Marching or crawling towards an artificial pancreas

Dr Roman Hovorka (Department of Paediatrics, University of Cambridge)

Following the first reported use of continuous ex vivo glucose measurement in humans by Weller et al in 1960, Kadish used continuous real-time glucose monitoring to close the loop with "on-off system" using an intravenous infusion of insulin and glucose in a subject with diabetes in 1964.

Ten years later, in 1974, two groups independently developed a true "artificial endocrine pancreas". The commercial device, the Biostator (Miles Laboratory Inc., USA) was put into production in 1977.

The last two decades witnessed considerable technological progress. Three continuous or semi-continuous monitors have received regulatory approval. Since the introduction of continuous subcutaneous insulin infusion (CSII), insulin pumps have been miniaturised and their reliability improved. Novel titrating algorithms have been postulated adopting new control paradigms. All these factors have advanced the progress towards a truly personal wearable treatment system.

The presentation will describe the development of artificial pancreas within the EC funded project Adicol. This includes the development of model predictive controller, the development of the metabolic simulator, and clinical testing. Further applications of closed-loop system for insulin delivery at the intensive care unit will be described.