The future of open- and closed-loop insulin delivery systems

Abstract

We have analysed several aspects of insulin-dependent diabetes mellitus, including the glucose metabolic system, diabetes complications, and previous and ongoing research aimed at controlling glucose in diabetic patients. An expert review of various models and control algorithms developed for the glucose homeostasis system is presented, along with an analysis of research towards the development of a polymeric insulin infusion system. Recommendations for future directions in creating a true closed-loop glucose control system are presented, including the development of multivariable models and control systems to more accurately describe and control the multi-metabolite, multi-hormonal system, as well as in-vivo assessments of implicit closed-loop control systems.

Facile one-pot synthesis of fluorescent hyperbranched polymers for optical detection of glucose

“…This could lead to better control of blood glucose levels in diabetic patients. [12] This approach involves an enzyme-substrate reaction that results in a change of microenvironment.…”

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

“…This practice is typically “low frequency” since observations and corrections may occur on the time scales of days, weeks, or months. Cancer chemotherapy may be one area in which relatively sophisticated models of dosing and monitoring are of importance, due to the severity of side effects [6]. …”

“…There has been considerable research, however, into automatic control algorithms and instrumentation in the domains of anesthesia and critical care [6-10]. In this case, patient’s vital signs, including blood pressure, tidal volume, heart rate, cardiac output, EKG, EEG, and blood chemistry (including pH, pO 2 , and pCO 2 ) can be monitored nearly continuously, and the critical state of the patient is such that sudden changes in these signs require rapid attention and compensation.…”

“…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.…”

Electrodeposition of Biocomposite Film Onto ZnO Nanoparticles Modified Electrode for Closed-Loop Insulin Delivery

“…As the core part of insulin delivery system, the link of continuous glucose-sensing to insulin delivery in a small and selfregulating system is still challenging and highly desirable. 6 For this propose, several controlled delivery systems have been investigated for insulin release. [7][8][9] Most of the systems studied so far were based on the incorporation of * Author to whom correspondence should be addressed.…”