Dr Eda Cengiz on Improvements in Closed-Loop Systems

Eda Cengiz, MD, MHS, FAAP, associate professor of pediatrics at Yale School of Medicine addresses the improvements that are needed in the future of closed-loop systems for diabetes treatment.

Transcript (slightly modified)

What are the opportunities for improvement with the current closed-loop systems and how can they be addressed?

I know the system is approved but this is not the end of the closed-loop system research, it’s just the beginning actually, we are just starting.

We have a hybrid closed-loop system. It still requires users input for meals, you still have to count carbs, and in the background its adjusting insulin delivery. For future systems, our ultimate goal is the full automated system. It's on autopilot; you don’t have to worry about it, and it will deliver insulin, make adjustments, and in a way you can forget about diabetes—that’s the goal. To get there, we need better devices, maybe even smaller devices, better connection—so phone or other devices—and personalized medicine, like fine-tuning that insulin dose adjustments just for you.

I think we can do a lot more in that field and investigate closed-loop systems in populations like younger children and elderly so we can customize treatments for them. When you have a fast system, when you have a system that’s optimizing insulin delivery every 5 minutes, you need better insulins to keep up with that. It’s like you can’t think of using those old phone and internet connections with your iPads now. It might work, but you’re not going to get the best results with those old, slow internet connections. Like that, we need faster methods to accelerate insulin action so it can keep up with the system.

I think there is so much more, we are going to learn a lot, and this is going to also be a learning experience. Once we have more experience, we’ll have more questions and more ways to improve the system. But, the ultimate goal is just to have a system that is small, easy to use, and takes away all of the burden and fear of hypoglycemia so you can enjoy your life and the algorithm and device will do the work for you. So, that’s hopefully going to be the system of the near future.