Table 1

Closed-loop approaches according to treatment objective


Insulin-delivery modulation

Reduce severity and/or duration of hypoglycemia

Suspension of insulin delivery at hypoglycemia (low glucose suspend)

Hypoglycemia prevention

Pre-emptive suspension/reduction of insulin delivery before hypoglycemia occurs

Control to range

Modulation (increase or decrease) of insulin delivery outside target range to limit hypoglycemia and hyperglycemic excursions

Overnight glucose control

Modulation of insulin delivery for nocturnal glucose control; lifestyle disturbances have limited effect

Closed-loop system with meal/exercise announcement

Modulation of insulin delivery after meals using boluses administered by patient with announcement of these, and exercise to the algorithm

Fully closed-loop system

Modulation of insulin delivery when the control algorithm is unaware of meals, exercise, stress and other lifestyle disturbances that affect glucose control; glucagon may be coadministered to reduce risk of hypoglycemia

Elleri et al. BMC Medicine 2011 9:120   doi:10.1186/1741-7015-9-120

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