Current Advances of Artificial Pancreas Systems: A Comprehensive Review of the Clinical Evidence

Moon, Sun Joon; Jung, Inha; Park, Cheol-Young

doi:2021.45.6.813

Diabetes Metab J > Volume 45(6); 2021 > Article

Review

Technology/Devise

Diabetes & Metabolism Journal 2021;45(6):813-839.
DOI: https://doi.org/10.4093/dmj.2021.0177 Published online November 22, 2021.

Current Advances of Artificial Pancreas Systems: A Comprehensive Review of the Clinical Evidence

Sun Joon Moon

, Inha Jung

, Cheol-Young Park

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence: Cheol-Young Park, Tel: cydoctor68@gmail.com,

Received: 30 July 2021 • Accepted: 24 October 2021
*Sun Joon Moon and Inha Jung contributed equally to this study as co-first authors.

Abstract

Since Banting and Best isolated insulin in the 1920s, dramatic progress has been made in the treatment of type 1 diabetes mellitus (T1DM). However, dose titration and timely injection to maintain optimal glycemic control are often challenging for T1DM patients and their families because they require frequent blood glucose checks. In recent years, technological advances in insulin pumps and continuous glucose monitoring systems have created paradigm shifts in T1DM care that are being extended to develop artificial pancreas systems (APSs). Numerous studies that demonstrate the superiority of glycemic control offered by APSs over those offered by conventional treatment are still being published, and rapid commercialization and use in actual practice have already begun. Given this rapid development, keeping up with the latest knowledge in an organized way is confusing for both patients and medical staff. Herein, we explore the history, clinical evidence, and current state of APSs, focusing on various development groups and the commercialization status. We also discuss APS development in groups outside the usual T1DM patients and the administration of adjunct agents, such as amylin analogues, in APSs.

Key Words: Blood glucose self-monitoring, Diabetes mellitus, type 1, Hypoglycemia, Insulin infusion systems, Pancreas, artificial, Wearable electronic devices

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