AP@home

Abstract

In the past years the development of an artificial pancreas (AP) has made great progress and many activities are ongoing in this area of research. The major step forward made in the last years was moving the evaluation of AP systems from highly controlled experimental conditions to daily life conditions at the home of patients with diabetes; this was also the aim of the European Union-funded AP@home project. Over a time period of 5 years a series of clinical studies were performed that culminated in 2 "final studies" during which an AP system was used by patients in their home environment for 2 or 3 months without supervision by a physician, living their normal lives. Two different versions of the AP system developed within this project were evaluated. A significant improvement in glycated hemoglobin was observed during closed-loop conditions despite the fact that during the control period the patients used the best currently available therapeutic option. In addition, a "single-port AP system" was developed within the project that combines continuous glucose monitoring and insulin infusion at a single tissue site. By using such a combined device the patients not only have to carry one less device around, the number of access points through the skin is also reduced from 2 to 1. In summary, close cooperation of 12 European partners, both academic centers and industry, enabled the development and evaluation of AP systems under daily life conditions. The next step is to develop these into products in cooperation with commercial partners.

Efficacy and safety of the artificial pancreas in the paediatric population with type 1 diabetes

“…The results demonstrated that the insulin limit strategy was effective in avoiding overnight and exercise-induced hypoglycaemia, even in the presence of an over-reading glucose sensor [ 59 ]. Another future prospect is to improve the devices with auxiliary technologies that can provide information about the movement of the patient, such as an accelerometer or a recorder of the heart rate [ 60 , 61 ].…”

Remote Blood Glucose Monitoring in mHealth Scenarios: A Review

“…Since 2010, we have been part of the AP@home project, an initiative funded by the European Union within the 7th Framework Programme aimed at designing and implementing the AP [38]. During the five-year project lifespan, several clinical trials were planned, enrolling patients over longer times and scheduling their experiments in environments getting each time closer to real-life conditions.…”

Artificial Pancreas Systems for People With Type 2 Diabetes: Conception and Design of the European CLOSE Project

“…Massive progress has been seen in the advancement of artificial pancreas (AP) systems for the treatment of people with type 1 diabetes (T1D). 1 Recently the first (hybrid) AP system (MiniMed 670G) was granted marketing authorization for the treatment of people with T1D in the United States and the European Union. 2,3…”

“…In this way the AP is taking over control of the patient’s blood glucose levels. 1 In a most advanced design the AP would mean a fully automated dosing of insulin to cover both basal and meal-related insulin requirements. Although this would not lead to a “technical cure” of diabetes, it should mimic glycemic control in healthy people most widely.…”

“…Outpatient clinical trials provided substantial evidence for a safe and effective operation of (hybrid) APs in people with T1D. 5 Until now the longest real-life AP experience was provided by a study implemented by the EU-funded AP@home consortium, 1 which investigated 12 weeks of unsupervised AP use. As compared to sensor-augmented insulin pump therapy (SAP) the percentage of time in the predefined target ranges of sensor glucose concentrations (adults: 70-180 mg/dl, 3.9-10.0 mg/l; children/ adoles-cents: 70-145 mmol/l, 3.9-8.0 mmol/l) was significantly higher in both adults and children/adolescents, accompanied by reduced time in hypoglycemia and no change in total daily insulin doses when using the experimental AP system developed by the consortium.…”