Can We Really Close the Loop and How Soon? Accelerating the Availability of an Artificial Pancreas: A Roadmap to Better Diabetes Outcomes
Can We Really Close the Loop and How Soon? Accelerating the Availability of an Artificial Pancreas: A Roadmap to Better Diabetes Outcomes
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DOI：
10.1089/dia.2008.0031
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发表时间：
2009-04-01
影响因子：
5.4
通讯作者：
Kowalski, Aaron J.
中科院分区：
文献类型：
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作者：
Kowalski, Aaron J.
开发一种闭环人工胰腺一直是一个长期的目标，可以改变糖尿病的管理。直到最近几年，主要的限制是缺乏一个强大的和便携式的连续葡萄糖传感器。在过去5年中，连续葡萄糖监测（CGM）设备的开发和商业化取得了重大进展。连续血糖监测（CGM）已被证明可通过增加血糖达标时间和改善总体血糖控制，在改善糖尿病管理方面增加显著价值。然而，这些益处受限于人类用户对设备提供的数据作出响应的有限能力。通过计算机算法自动化组合传感器/泵系统的胰岛素输送功能的一部分，可以更快速有效地处理即将发生的偏移。本综述将描述非常有前途的初步闭环研究，描述一个潜在的路线图，人工胰腺，将是安全和有效的，并提出了一个解决方案，低血糖和高血糖最大限度地减少控制范围的方法，可以允许短期交付的半自动化系统的糖尿病患者。
Development of a closed-loop artificial pancreas has been a long-time goal that could transform diabetes management. The primary limitation until recent years was the lack of a robust and portable continuous glucose sensor. There has been significant progress over the past 5 years in the development and commercialization of continuous glucose monitoring (CGM) devices. Used adjunctively, CGM has been demonstrated to add significant value in improving diabetes management by increasing time spent in glycemic targets and improving overall glycemic control. However, these benefits are limited by the human user's finite capacity to respond to the data provided by the device. By automating even a portion of the insulin delivery functionality of combined sensor/pump systems via computer algorithm, impending excursions could be handled more quickly and effectively. This review will describe very promising preliminary closed-loop studies, describe a potential roadmap to an artificial pancreas that will be safe and effective, and propose a solution-a hypo-and hyperglycemia minimizing control-to-range approach-that may allow for near-term delivery of a semiautomated system to people with diabetes.