Feasibility of automating insulin delivery for the treatment of type 1 diabetes
Feasibility of automating insulin delivery for the treatment of type 1 diabetes
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DOI：
10.2337/db06-0419
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发表时间：
2006-12-01
期刊：
影响因子：
7.7
通讯作者：
Saad, Mohammed F.
中科院分区：
文献类型：
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作者：
Steil, Garry M.;Rebrin, Kerstin;Saad, Mohammed F.
对10例1型糖尿病患者(男性2例，女性8例，平均[+/-SD]年龄43.4+/-11.4岁，糖尿病病程18.2+/-13.5年)进行了基于皮下血糖感知和皮下胰岛素输送的自动闭环胰岛素输送系统的评估。在类似于30h的时间内评估闭环控制，并与在3d评估的开环控制进行比较。使用β细胞对葡萄糖的多时相胰岛素反应模型计算闭合循环胰岛素输送。血糖在闭合循环开始时为160+/-66 mg/dl，之后在下午1点(餐前午餐)降至71+/-19。第二天早晨的空腹血糖与目标血糖无差异(分别为124+/-25vs.120 mg/dl；P>；0.05)。平均血糖水平在开环和闭环之间没有差别(分别为133+/-63和133+/-52 mg/dl；P>；0.65)。然而，在闭合循环下，75%的时间血糖在70-180 mg/dl范围内，而在开环状态下，这一比例为63%。两种治疗方法的生化低血糖发生率(血糖60 mg/dl)相似。没有发生严重的低血糖。这些数据提供了概念上的证据，即可以通过完全自动的外部闭环式胰岛素给药系统实现血糖控制。
An automated closed-loop insulin delivery system based on subcutaneous glucose sensing and subcutaneous insulin delivery was evaluated in 10 subjects with type 1 diabetes (2 men, 8 women, mean [+/- SD] age 43.4 +/- 11.4 years, duration of diabetes 18.2 +/- 13.5 years). Closed-loop control was assessed over similar to 30 h and compared with open-loop control assessed over 3 days. Closed-loop insulin delivery was calculated using a model of the beta-cell's multiphasic insulin response to glucose. Plasma glucose was 160 +/- 66 mg/dl at the start of closed loop and was thereafter reduced to 71 +/- 19 by 1:00 P.M. (preprandial lunch). Fasting glucose the subsequent morning on closed loop was not different from target (124 +/- 25 vs. 120 mg/dl, respectively; P > 0.05). Mean glucose levels were not different between the open and closed loop (133 +/- 63 vs. 133 +/- 52 mg/dl, respectively; P > 0.65). However, glucose was within the range 70-180 mg/dl 75% of the time under closed loop versus 63% for open loop. Incidence of biochemical hypoglycemia, (blood glucose < 60 mg/dl) was similar under the two treatments. There were no episodes of severe hypoglycemia. The data provide proof of concept that glycemic control can be achieved by a completely automated external closed-loop insulin delivery system.