TABLE 1

Components of the AP system and the improvements needed before the ambulatory AP enters mainstream use

ComponentsDesirable improvements
Glucose sensingReliability (minimize missing data)
Error (reduce noise and drift, improve calibration)
Durability and wearability
Long-term implantable and noninvasive technologies
Insulin deliveryInsulin pharmacokinetics and pharmacodynamics
Reliability of infusion (infusion sets)
Durability and wearability
Alternative routes (intraperitoneal, intradermal, inhaled)
Control algorithmModel prediction (improve horizon and accuracy)
Individualization (prescription of a control algorithm)
Automated meal and exercise recognition and control
Real-time adaptation to patient physiology and behavior
PlatformCommunication between devices (first step to integration)
Remote monitoring, alerts, and telecommunication
Integration of pump, sensor, and control devices
Integration of sensing and insulin delivery sites
Human factorsDevice user interface (typically graphical user interface)
Hazard identification and task prioritization
Hazard mitigation and unexpected event control
Human factors validation testing