Insulinothérapie en boucle fermée : vers le pancréas artificiel ambulatoire

The availability of safe and reliable insulin pumps, fast-acting insulin analogues and devices allowing for continuous glucose measurement, has renewed the project of a continuous insulin infusion modulated at all times by blood glucose levels, i.e. in closed-loop. The recent research efforts focussed on the development of innovative algorithms in order to set a safe and efficient functional link between continuous glucose measurement and insulin infusion. Indeed, the combined delays of insulin action when subcutaneously infused and glucose estimation from measured glucose in the insterstitium represent the main concerns. The building of simulation platforms has boosted the creation of algorithms based upon the principle of model predictive control. The obtained validation of these control algorithms in hospital environment allows now the first ambulatory trials of wearable artificial pancreas models thanks to communication platforms which integrate the key-elements of the system.