Diabetes is a dreadful affliction, not very frequent among men, being a melting down of the flesh and limbs into urine. The patients never stop making water and the flow is incessant, like the opening of the aqueducts. Life is short, unpleasant and painful, thirst unquenchable, drinking excessive and disproportionate to the large quantity of urine, for yet more urine is passed. If for a while they abstain from drinking, their mouths become parched and their bodies dry; the viscera seem scorched up, the patients are affected by nausea, restlessness and a burning thirst, and within a short time they expire.

Aretaeus of Cappadocia, second century AD

Diabetes mellitus (DM) is a chronic condition with a significantly increasing prevalence worldwide among people of all ages. It is a heterogeneous group of diseases sharing the common trait of impaired blood glucose (BG) regulation. In type 1 DM (T1D), pancreas has either complete or near-to-zero insulin production. In type 2 DM (T2D), the pancreas is healthy but the cells develop insulin resistance. Apart from elevated BG (hyperglycemia), the patients also experience decreased BG (hypoglycemia). This condition may arise from insulin overdosing and is very dangerous to the patient. Due to the possible brain damage from a hypoglycemic condition, patients with DM usually choose to maintain a BG above the healthy level, which gains them a partial protection in the case of incorrect insulin administration. DM is associated with additional diseases and multiple risk factors that can be classified as microvascular (e.g., neuropathy, nephropathy, and retinopathy) or macrovascular (e.g. cardiovascular disease, stroke, and peripheral vascular disease)

Researchers and engineers work on providing sustainable and safe solutions to issues associated with DM, with the ultimate goal being the construction of an artificial pancreas (AP). Such a system must safely and reliably deal with many challenges associated with the management of DM, such as accurately predicting BG concentration and providing flexible adjustment to meal intake and physical activities performed by the patients.

Tomas Koutny et al 2026 Prog. Biomed. Eng. 8 023001