**6.5 Pancreas**

Artificial pancreas treatment is an alternative treatment that combines insulin pump and continuous glucose monitoring with a control algorithm to deliver insulin in a glucose- responsive manner. It is also named "closed-loop system" or "automated insulin delivery". The artificial pancreas can be either insulin-only or dual hormone [glucagon] type. A systemic review and meta-analysis conducted by Bekiari and associates have shown that artificial pancreas systems are beneficial and safe treatment options for patients with type 1 diabetes. The authors have noted that the current research evidence on artificial pancreas systems is limited by inconsistency in outcome reporting, small sample size, and short follow-up duration of individual trials. So the future efforts should focus on such issues along with exploring artificial pancreas use in relevant groups of people with type 2 diabetes such as those with inpatient hyperglycemia [53]. Other areas of interest for the future would be faster acting insulin in the artificial pancreas, increased accuracy, and reduced lag-time of continuous glucose monitoring. Self-learning adapting algorithms will improve the level of automation and effectiveness. Cost-effectiveness in the general public is another issue to be taken into consideration [54].
