Evolution of Insulin Delivery Devices: From Syringes, Pens, and Pumps to DIY Artificial Pancreas

Abstract

The year 2021 will mark 100 years since the discovery of insulin. Insulin, the first medication to be discovered for diabetes, is still the safest and most potent glucose-lowering therapy. The major challenge of insulin despite its efficacy has been the occurrence of hypoglycemia, which has resulted in sub-optimal dosages being prescribed in the vast majority of patients. Popular devices used for insulin administration are syringes, pens, and pumps. An artificial pancreas (AP) with a closed-loop delivery system with [ 95% time in range is believed to soon become a reality. The development of closed-loop delivery systems has gained momentum with recent advances in continuous glucose monitoring (CGM) and computer algorithms. This review discusses the evolution of syringes, disposable, durable pens and connected pens, needles, tethered and patch insulin pumps, bionic pancreas, alternate controller-enabled infusion (ACE) pumps, and do-it-yourself artificial pancreas systems (DIY-APS).

On the centenary of the insulin discovery

“…Уже около 40 лет идут работы по пересадке бета-клеток с параллельной селективной иммуносупрессией их отторжения [10]; по выращиванию иммунологически защищенных стволовых слеток, которые после пересадки реципиенту запрограммированы на преобразование в бета-клетки [11]; по полной пересадке поджелудочной железы: активно разрабатываются системы замкнутого контура в помповой инсулинотерапии и другие технологии [12,13].…”

Delivery of Insulin via Skin Route for the Management of Diabetes Mellitus: Approaches for Breaching the Obstacles

“…Later, alternative routes—for instance, pulmonary, nasal, and oral routes—were investigated [ 8 , 9 ]. Pens, jet injectors, sharp needles, supersonic injectors, and infusion pumps have been introduced to minimize pain and enhance adherence to insulin regimens [ 10 , 11 , 12 , 13 ]. Still, compared to subcutaneous injections, the insulin absorption from the aforementioned techniques into the blood is quite low, and, consequently, other systems for insulin therapy are required [ 14 , 15 ].…”

Standardized Hybrid Closed-Loop System Reporting

“…38,39 Another system not approved by the FDA or European Medicine Agency, but used by a few thousand patients, is commonly referred to as ''Do-it-Yourself AP system'' in the USA and Europe. [40][41][42] There are other HCL systems in different stages of development (such as OP5 HCL system by Insulet [Acton, MA] and insulin-only HCL system by BetaBionics [Boston, MA]). 43 Each diabetes technology comes with its own proprietary software platform to download their device.…”