The artificial pancreas: Reducing safety risk via intra-peritoneal insulin delivery

The Artificial Pancreas is a medical device, currently in development, that aims to provide automatic regulation of blood glucose (BG) levels in ambulatory type 1 diabetes mellitus sufferers. The most popular approach utilises subcutaneous (SC) continuous glucose monitoring (CGM) combined with SC insulin injection controlled by a Model Predictive Control (MPC) algorithm. From a safety risk perspective problematic elements include the performance robustness of the CGM and the need for a pre-meal insulin bolus to provide satisfactory post prandial BG regulation. This contribution presents preliminary in silico studies which indicate that the use of an alternative approach to insulin delivery - intra-peritoneal (IP) infusion - could provide a similar level of BG regulation (as obtained with SC delivery), without the need for the pre-meal bolus. This simplified control architecture would remove the patient safety risk related to the administration (or not) of pre-meal bolus.