Bioengineered Artificial Pancreas

Abstract

The bioengineered artificial pancreas aims to restore autonomous glucose regulation in people with type 1 diabetes by combining living insulin-secreting cells with synthetic scaffolds and closed-loop sensing hardware, moving beyond external pump-and-sensor systems that still require manual oversight. We assessed 214 bioengineered artificial pancreas programmes conducted across clinical and preclinical centres in France and Spain between 2014 and 2024, spanning five platform categories: macro-encapsulated islet devices, micro-encapsulated islet constructs, stem-cell-derived beta-cell implants, vascularised bioprinted constructs, and hybrid closed-loop bioelectronic systems. A Bioengineered Pancreas Translational Index (BPTI) was constructed from five sub-scores -- glycaemic normalisation efficacy, graft survival duration, immunoprotection adequacy, vascularisation quality, and scalability of manufacture - with weights from regression against progression to next-phase clinical trials. BPTI correlated with translational advancement at r = +0.83 and discriminated programmes that advanced from those that stalled with an AUC of 0.878. Hybrid closed-loop bioelectronic systems scored highest (mean BPTI 0.806), while micro-encapsulated islet constructs trailed at 0.588. Only 32.7 percent of programmes exceeded the 0.75 BPTI threshold. Glycaemic normalisation efficacy carried the largest regression weight (beta = +0.278), followed by graft survival duration (beta = +0.228).