Evolution of Insulin Delivery Devices: From Syringes, Pens, and Pumps to DIY Artificial Pancreas
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REVIEW
Evolution of Insulin Delivery Devices: From Syringes, Pens, and Pumps to DIY Artificial Pancreas Jothydev Kesavadev
. Banshi Saboo . Meera B. Krishna .
Gopika Krishnan
Received: March 4, 2020 Ó The Author(s) 2020
ABSTRACT The year 2021 will mark 100 years since the discovery of insulin. Insulin, the first medication to be discovered for diabetes, is still the safest and most potent glucose-lowering therapy. The major challenge of insulin despite its efficacy has been the occurrence of hypoglycemia, which has resulted in sub-optimal dosages being prescribed in the vast majority of patients. Popular devices used for insulin administration are syringes, pens, and pumps. An artificial pancreas (AP) with a closed-loop delivery system with [ 95% time in range is believed to soon become a reality. The development of closed-loop delivery systems has gained momentum with recent advances in continuous glucose monitoring (CGM) and computer algorithms. This review discusses the evolution of syringes, disposable, durable pens and connected pens, needles, tethered and patch insulin pumps, bionic pancreas, alternate controller-enabled infusion (ACE) pumps, and Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12199748. J. Kesavadev (&) M. B. Krishna G. Krishnan Jothydev’s Diabetes Research Centre, Mudavanmugal, Thiruvananthapuram, Kerala, India e-mail: [email protected] B. Saboo DiaCare, Ahmedabad, Gujarat, India
do-it-yourself artificial pancreas systems (DIYAPS).
Keywords: Artificial pancreas; Diabetes mellitus; Do-it-yourself artificial pancreas; Glycemic targets; Hypoglycemia; Insulin; Insulin delivery devices; Insulin syringes; Insulin pens; Insulin pumps Key Summary Points 2021 will mark 100 years since the discovery of insulin. Occurrence of hypoglycemia has resulted in sub-optimal use of insulin. Insulin delivery devices have rapidly advanced in the past 2 decades. A comprehensive review of the insulin delivery devices is presented in this article. Advances in the technologies from syringes and pens to pumps and a do-ityourself (DIY) artificial pancreas aim to accomplish 100% TIR and 0% time in hypoglycemia.
Diabetes Ther
INTRODUCTION All patients with type 1 diabetes mellitus (T1D) require insulin because of its absolute deficiency. With increasing longevity in type 2 diabetes mellitus (T2D) patients, they will require insulin because of progressive b-cell failure [1–3]. Even though insulin is the most powerful therapeutic option available to control hyperglycemia, patients with diabetes experience various challenges including, but not limited to, interference with daily living, financial constraints, complexity of regimens, injection discomfort, and public embarrassment for initiating and adhering to insulin therapy [2, 4]. Therefore, addressing such barriers with advanced and effective technologies for insulin delivery is essential to avoid the complications related to diabetes. The origin of diabetes therapy dates back to the 1920s with the disco
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