Evolution of Devices in Diabetes Management
Evolution of Devices in Diabetes Management
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DOI：
10.1089/dia.2011.0058
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发表时间：
2011-06-01
影响因子：
5.4
通讯作者：
Borot, Sophie
中科院分区：
文献类型：
--
作者：
Penfornis, Alfred;Personeni, Estelle;Borot, Sophie
胰岛素给药和血糖监测方面的最新技术进步使糖尿病患者越来越多地参与自己的护理。替代传统小瓶和注射器的装置（例如胰岛素笔）越来越受欢迎，并且提供简单和方便的胰岛素施用。注射笔器械与提高剂量准确性、降低低血糖或高血糖风险相关，并不断更新新的安全功能，以优化其性能。对于血糖变异性仍然存在问题的患者，通过植入式套管进行持续皮下胰岛素输注或通过植入式泵进行持续腹膜内胰岛素输注在正确使用时是安全有效的，尽管成本可能是一个限制因素。更准确的回顾性和实时连续监测设备，可以更好地检测血糖波动，已成为现代糖尿病管理的标准组成部分。最新的设备具有无线数据传输的传感器信号功能，从而减少了时间延迟和更准确的警报。最终，虽然自我管理仍然是目前改善血糖控制的关键因素，但人为错误可能会破坏即使是最准确的治疗干预措施。因此，糖尿病管理的一个关键长期目标是开发一种用于血糖监测和胰岛素输送的自动化和准确的闭环系统，以更好地反映葡萄糖稳态的生理机制并去除“人”元素。这种“人工胰腺”将为糖尿病管理提供最具创新性的干预措施，并有可能大大减轻患者的自我护理负担。
Recent technological advancements in insulin administration and glucose monitoring have allowed patients with diabetes to become increasingly involved in their own care. Devices replacing the traditional vial and syringe, such as insulin pens, are gaining popularity and offer simple and convenient insulin administration. Pen devices are associated with improved dose accuracy, reducing the risk of hypo- or hyperglycemia, and are continually being updated with new safety features in order to optimize their performance. In patients for whom glucose variability remains a problem, continuous subcutaneous insulin infusion via an implanted canula or continuous intraperitoneal insulin infusion via an implanted pump is safe and effective when used correctly, although cost can be a limitation. More accurate retrospective and real-time continuous monitoring devices, which can better detect blood glucose excursions, have become standard components of modern-day diabetes management. The most recent devices have sensor-signaling capabilities with wireless data transmission, leading to reduced time delay and more accurate alerts. Ultimately, though, while self-management remains a critical factor in improving glycemic control at present, human error may undermine even the most accurate treatment interventions. A key long-term goal in diabetes management is, therefore, to develop an automated and accurate closed-loop system for blood glucose monitoring and insulin delivery to better reflect the physiological mechanisms of glucose homeostasis and remove the "human" element. This "artificial pancreas" would offer the most innovative intervention for diabetes management and has the potential to considerably reduce the patient's burden of self-care.