Chapter 9 The future of pumps and sensors: research and development

• Current pumps are already highly technical and are expected to develop further• Pumps that receive information from continuous glucose monitoring (CGM) systems are likely to be in increasing use in the coming years. The first type is a version that automatically suspends insulin delivery in the event of hypoglycaemia, the first step towards an artificial pancreas• A fully closed-loop insulin delivery device with a glucose sensor coupled to a computer-controlled insulin infusion pump is being actively researched. It is a complex problem that may require some years of development. A hybrid system with patient-activated meal-time insulin and closing-the-loop only in the basal state is a likely first development for clinical use• Smaller, simpler patch pumps with integrated cannulae and novel pumping mechanisms are under development. Some may be used in type 2 diabetes• Fully implantable insulin pumps have been in the research phase for some decades and, as yet, have significant problems for transfer to widespread routine clinical use