Challenges and Recent Progress in the Development of a Closed-loop Artificial Pancreas.
Challenges and Recent Progress in the Development of a Closed-loop Artificial Pancreas.
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DOI：
10.1016/j.arcontrol.2012.09.007
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发表时间：
2012-12
影响因子：
9.4
通讯作者：
Bequette, B. Wayne
中科院分区：
文献类型：
--
作者：
Bequette, B. Wayne
在过去的六年里，对一种能自动控制1型糖尿病患者血糖的闭环人工胰腺的追求得到了加强。在这里，我们讨论了在迈向闭环系统的主要步骤中的最新进展和挑战。连续胰岛素输注泵已经广泛使用了二十多年，但“智能泵”技术使这种设备更容易使用，功能更强大。连续血糖监测（CGM）技术得到了改进，设备得到了更广泛的应用。目前正在研究一些完全闭环系统的方法；大多数只控制胰岛素，而另一些控制胰岛素和胰高血糖素。算法包括开关（用于预防夜间低血糖），比例-积分-导数（PID），模型预测控制（MPC）和基于模糊逻辑的学习控制。吃饭会对血糖造成严重的“干扰”，我们讨论了我们小组开发的技术，用来预测一顿饭可能会在什么时候被吃掉以及它的影响。我们进一步研究了生理和设备相关的挑战，包括胰岛素输液器失效和传感器信号衰减。最后，我们讨论了使闭环人工胰腺成为商业现实所需的下一步步骤。
Pursuit of a closed-loop artificial pancreas that automatically controls the blood glucose of individuals with type 1 diabetes has intensified during the past six years. Here we discuss the recent progress and challenges in the major steps towards a closed-loop system. Continuous insulin infusion pumps have been widely available for over two decades, but “smart pump” technology has made the devices easier to use and more powerful. Continuous glucose monitoring (CGM) technology has improved and the devices are more widely available. A number of approaches are currently under study for fully closed-loop systems; most manipulate only insulin, while others manipulate insulin and glucagon. Algorithms include on-off (for prevention of overnight hypoglycemia), proportional-integral-derivative (PID), model predictive control (MPC) and fuzzy logic based learning control. Meals cause a major “disturbance” to blood glucose, and we discuss techniques that our group has developed to predict when a meal is likely to be consumed and its effect. We further examine both physiology and device-related challenges, including insulin infusion set failure and sensor signal attenuation. Finally, we discuss the next steps required to make a closed-loop artificial pancreas a commercial reality.
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影响因子：
16.2
作者：
Atlas E;Nimri R;Miller S;Grunberg EA;Phillip M
通讯作者：
Phillip M
影响因子：
5.4
作者：
Bequette, B Wayne
通讯作者：
Bequette, B Wayne
影响因子：
158.5
作者：
Bergenstal, Richard M.;Tamborlane, William V.;Wood, Michael A.
通讯作者：
Wood, Michael A.
影响因子：
5.4
作者：
Anhalt, Henry;Bohannon, Nancy J. V.
通讯作者：
Bohannon, Nancy J. V.
影响因子：
7.7
作者：
Breton M;Farret A;Bruttomesso D;Anderson S;Magni L;Patek S;Dalla Man C;Place J;Demartini S;Del Favero S;Toffanin C;Hughes-Karvetski C;Dassau E;Zisser H;Doyle FJ 3rd;De Nicolao G;Avogaro A;Cobelli C;Renard E;Kovatchev B;International Artificial Pancreas Study Group
通讯作者：
International Artificial Pancreas Study Group