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However, clinically significant hypoglycemic and hyperglycemic episodes still occur with the artificial pancreas. Postprandial glucose excursions and exercise\u2010induced hypoglycemia represent major hurdles in improving glucose control and glucose variability in many patients with T1D. In this regard, dual\u2010hormone artificial pancreas systems delivering other hormones in addition to insulin (glucagon or amylin) may better reproduce the physiology of the endocrine pancreas and have been suggested as an alternative tool to overcome these limitations in clinical practice. In addition, novel ultra\u2010rapid\u2010acting insulin analogs with a more physiological time\u2013action profile are currently under investigation for use in artificial pancreas devices, aiming to address the unmet need for further improvements in postprandial glucose control. This review article aims to discuss the current progress and future outlook in the development of novel ultra\u2010rapid insulin analogs and dual\u2010hormone closed\u2010loop systems, which offer the next steps to fully closing the loop in the artificial pancreas.<\/jats:p>","DOI":"10.1111\/aor.14023","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T10:48:06Z","timestamp":1626346086000},"page":"968-986","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Dual\u2010hormone artificial pancreas for management of type 1 diabetes: Recent progress and future directions"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2032-8735","authenticated-orcid":false,"given":"Marco","family":"Infante","sequence":"first","affiliation":[{"name":"Clinical Cell Transplant Program Diabetes Research Institute University of Miami Miller School of Medicine  Miami FL USA"},{"name":"Division of Endocrinology, Metabolism and Diabetes Department of Systems Medicine CTO A. Alesini Hospital Diabetes Research Institute Federation University of Rome Tor Vergata  Rome Italy"},{"name":"UniCamillus Saint Camillus International University of Health Sciences  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Baidal","sequence":"additional","affiliation":[{"name":"Clinical Cell Transplant Program Diabetes Research Institute University of Miami Miller School of Medicine  Miami FL USA"},{"name":"Division of Endocrinology, Diabetes and Metabolism Department of Medicine Diabetes Research Institute University of Miami Miller School of Medicine  Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Rickels","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Department of Medicine Institute for Diabetes, Obesity and Metabolism University of Pennsylvania Perelman School of Medicine  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Diabetes Department of Systems Medicine CTO A. 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