Insulin Patch Pumps: Their Development and Future in Closed-Loop Systems
Insulin Patch Pumps: Their Development and Future in Closed-Loop Systems
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DOI：
10.1089/dia.2010.0016
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发表时间：
2010-06-01
影响因子：
5.4
通讯作者：
Bohannon, Nancy J. V.
中科院分区：
文献类型：
--
作者：
Anhalt, Henry;Bohannon, Nancy J. V.
所谓的“人工胰腺”正在稳步发展，它最终可能是一个全自动的、闭环的血糖控制系统，包括一个连续的血糖监测器、一个胰岛素泵和一个控制器。该控制器将使用个性化算法来直接输送胰岛素，而无需用户输入。推动人工胰腺发展的一个主要因素是与当前1型糖尿病（T1DM）胰岛素给药方式相关的低血糖和极端高血糖的大量发病率，以及随之而来的患者、家长和医生的担忧。一个成功的全自动人工胰腺可能会减少低血糖和明显高血糖的频率和焦虑。贴片泵系统（“贴片泵”）可能越来越多地用于T1DM的控制，并可能被纳入未来的人工胰腺系统。贴片泵没有油管，体积小，重量轻，不显眼。本文描述了贴片泵的特点，已批准在美国销售或正在开发中。本文介绍了驱动胰岛素输送的控制算法，特别是两种主要类型：比例综合导数控制和模型预测控制。在闭环系统的临床开发中使用先进的算法，并对人工胰腺发展的下一步进行了回顾。
Steady progress is being made toward the development of a so-called "artificial pancreas," which may ultimately be a fully automated, closed-loop, glucose control system comprising a continuous glucose monitor, an insulin pump, and a controller. The controller will use individualized algorithms to direct delivery of insulin without user input. A major factor propelling artificial pancreas development is the substantial incidence of-and attendant patient, parental, and physician concerns about-hypoglycemia and extreme hyperglycemia associated with current means of insulin delivery for type 1 diabetes mellitus (T1DM). A successful fully automated artificial pancreas would likely reduce the frequency of and anxiety about hypoglycemia and marked hyperglycemia. Patch-pump systems ("patch pumps") are likely to be used increasingly in the control of T1DM and may be incorporated into the artificial pancreas systems of tomorrow. Patch pumps are free of tubing, small, lightweight, and unobtrusive. This article describes features of patch pumps that have been approved for U. S. marketing or are under development. Included in the review is an introduction to control algorithms driving insulin delivery, particularly the two major types: proportional integrative derivative and model predictive control. The use of advanced algorithms in the clinical development of closed-loop systems is reviewed along with projected next steps in artificial pancreas development.