Artificial Pancreas: <i>In Silico</i> Study Shows No Need of Meal Announcement and Improved Time in Range of Glucose With Intraperitoneal vs. Subcutaneous Insulin Delivery

Contemporary Artificial Pancreas (AP) consists of a subcutaneous (SC) glucose sensor, SC insulin pump and control algorithm. Even the most advanced systems are far from optimal, in particular due to non-physiologic nature route. While delivery is convenient minimally invasive, it introduces delays action that make tight difficult, particularly during meals. In addition frequent patient interventions needed, e.g., at mealtime. The intraperitoneal (IP) could address this major challenge since exhibits faster pharmacokinetics/pharmacodynamics, hence making easier quickly respond glycemic disturbances. A 1-day hospital closed-loop study has shown significant improvements IP vs AP, meal announcement not necessary. However, AP been tested more realistic everyday life conditions. work we have performed an silico 14 days by using UVA/Padova simulator which includes intra- inter-day variability sensitivity several real scenarios. We show superiority terms quality (time range 87% 80% SC) without need announcement.