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Closed-loop systems for type 1 diabetes will be the new future in a couple of years, according todays session. T1DM is 24 h/7/365 day disease with demanding focuse on the blood glucose, it should not be too high and not to low. Always on a daily basis, minute-to-minute the patient should be aware how to handle the challenges, to control diabetes, and every single day, and even more complicated if the patient after 10-20 years has unawareness of hypoglycemia.

Insulin is a wondserful drug, but also a frustrating one, And it is not precribed like a pill, it needs perfect steering, from the patient - a very tuff job. Insulin needs better steering devices to be more safe.

Every 5 min a computer algorithm can decide the amount of insulin toi be given, by a pump and a CGM controls the blood glucose. These systems work in synergy. The patient can relax, day and night. It works automatic. And it dynamic continuously updates the algorithm. The control will be better the longer time the system works. You just have to stop in the weight of the patient and the ordinary insulin doses - and then the system takes over, like an autopilot in an aircraft or a ship on the ocean. There will be no restrictions on diet or exercise. The system can handle these challenges, too. It will reduce the burdens of diabetes and also providing better metabolic control. This is the genuine goal for the nclosed-loop system in the near future.    

The latest issue is to use a dual hormone bionic system with glucagon besides insulin. In a random control trial cross over with 39 adults the investigator Edward Damiano, prof biomedical enginieering Boston University used the system for 11 days. The results were significant less time in hypoglycemia area, better mean glucose, and less glucose variations.    

At the ADA meeting the new Medtronic pump and Animas pump will be presented, and they will take care together with CGM both the low and high glucose levels by dynamic decreasing stopping respective increasing insulin to the body. We are lookinhg forward to get more results

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