Closed loop insulin delivery using implanted insulin pumps and sensors in type 1 diabetic patients
Closed loop insulin delivery using implanted insulin pumps and sensors in type 1 diabetic patients
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DOI：
10.1016/s0168-8227(06)70026-2
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发表时间：
2006-12-01
影响因子：
5.1
通讯作者：
Bringer, Jacques
中科院分区：
文献类型：
--
作者：
Renard, Eric;Costalat, Guy;Bringer, Jacques
我们通过使用基于通过腹膜内途径注入胰岛素的植入胰岛素泵和静脉内酶促葡萄糖传感器耦合的模型来研究闭环胰岛素输送的可行性。通过比例、积分和微分算法对 4 名 1 型糖尿病受试者启动闭环控制 (CLC)，这些受试者已植入两种设备（Mini Med-Medtronic，北岭，加利福尼亚州，美国），并持续 48 小时。每日三餐 40 克碳水化合物，两餐 80 克碳水化合物。进餐前两小时每 10 分钟评估一次血糖，其他时间每 30 分钟评估一次血糖。在实验过程中根据先前的血糖水平凭经验调整算法参数。由于传感器性能不足，一名受试者的 CLC 在 24 小时后停止。在 CLC 期间，该算法在 84.1% 的时间内将血糖保持在 80-240 mg/dl 范围内。算法重新调整没有改变葡萄糖> 240 mg/dl的百分比，但在最后24小时内增加了80-120 mg/dl范围内的百分比。不包括膳食，98% 的时间里葡萄糖<240 mg/dl。我们的结论是，一旦实现调整优化，使用该模型自动控制血糖是可行的。最佳闭环胰岛素输送补偿仍有待定义，以允许永久恢复正常血糖控制。 (c) 2006 Elsevier Ireland Ltd. 保留所有权利。
We investigated the feasibility of closed loop insulin delivery by using a model based upon the coupling of an implanted insulin pump that infuses insulin by intra-peritoneal route and an intravenous enzymatic glucose sensor. Closed Loop Control (CLC) by a proportional, integral and derivative algorithm was initiated in 4 type 1 diabetic subjects, already implanted with both devices (Mini Med-Medtronic, Northridge, CA, USA), and continued for 48 hours. Three meals of 40 g and twice 80 g carbohydrates were served daily. Blood glucose was assessed every 10 minutes for the first two hours of meals and every 30 minutes otherwise. Algorithm parameters were empirically adjusted during the experiment based on antecedent blood glucose levels. CLC in one subject was stopped after 24 hours due to inadequate sensor performance. During CLC, the algorithm kept glucose within 80-240 mg/dl for 84.1% of the time. Algorithm retuning did not change the percentage of glucose > 240 mg/dl but increased the percentage within the 80-120 mg/dl range during the final 24 hours. Excluding meals, glucose was < 240 mg/dl for 98% of the time. We conclude that once tuning optimization is achieved, automated control of blood glucose is feasible using this model. Optimal closed loop insulin delivery compensations remain to be defined to allow permanent restoration of normal glucose control. (c) 2006 Elsevier Ireland Ltd. All rights reserved.