CLOSE – Automated glucose control at home for people with chronic disease
Innovation in interconnected diabetes care
CLOSE (automated glucose control at home for people with chronic disease) is going to implement closed-loop metabolic control by means of an Artificial Pancreas (AP) for people with type 2 diabetes (T2D). Initially, CLOSE is going to implement a comprehensive product and service package (AP+) centered on closed-loop metabolic control within a French ecosystem for homecare service provision. From there CLOSE will create a portfolio of AP+ solutions tailored to the needs and requirements of wider patient populations and different care environments. In perspective CLOSE will make AP+ a part of interconnected ecosystems for health and social care. CLOSE follows the triple goal of improving the patients’ healthcare experience and satisfaction, the health of people with diabetes, and the sustainability of healthcare systems.
The Artificial Pancreas (AP) core system approaches a “technical cure” of diabetes by closing the loop between glucose levels and insulin infusion when the insulin infusion rates are varied by a control algorithm taking changes in glucose levels into account. The algorithm can be implemented in a smart phone. The communication between the components can be established via Bluetooth. Glucose levels are measured continuously by a glucose sensor in the interstitial fluid.
CLOSE AP+ product and service package for people with T2D on homecare. AP+ comprises the AP, obligatory training and education modules, and a panel of outcome predictors of performance indicators helping to identify patients who might benefit most from AP usage and to measure the impact of AP operation on the quality and effectiveness of diabetes care.
The CLOSE EIT Health innovation project serves to innovate care for insulin-treated people with type 2 diabetes (T2D) by introducing an Artificial Pancreas (AP) for closed-loop metabolic control (Figure 1). In order to achieve most attractive risk- and cost-benefit balances CLOSE is putting the AP into the center of comprehensive product and service packages (AP+, Figure 2) designed by realizing a co-creative and open innovation approach.
Initially CLOSE is going to set up a French AP+ test scenario (Figure 2) within a well-established ecosystem for the provision of homecare services to people with chronic disease(s). Here – at the crossroads of patients, caregivers, payers, and prescribers ̶ CLOSE will prove a safe and cost-effective AP+ operation. Using homecare as a starting point AP+ operation can be easily adapted to both operation in the hospital and under the more independent living conditions of patients with T2D. Geographical scalability will benefit from a careful consideration of existing local/national competencies and healthcare structures. A train-the-trainer approach to efficiently develop and maintain a network of professionals delivering trainings to those installing, operating, and monitoring AP+ operation will guarantee a safe and cost effective operation of AP+ wherever.
CLOSE will improve diabetes care, alleviate strain on supporting relatives, prevent further health complications and reduce treatment costs.
Publications of CLOSE partners
Autor(s): Fortes Ana M., Granell Antonio, Pezzotti Mario, Bouzayen Mondher
Title: Molecular and Metabolic Mechanisms Associated with Fleshy Fruit Quality
Place of Publication: Frontiers in Plant Science Volume 8:1236
CDTM Trend Seminar 2016
The CLOSE EIT Health innovation project by design is executed by a partnership which would not exist without the enabling EIT Health innovation environment. The partnership holds key capabilities in healthcare service provision, AP development, education & training, performance measurement as well as market implementation and advancement of diabetes technologies. In addition expertise in healthcare research, economic modelling, and the development of performance measurement instruments is available within the partnership. Furthermore the CLOSE partnership receives valuable advice from the CLOSE advisory board members Prof. Dr Eric Renard (Centre Hospitalier Universitaire de Montpellier, Department of Endocrinology, Diabetes and Nutrition) and Prof. Dr Lutz Heinemann (SCIENCE & CO, Profil GmbH).
Profil Institut für Stoffwechselforschung GmbH
Profil GmbH is a globally operating full service CRO founded in 1999 by Tim Heise and Lutz Heinemann. Profil GmbH operates two clinical research units in Neuss and Mainz (Germany). The company is uniquely positioned by its focus on translational and early phase clinical trials evaluating drugs and devices for people living with obesity, (pre)diabetes and diabetes complications. Profil has been involved in developing nearly all major anti-diabetic compounds and devices in the market today. Together with the Academic Medical Center Amsterdam Profil GmbH has coordinated the EU-funded AP@home project dedicated to the development of an AP system for people with type 1 diabetes. Profil GmbH is the organisation coordinating CLOSE EIT Health innovation project.
Air Liquide Santé International
Air Liquide Santé International is the European leader in homcare service provision to chronically ill patients. The corporation follows the ambition to facilitate the access of chronic patients to infusion therapies through the integration of innovative solutions into its homecare service portfolio. Within the CLOSE project Air Liquide Santé International contributes its integrated homecare operations service platform CLOSE will use as a co-creation environment for developing the French AP+ scenario. ALSI carries key responsibilities for AP systems integration, stakeholder engagement and customizing the train-the-trainer program, and outreaching the French AP+ paradigm across Europe and globally.
IESE, Business School, Universidad de Navarra
The IESE Business School deploys a wide range of professional and training capacities in all managerial aspects, being at the vanguard of innovative management in business and public administration for more than 50 years. Within CLOSE IESE will lead business analysis and modelling of homecare solutions for T2D management and will determine the potential for expansion and growth into new markets. IESE will also produce a detailed analysis of the conditions in which cost-effectiveness will be achievable. AP market entry barriers and key enablers will be identified and the value of an AP for all relevant stakeholders will be defined.
Prof. Dr Magda Rosenmöller
Senior Lecturer of Production, Technology and Operations Management
Katholieke Universiteit Leuven
The group of Clinical and Experimental Endocrinology involved in the CLOSE project (lead by Prof. Mathieu and Prof. Gillard), is one of the world leaders in Clinical and Experimental Diabetolgy. Beyond performing basic research in prevention and intervention in T1D, obesity and T2D the group is coordinating a large network of clinical research groups being part of very active pharmacological intervention programs, interacting with major pharma corporations and major initiatives in gestational diabetes. There is also a strong engagement in translational research on islet transplantation and continuous glucose monitoring. Due to its involvement in the organization of diabetes care and the evaluation of clinical outcomes in diabetes, the group is very interested in the impact of the disease on the patients’ quality and quantity of life.
Medical University of Lodz
The Medical University of Lodz is one of the largest medical universities in Poland. Its clinical facilities include four hospitals that score top positions in national rankings. The University educates future doctors and specialists in medical sciences and medicine-related fields. The universities key contributions to CLOSE is the provision of education and trainings on new innovation technologies, such as AP+, to young doctors and other medical staff, facilitating the deployment of AP+ across Eastern Europe.
Sanofi is committed to working to address the diabetes public health concern worldwide through its integrated treatments and medical devices. Sanofi has an 85-year commitment to improving the health and wellbeing of diabetes patients. Sanofi has recently inaugurated a €75 million high-tech building designed to produce a new type of insulin to treat around 6 million patients. It houses the most modern technology, enabling Sanofi to achieve the highest sterility standards in the industry. The company is driven by the strong commitment to truly patient-centred, integrated diabetes management and reinforces its commitment in diabetes by building strategic alliances and collaborations with the aim to enhance life of people living with diabetes.
Aqua Institute GmbH
aQua is an independent and impartial corporation that provides services for quality assurance in the field of science. It is one of the pioneers of medical quality circles (peer review groups), the evaluation of new treatment models, the development and implementation of quality indicators, patient surveys, and data driven quality management. It is one of the most experienced and successful providers of concepts and solutions in the field of healthcare quality improvement in Germany and can provide data analysis, counselling and strategies for quality improvement and quality assurance as well as the implementation of comprehensive projects. Within the CLOSE project, aQua contributes its expertise to the development of indicators for a comprehensive impact analysis, to healthcare research and assuring healthcare quality during the development and application of an AP+.
European Research and Project Office GmbH
EURICE offers comprehensive support services for the planning, initiation, and implementation of international collaborative research and innovation projects with competencies in project, communication and innovation management. Given the scope and high complexity of multinational research projects, professional project management is crucial for success. Here EURICE has gained expertise in over 100 projects in EU funding programmes. In addition to classical project manage-ment, EURICE offers strategic and operational support to maximise the value of project results through its extended network of internal and external Intellectual Property (IP) and innovation ex-perts – fully in line with the priorities of Horizon 2020 to place more emphasis on systematic exploi-tation strategies and activities.