Feasibility of Outpatient Fully Integrated Closed-Loop Control First studies of wearable artificial pancreas Featured Article: Boris P. Kovatchev, Ph.D.,

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Feasibility of Outpatient Fully Integrated Closed-Loop Control First studies of wearable artificial pancreas Featured Article: Boris P. Kovatchev, Ph.D., Eric Renard, M.D., Ph.D., Claudio Cobelli, Ph.D., Howard C. Zisser, M.D., Patrick Keith-Hynes, Ph.D., Stacey M. Anderson, M.D., Sue A. Brown, M.D., Daniel R. Chernavvsky, M.D., Marc D. Breton, Ph.D., Anne Farret, M.D., Ph.D., Marie-Josée Pelletier, M.D., Jérôme Place, M.S.C., Daniela Bruttomesso, M.D., Ph.D., Simone del Favero, Ph.D., Roberto Visentin, M.S.C., Alessio Filippi, M.D., Rachele Scotton, M.D., Angelo Avogaro, M.D., Ph.D., Francis J. Doyle III, Ph.D. Diabetes Care Volume 36: July, 2013

STUDY OBJECTIVE To evaluate the feasibility of a wearable artificial pancreas system, the Diabetes Assistant (DiAs) System uses a smart phone as a closed-loop control platform Kovatchev B. P. et al. Diabetes Care 2013;36:

STUDY DESIGN AND METHODS 20 patients with type 1 diabetes were enrolled at the Universities of Padova, Montpellier, and Virginia and at the Sansum Diabetes Research Institute U.S. studies were conducted entirely in an outpatient setting Studies in Italy and France were hybrid hospital–hotel admissions A continuous glucose monitoring/pump system was placed on the subject and was connected to DiAs Patient operated the system via the DiAs user interface in open-loop mode (first 14 h of study), switching to closed- loop for the remaining 28 h Study personnel monitored remotely via 3G or WiFi connection to DiAs and were available onsite for assistance Kovatchev B. P. et al. Diabetes Care 2013;36:

RESULTS Total duration of proper system communication functioning was h (274 h in open-loop and h in closed-loop) 97.7% of the total possible time from admission to discharge represented Predetermined primary end point of 80% system functionality was exceeded Kovatchev B. P. et al. Diabetes Care 2013;36:

CONCLUSIONS Contemporary smart phones are capable of running outpatient closed-loop control Future steps should include equipping insulin pumps and sensors with wireless capabilities, as well as studies focusing on control efficacy and patient-oriented clinical outcomes Kovatchev B. P. et al. Diabetes Care 2013;36: