Publications

The artificial pancreas (AP) represents a transformative approach in the management of type 1 diabetes mellitus, aiming to automate insulin delivery and maintain glucose homeostasis. This narrative review synthesizes current knowledge on AP technologies, including hybrid and fully closed-loop systems, sensor modalities, actuation mechanisms, control algorithms, and clinical outcomes. Historical development from early intravenous systems to modern wearable devices highlights the evolution of closed-loop insulin delivery and bihormonal approaches. Advances in continuous glucose monitoring, predictive algorithms, and personalized control strategies have demonstrated significant improvements in glycemic control, reduction of hypoglycemic events, and enhanced patient quality of life across pediatric, adolescent, and adult populations. Despite clinical successes, challenges persist in sensor accuracy, real-world usability, regulatory approval, and integration of multi-hormonal or multidrug approaches. Ethical considerations, patient adherence, and methodological limitations in clinical evaluations further underscore the need for ongoing research. Future directions emphasize standardization of key performance metrics, enhanced interoperability, and expansion of artificial pancreas accessibility to diverse populations. Overall, AP technologies offer a promising pathway toward replicating physiological insulin regulation and improving outcomes for individuals with type 1 diabetes.