El Páncreas Artificial, Control Automático de Infusión de Insulina en Diabetes Mellitus Tipo 1

Type 1 diabetes mellitus is a chronic disease that affects approximately to 30 million people worldwide and is characterized by high blood glucose concentration levels produced by an absolute deficiency of insulin. That produces numerous long-term complications like retinopathy, nephropathy and neuropathy among others. Current therapies based on the exogenous delivery of insulin (through injections or an insulin pump), do not manage to normalize the glucose levels efficiently. Technological advances in the last decade in continuous glucose monitoring and insulin infusion have been a springboard for the development of the artificial pancreas, or automatic control of insulin infusion. In this work, the past, present and future of this technology, so long awaited by the diabetic patient, will be presented in the form of a tutorial. Current technology for sensorization and actuation will be reviewed, as well as main challenges from the control point of view, different “schools of thought” and clinical studies for controllers performance evaluation, and tools for the validation of controllers through simulation. Due to the complexity of the problem, the development of the artificial pancreas will be staggered, resulting progressively in an improvement of the patient’s quality of life. The big advances during last five years foresee a close horizon for a first generation of artificial pancreas.