise is challenging due to the effects of exercise on glycemic control. Artificial pancreas (AP) systems aim to automatically control blood glucose levels, but exercise-induced hypoglycemia is a major challenge for these systems, especially in uni-hormonal configurations. The aim of this work was to evaluate the ability of several feed-forward (FF) actions to prevent exercise-induced hypoglycemia in a closed-loop setting...
April 2, 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29566547/adaptive-and-personalized-plasma-insulin-concentration-estimation-for-artificial-pancreas-systems
#5
Iman Hajizadeh, Mudassir Rashid, Sediqeh Samadi, Jianyuan Feng, Mert Sevil, Nicole Hobbs, Caterina Lazaro, Zacharie Maloney, Rachel Brandt, Xia Yu, Kamuran Turksoy, Elizabeth Littlejohn, Eda Cengiz, Ali Cinar
BACKGROUND: The artificial pancreas (AP) system, a technology that automatically administers exogenous insulin in people with type 1 diabetes mellitus (T1DM) to regulate their blood glucose concentrations, necessitates the estimation of the amount of active insulin already present in the body to avoid overdosing. METHOD: An adaptive and personalized plasma insulin concentration (PIC) estimator is designed in this work to accurately quantify the insulin present in the bloodstream...
March 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29565722/sensor-augmented-pump-based-customized-mathematical-model-for-type-1-diabetes
#6
Benyamin Grosman, Di Wu, Diana Miller, Louis Lintereur, Anirban Roy, Neha Parikh, Francine R Kaufman
BACKGROUND: Simulations using mathematical models are important for studying, developing, and improving therapies for people with type 1 diabetes. METHODS: The Medtronic CareLink® database was used to create virtual patients with a variety of inter-insulin sensitivities, meal absorption rates, pharmacokinetics, age, and gender. In addition, intra-insulin sensitivities of the virtual patients change over a 24-h cycle. RESULTS: A total of 2087 virtual patients were developed...
March 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29565720/ongoing-debate-about-models-for-artificial-pancreas-systems-and-in-silico-studies
#7
Gregory P Forlenza
No abstract text is available yet for this article.
March 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29559955/understanding-pre-type-1-diabetes-the-key-to-prevention
#8
REVIEW
Laura M Jacobsen, Michael J Haller, Desmond A Schatz
While the incidence of type 1 diabetes continues to rise by 3% each year, the ability to prevent this disease remains elusive. Hybrid closed loop devices, artificial pancreas systems, and continuous glucose monitoring technology have helped to ease the daily burden for many people living with type 1 diabetes. However, the artificial pancreas is not a cure; more research is needed to achieve our ultimate goal of preventing type 1 diabetes. The preceding decades have generated a wealth of information regarding the natural history of pre-type 1 diabetes...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29547553/unannounced-meals-in-the-artificial-pancreas-detection-using-continuous-glucose-monitoring
#9
Charrise M Ramkissoon, Pau Herrero, Jorge Bondia, Josep Vehi
The artificial pancreas (AP) system is designed to regulate blood glucose in subjects with type 1 diabetes using a continuous glucose monitor informed controller that adjusts insulin infusion via an insulin pump. However, current AP developments are mainly hybrid closed-loop systems that include feed-forward actions triggered by the announcement of meals or exercise. The first step to fully closing the loop in the AP requires removing meal announcement, which is currently the most effective way to alleviate postprandial hyperglycemia due to the delay in insulin action...
March 16, 2018: Sensors
https://www.readbyqxmd.com/read/29520615/customization-of-home-closed-loop-insulin-delivery-in-adult-patients-with-type-1-diabetes-assisted-with-structured-remote-monitoring-the-pilot-wp7-diabeloop-study
#10
Pierre Yves Benhamou, Erik Huneker, Sylvia Franc, Maeva Doron, Guillaume Charpentier
AIMS: Improvement in closed-loop insulin delivery systems could result from customization of settings to individual needs and remote monitoring. This pilot home study evaluated the efficacy and relevance of this approach. METHODS: A bicentric clinical trial was conducted for 3 weeks, using an MPC-based algorithm (Diabeloop Artificial Pancreas system) featuring five settings designed to modulate the reactivity of regulation. Remote monitoring was ensured by expert nurses with a web platform generating automatic Secured Information Messages (SIMs) and with a structured procedure...
March 9, 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29511779/defining-outcomes-for-beta-cell-replacement-therapy-a-work-in-progress
#11
Lorenzo Piemonti, Eelco J P de Koning, Thierry Berney, Jon S Odorico, James F Markmann, Peter G Stock, Michael R Rickels
Defined outcomes for beta cell replacement therapy in the treatment of diabetes are critically needed. Progress towards the clinical acceptance of pancreas and islet transplantation has been hampered by the lack of clear definitions of functional and efficacy outcomes, as well as a lack of consistently applied glycaemic control metrics, together with poor alignment with the field of artificial insulin delivery/artificial pancreas development. To address this problem, the International Pancreas & Islet Transplant Association (IPITA) collaborated with the European Pancreas and Islet Transplant Association (EPITA) to develop a consensus for a joint statement on the definition of function and failure of beta cell replacement therapies, which is summarised in this commentary...
March 6, 2018: Diabetologia
https://www.readbyqxmd.com/read/29483036/blood-glucose-monitoring-during-aerobic-and-anaerobic-physical-exercise-using-a-new-artificial-pancreas-system
#12
Carmen Quirós, Arthur Bertachi, Marga Giménez, Lyvia Biagi, Judith Viaplana, Clara Viñals, Josep Vehí, Ignacio Conget, Jorge Bondia
AIM: To assess an artificial pancreas system during aerobic (AeE) and anaerobic exercise (AnE). METHODS: A pilot clinical trial on five subjects with type 1 diabetes (4 males) aged 37±10.9 years, diabetes diagnosed 21.2±12.2 years before, insulin pump users, and with a mean HbA1c level of 7.8±0.5%. Every subject did three AeE and three AnE sessions. Blood glucose levels were monitored by the artificial pancreas system during exercise and up to four hours later...
February 23, 2018: Endocrinología, Diabetes y Nutrición
https://www.readbyqxmd.com/read/29460328/predictive-models-control-of-the-artificial-pancreas-compartmental-or-neural-networks-models
#13
EDITORIAL
Vincenzo Piemonte
No abstract text is available yet for this article.
February 20, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29451021/the-uva-padova-type-1-diabetes-simulator-goes-from-single-meal-to-single-day
#14
Roberto Visentin, Enrique Campos-Náñez, Michele Schiavon, Dayu Lv, Martina Vettoretti, Marc Breton, Boris P Kovatchev, Chiara Dalla Man, Claudio Cobelli
BACKGROUND: A new version of the UVA/Padova Type 1 Diabetes (T1D) Simulator is presented which provides a more realistic testing scenario. The upgrades to the previous simulator, which was accepted by the Food and Drug Administration in 2013, are described. METHOD: Intraday variability of insulin sensitivity (S I ) has been modeled, based on clinical T1D data, accounting for both intra- and intersubject variability of daily S I . Thus, time-varying distributions of both subject's basal insulin infusion and insulin-to-carbohydrate ratio were calculated and made available to the user...
February 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29446980/best-use-of-models-to-advance-the-artificial-pancreas
#15
Garry M Steil
No abstract text is available yet for this article.
March 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29446890/building-a-better-pancreas
#16
Andrew Curry
For years, an artificial pancreas was a pipe dream. Now, we're closer than ever to systems that will automatically adjust background insulin. Here's what's in the works--and what's still to come.
May 2017: Diabetes Forecast
https://www.readbyqxmd.com/read/29445834/the-combination-of-2-5-dihydroxybenzoic-acid-and-2-5-dihydroxyacetophenone-matrices-for-unequivocal-assignment-of-phosphatidylethanolamine-species-in-complex-mixtures
#17
Jenny Schröter, Annabelle Fülöp, Carsten Hopf, Jürgen Schiller
Unequivocal assignment of phospholipid peaks in complex mixtures is difficult if only the m/z values but no tandem mass spectrometry (MS/MS) data are available. This is usually the case for matrix-assisted laser/desorption ionization time-of-flight (MALDI-TOF) MS imaging experiments and the analysis has normally to be performed without prior separation. Another problem might be the often matrix-induced loss of one methyl group in phosphatidylcholine (PC) species, which makes them detectable as negative ions becoming isomers of some phosphatidylethanolamines (PEs)...
February 14, 2018: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/29422651/impact-of-erroneous-meal-insulin-bolus-with-dual-hormone-artificial-pancreas-using-a-simplified-bolus-strategy-a-randomized-controlled-trial
#18
Véronique Gingras, Mohamed Raef Smaoui, Charlotte Cameli, Virginie Messier, Martin Ladouceur, Laurent Legault, Rémi Rabasa-Lhoret
Postprandial glucose control remains challenging for patients with type 1 diabetes (T1D). A simplified meal bolus approach with a dual-hormone (insulin and glucagon) closed-loop system (DH-CLS) has been tested; yet, the impact of categorization errors with this strategy is unknown. The objective was to compare, in a randomized controlled inpatient trial, DH-CLS with the simplified meal bolus approach for two different meals properly categorized or overestimated. We tested, in patients with T1D, the simplified strategy with two standardized breakfasts (n = 10 per meal) adequately categorized or overestimated: (1) 75 g and (2) 45 g of carbohydrate...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29421420/continuous-blood-glucose-monitoring-may-detect-carotid-occlusion-intolerance-during-carotid-artery-stenting
#19
Ryo Hiramatsu, Motomasa Furuse, Ryokichi Yagi, Tomohisa Ohmura, Hiroyuki Ohnishi, Naokado Ikeda, Naosuke Nonoguchi, Shinji Kawabata, Shigeru Miyachi, Toshihiko Kuroiwa
BACKGROUND: The frequency of the occurrence of adverse events associated with carotid artery stenting (CAS) is usually low, but serious adverse events such as cerebral hyperperfusion syndrome (CHS) may occur. Real-time monitoring is ideal for the early detection of adverse events during the surgical procedure. This study aimed to evaluate continuous blood glucose (BG) monitoring for the detection of adverse events during CAS. METHODS: Forty patients undergoing scheduled CAS were prospectively enrolled...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29412837/glucose-lowering-therapies-in-type-2-diabetes-opportunities-and-challenges-for-peptides
#20
REVIEW
Clifford J Bailey
This overview considers the opportunities and challenges that face the use of gluco-regulatory peptides to treat type 2 diabetes. New insulin analogues and formulations are being developed with pharmacokinetic properties to speed-up or prolong transfer from a subcutaneous injection site to the target tissues, or to selectively favour effects on the liver. Alternative routes of insulin administration continue to attract attention, and advances in the integration of glucose monitoring with insulin pump devices are improving miniaturised 'closed loop' artificial pancreas systems...
February 2018: Peptides
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