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Artificial pancreas

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https://www.readbyqxmd.com/read/29893593/skin-problems-associated-with-insulin-pumps-and-sensors-in-adults-with-type-1-diabetes-a-cross-sectional-study
#1
Anna Korsgaard Berg, Kirsten Nørgaard, Jacob P Thyssen, Claus Zachariae, Eva Hommel, Karen Rytter, Jannet Svensson
BACKGROUND: In the future, widespread use of closed-loop infusion (artificial pancreas) systems to treat type 1 diabetes (T1D) may significantly improve glycemic control and enhance treatment flexibility. However, the infusion sets and plasters necessary for these treatments can cause dermatological complications that may hamper the spread of the new technology; few studies have investigated these complications in adults. The aim of this study was to describe the dermatological complications associated with continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) in adults...
June 12, 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29873517/the-hybrid-closed-loop-system-evolution-and-practical-applications
#2
Kathryn W Weaver, Irl B Hirsch
Achievement of well-controlled blood glucose is essential for preventing complications in patients with type 1 diabetes. Since the inception of continuous subcutaneous insulin infusion, the aim has been to develop an artificial pancreas, with the ability to use an automated algorithm to deliver one or more hormones in response to blood glucose with the intent to keep blood sugar as close to a prespecified target as possible. Development and rapid improvement of continuous glucose sensor technology has recently allowed swift progress toward a fully closed-loop insulin delivery system...
June 6, 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29753624/a-critical-review-and-analysis-of-ethical-issues-associated-with-the-artificial-pancreas
#3
REVIEW
A Quintal, V Messier, R Rabasa-Lhoret, E Racine
The artificial pancreas combines a hormone infusion pump with a continuous glucose ontinuous glucose monitoring, supported by a dosing algorithm currently installed on the pump. It allows for dynamic infusions of insulin (and possibly other hormones such as glucagon) tailored to patient needs. For patients with type 1 diabetes the artificial pancreas has been shown to prevent more effectively hypoglycaemic events and hyperglycaemia than insulin pump therapy and has the potential to simplify care. However, the potential ethical issues associated with the upcoming integration of the artificial pancreas into clinical practice have not yet been discussed...
April 25, 2018: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29744820/artificial-pancreas-as-an-effective-and-safe-alternative-in-patients-with-type-1-diabetes-mellitus-a-systematic-review-and-meta-analysis
#4
Xia Dai, Zu-Chun Luo, Lu Zhai, Wen-Piao Zhao, Feng Huang
INTRODUCTION: Insulin injection is the main treatment in patients with type 1 diabetes mellitus (T1DM). Even though continuous glucose monitoring has significantly improved the conditions of these patients, limitations still exist. To further enhance glucose control in patients with T1DM, an artificial pancreas has been developed. We aimed to systematically compare artificial pancreas with its control group during a 24-h basis in patients with T1DM. METHODS: Electronic databases were carefully searched for English publications comparing artificial pancreas with its control group...
May 9, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29725915/postprandial-fuzzy-adaptive-strategy-for-a-hybrid-proportional-derivative-controller-for-the-artificial-pancreas
#5
Aleix Beneyto, Josep Vehi
This paper presents a support fuzzy adaptive system for a hybrid proportional derivative controller that will refine its parameters during postprandial periods to enhance performance. Even though glucose controllers have improved over the last decade, tuning them and keeping them tuned are still major challenges. Changes in a patient's lifestyle, stress, exercise, or other activities may modify their blood glucose system, making it necessary to retune or change the insulin dosing algorithm. This paper presents a strategy to adjust the parameters of a proportional derivative controller using the so-called safety auxiliary feedback element loop for type 1 diabetic patients...
May 3, 2018: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29719565/the-rat-pancreatic-body-tail-as-a-source-of-a-novel-extracellular-matrix-scaffold-for-endocrine-pancreas-bioengineering
#6
Huajun Yu, Yunzhi Chen, Hongru Kong, Qikuan He, Hongwei Sun, Pravin Avinash Bhugul, Qiyu Zhang, Bicheng Chen, Mengtao Zhou
Background: Regenerative medicine and tissue engineering are promising approaches for organ transplantation. Extracellular matrix (ECM) based scaffolds obtained through the decellularization of natural organs have become the preferred platform for organ bioengineering. In the field of pancreas bioengineering, acellular scaffolds from different animals approximate the biochemical, spatial and vascular relationships of the native extracellular matrix and have been proven to be a good platform for recellularization and in vitro culture...
2018: Journal of Biological Engineering
https://www.readbyqxmd.com/read/29717373/transpapillary-endopancreatic-surgery-decompression-of-duct-system-and-comparison-of-greenlight-laser-with-monopolar-electrosurgical-device-in-ex-vivo-and-in-vivo-animal-models
#7
Philip C Müller, Daniel C Steinemann, Lukas Chinczewski, Gencay Hatiboglu, Felix Nickel, Kaspar Z'graggen, Beat P Müller-Stich
BACKGROUND: Endopancreatic surgery (EPS) is an experimental minimally invasive technique for resection of pancreatic tissue from inside the pancreatic duct, accessed via the duodenum and papilla. It is proposed as an alternative to duodenum-preserving pancreatic head resection in benign diseases such as chronic pancreatitis (CP). This study evaluated the use of EPS for resection of pancreatic duct stenoses. Moreover, greenlight laser (GLL) and monopolar electrosurgical device (MES) were compared as resection tools for EPS...
May 1, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29681172/analyzing-the-potential-of-advanced-insulin-dosing-strategies-in-patients-with-type-2-diabetes-results-from-a-hybrid-in-silico-study
#8
Florian Reiterer, Matthias Reiter, Luigi Del Re, Merete Bechmann Christensen, Kirsten Nørgaard
BACKGROUND: The ongoing improvement of continuous glucose monitoring (CGM) sensors and of insulin pumps are paving the way for a fast implementation of artificial pancreas (AP) for type 1 diabetes (T1D) patients. The case for type 2 diabetes (T2D) patients is less obvious since usually some residual beta cell function allows for simpler therapy approaches, and even multiple daily injections (MDI) therapy is not very widespread. However, the number of insulin dependent T2D patients is vastly increasing and therefore a need for understanding chances and challenges of an automated insulin therapy arises...
April 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29669716/artificial-pancreas-treatment-for-outpatients-with-type-1-diabetes-systematic-review-and-meta-analysis
#9
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
#10
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...
May 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
#11
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...
May 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
#12
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 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29566547/adaptive-and-personalized-plasma-insulin-concentration-estimation-for-artificial-pancreas-systems
#13
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...
May 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29565722/sensor-augmented-pump-based-customized-mathematical-model-for-type-1-diabetes
#14
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
#15
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
#16
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
#17
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
#18
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...
June 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29511779/defining-outcomes-for-beta-cell-replacement-therapy-a-work-in-progress
#19
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...
June 2018: Diabetologia
https://www.readbyqxmd.com/read/29483036/blood-glucose-monitoring-during-aerobic-and-anaerobic-physical-exercise-using-a-new-artificial-pancreas-system
#20
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
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