Diabetes Mellitus and Closed-Loop Insulin Delivery

Adams, Gary G.; Clark, J. Stephen; Sahota, Tarsem; Tanna, Sangeeta; Taylor, M. Joan

doi:10.1080/02648725.2000.10648002

Cited by 9 publications

(4 citation statements)

References 147 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Under normal physiological conditions, glycogenesis and glycogenolysis ensure that the euglycaemic levels are maintained within the range of 3.5–6.5 mmol/L 33. In a patient presenting with diabetes, however, hyperglycaemic states can prevail because insulin does not function normally.…”

Section: Resultsmentioning

confidence: 99%

Insulin‐based regimens decrease mortality rates in critically ill patients: a systematic review

Langley

Adams

2007

Diabetes Metabolism Res

Self Cite

View full text Add to dashboard Cite

SummaryObjectives To determine whether treatment with glucose-insulin-potassium (GIK), insulin and glucose, or insulin by itself is beneficial in limiting organ damage after acute myocardial infarction (AMI) and reducing mortality and morbidity among critically ill hyperglycaemic patients.Methods Systematic review of randomized controlled trials.Main outcome measure To assess whether tight glycaemic control reduces morbidity and mortality. Studies reviewed Randomized controlled trials of insulin-based regimens in the treatment of critically ill patients.Results Nine hundred and twenty-four potentially relevant studies were identified and screened for retrieval. Of these, 16 randomized controlled trials met the inclusion criteria (Table 1). Ten studies examined the effects of GIK, and six of these studies reported a mortality reduction with GIK treatment in addition to enhanced myocardial performance. Five studies examined the administration of insulin. Among these studies, tight glycaemic control of blood glucose in one study was shown to reduce morbidity and mortality of patients in intensive care. Only one study examined insulin/glucose therapy, and it showed a post-myocardial infarction mortality reduction of one year.Conclusions There is increasing evidence that maintaining normoglycaemia and treatment with insulin-based regimens is beneficial in limiting organ damage and significantly reduces both morbidity and mortality in critically ill patients who require intensive care therapy.

show abstract

Section: Resultsmentioning

confidence: 99%

Insulin‐based regimens decrease mortality rates in critically ill patients: a systematic review

Langley

Adams

2007

Diabetes Metabolism Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…One element that is lacking in even the most advanced commercial systems is an intrinsic algorithm to compute the dosing schedule [6, 9, 32-40]. Such an algorithm would completely close the loop and take the patient out of the picture.…”

Section: Nonpolymeric Systemsmentioning

confidence: 99%

Stimuli sensitive polymers and self regulated drug delivery systems: A very partial review

Siegel

2014

Journal of Controlled Release

111

View full text Add to dashboard Cite

Since the early days of the Journal of Controlled Release, there has been considerable interest in materials that can release drug on an “on-demand” basis. So called “stimuli-responsive” and “intelligent” systems have been designed to deliver drug at various times or at various sites in the body, according to a stimulus that is either endogenous or externally applied. In the past three decades, research along these lines has taken numerous directions, and each new generation of investigators has discovered new physicochemical principles and chemical schemes by which the release properties of materials can be altered. No single review could possibly do justice to all of these approaches. In this article, some general observations are made, and a partial history of the field is presented. Both open loop and closed loop systems are discussed. Special emphasis is placed on stimuli-responsive hydrogels, and on systems that can respond repeatedly. It is argued that the most success at present and in the foreseeable future is with systems in which biosensing and actuation (i.e. drug delivery) are separated, with a human and/or cybernetic operator linking the two.

show abstract

“…A self-regulating (closed-loop) insulin delivery system, where insulin can be delivered automatically to match blood glucose levels, would be important in the treatment of diabetes (Adams, Clark, Sahota, Tanna, & Taylor, 2000;Taylor, Clark, Tanna, & Sahota, 2003;Taylor, Tanna, & Sahota, 2004).…”

Section: Introductionmentioning

confidence: 98%

UV Cross-Linked Dextran Methacrylate—Concanavalin A Methacrylamide Gel Materials for Self-Regulated Insulin Delivery

Taylor

Tanna

Sahota

2008

Drug Development and Industrial Pharmacy

Self Cite

View full text Add to dashboard Cite

In this study, the successful acrylic derivatization of dextran and concanavalin A (con A) to form dextran methacrylate and con A methacrylamide is shown. These derivatized acrylic monomers are then photopolymerized in the presence of a water soluble photoinitiator Irgacure ® under various conditions to form covalently bonded glucose-responsive gel materials, which undergo a transformation to sol in the presence of free glucose. Rheological data have revealed that as the degree of substitution for dextran methacrylate is increased, a more elastic material is produced due to the increased covalent linkages. Some of these gel systems show negligible component loss in in vitro diffusion experiments used to simulate the behavior of the cross-linked gel, as would be used in a self-regulated insulin delivery device.

show abstract

Diabetes Mellitus and Closed-Loop Insulin Delivery

Cited by 9 publications

References 147 publications

Insulin‐based regimens decrease mortality rates in critically ill patients: a systematic review

Insulin‐based regimens decrease mortality rates in critically ill patients: a systematic review

Stimuli sensitive polymers and self regulated drug delivery systems: A very partial review

UV Cross-Linked Dextran Methacrylate—Concanavalin A Methacrylamide Gel Materials for Self-Regulated Insulin Delivery

Contact Info

Product

Resources

About