Dassau Eyal, Jovanovic Lois, Doyle Francis J, Zisser Howard C
Department of Chemical Engineering, University of California at Santa Barbara, Santa Barbara, California 93106-5080, USA.
J Diabetes Sci Technol. 2009 Nov 1;3(6):1501-6. doi: 10.1177/193229680900300632.
Intensive insulin therapy has an inherent risk of hypoglycemia that can lead to loss of consciousness, cardiac arrhythmia, seizure, and death ("dead-in-bed syndrome"). This risk of hypoglycemia is a major concern for patients, families, and physicians. The need for an automated system that can alert in the event of severe hypoglycemia is evident. In engineering systems, where there is a risk of malfunction of the primary control system, alert and safety mechanisms are implemented in layers of protection. This concept has been adopted in the proposed system that integrates a hypoglycemia prediction algorithm with a global position system (GPS) locator and short message service such that the current glucose value with the rate of change (ROC) and the location of the subject can be communicated to a predefined list. Furthermore, if the system is linked to the insulin pump, it can suspend the pump or decrease the basal insulin infusion rate to prevent the pending event. The system was evaluated on clinical datasets of glucose tracings from the DexCom Seven system. Glucose tracings were analyzed for hypoglycemia events and then a text message was broadcast to a predefined list of people who were notified with the glucose value, ROC, GPS coordinates, and a Google map of the location. In addition to providing a safety layer to a future artificial pancreas, this system also can be easily implemented in current continuous glucose monitors to help provide information and alerts to people with diabetes.
强化胰岛素治疗存在低血糖的固有风险，可能导致意识丧失、心律失常、癫痫发作和死亡（“睡梦中死亡综合征”）。这种低血糖风险是患者、家属和医生主要关注的问题。显然需要一种在严重低血糖事件发生时能够发出警报的自动化系统。在工程系统中，若主控制系统存在故障风险，会在多层保护中实施警报和安全机制。该概念已应用于所提出的系统中，该系统将低血糖预测算法与全球定位系统（GPS）定位器和短信服务集成在一起，从而能将当前血糖值及变化率（ROC）以及受试者的位置传达给预定义列表。此外，如果该系统与胰岛素泵相连，它可以暂停泵或降低基础胰岛素输注速率以预防即将发生的事件。该系统在来自德康七号系统的葡萄糖追踪临床数据集上进行了评估。对葡萄糖追踪数据进行低血糖事件分析，然后向预定义的人员列表发送短信，通知他们血糖值、ROC、GPS坐标以及该位置的谷歌地图。除了为未来的人工胰腺提供安全保障外，该系统还可以很容易地应用于当前的连续血糖监测仪中，以帮助为糖尿病患者提供信息和警报。
