What’s the Time? Does the Artificial Pancreas Need to Know?

The development of a closed-loop artificial pan-creas (AP) represents a major technological ef-fort that aims to improve glucose control,prevent complications, and decrease disease burden for patients with diabetes. An AP consists of three components: 1) a subcutaneous glucose monitor, 2) a subcutaneous insulin pump, and 3) an automated control algorithm (Fig. 1) (1,2). Until recently, clinical trials in-vestigating AP function were limited to controlled, in-hospital settings (1,3). However, several recent studies showed that an AP can maintain (4) or even improve (5) glycemic control outside of the hospital. Several types of control algorithms have been de-veloped. On the one hand, proportional-integrative de-rivative algorithms use a classical feedback approach. On the other hand, model-predictive control (MPC) algorithms continuously update a strategic plan for glucose control. These MPC algorithms can possibly be further improve