Purpose of review: Here, we provide a review of recent advancements in closed-loop or automated insulin delivery systems commonly referred to as the "artificial pancreas" (AP) for the management of type 1 diabetes (T1D).
Recent findings: The use of hybrid closed-loop devices in children and adolescents with T1D consistently increases time in the target glucose range (70-180 mg/dL) without increasing the risk of hypoglycemia. Although hybrid closed-loop systems are able to maintain fairly tight glycemic control overnight, daytime control remains challenging, primarily due to meals and exercise, and careful carbohydrate counting and meal boluses remain essential components of optimal diabetes control. Bihormonal and fully automated AP systems remain investigational at this time. While commercially available hybrid closed-loop AP systems improve glycemic control in children with T1D, more work is needed to achieve a fully automated AP system and decrease the burden of using diabetes technology.
Keywords: Artificial pancreas; Automated insulin delivery; Closed-loop control; Pediatric; Type 1 diabetes.