This setup fully automates basal insulin doses but still requires carb
counting and input from users to con;rm correction insulin doses
and mealtime boluses. Because such systems are the least ambitious,
they’re the ;rst to make it through the Food and Drug Administration’s
clearance process. The ;rst device in this category to hit the market is Medtronic’s MiniMed 670G.
Also in development: Insulet’s tubeless Omnipod Horizon Automated Glucose Control System, Bigfoot
Biomedical’s Bigfoot Smartloop, and Tandem Diabetes Care’s inControl.
Here are some of the di;erent systems researchers
hope to roll out in the next few years:
Damiano and others are working on arti;cial pancreas systems
that can administer both insulin and glucagon, the hormone that
tells the liver to release stored glucose into the bloodstream to
replenish low blood glucose levels. Ideally, such devices will be
able to prevent both blood glucose highs and lows, further reducing the burden of care for people with
diabetes. But these are still several years from commercial approval. “A bi-hormonal system is more
complicated to develop,” Damiano says, “but it provides a simpler end technology to the user.” One
hurdle: There’s no commercially available or FDA-approved stable liquid glucagon—yet.
When they’re commercially available, possibly in early 2019, the
algorithms in these devices will be able to sense and bolus for mealtime
blood glucose surges and other irregularities by themselves. The Beta
Bionics iLet is an example of a closed-loop system.