Klonoff David C, Cobelli Claudio, Kovatchev Boris, Zisser Howard C
Mills-Peninsula Health Services, San Mateo, California 94401, USA.
J Diabetes Sci Technol. 2009 Sep 1;3(5):1002-4. doi: 10.1177/193229680900300502.
This issue of Journal of Diabetes Science and Technology contains a collection of 12 original articles describing the latest advances in the development of algorithms for controlling insulin delivery in an artificial pancreas. Algorithms presented in this issue are affected by numerous quantifiable factors, including insulin pharmaco-kinetics, timing of meal carbohydrate appearance, meal size, amount of exercise, presence of stress, day-to-day variations in insulin sensitivity, insulin time-activity profiles, accuracy of glucose monitor calibration, metabolic profiles of both adults and neonates, and risks of hypoglycemia/hyperglycemia. These articles present theoretical advances in insulin delivery algorithms from modeled in silico patients, as well as clinical data from actual patients who have used closed loop systems. The novel approaches described in these articles are expected to bring us much closer to realization of a commercially available closed loop system for controlling glucose levels in patients with diabetes.
本期《糖尿病科学与技术杂志》刊载了12篇原创文章,介绍了人工胰腺中胰岛素输送控制算法开发的最新进展。本期文章中介绍的算法受到众多可量化因素的影响,包括胰岛素药代动力学、膳食碳水化合物出现的时间、膳食量、运动量、压力的存在、胰岛素敏感性的日常变化、胰岛素时间-活性曲线、血糖监测仪校准的准确性、成人和新生儿的代谢谱以及低血糖/高血糖风险。这些文章展示了来自计算机模拟患者的胰岛素输送算法的理论进展,以及使用闭环系统的实际患者的临床数据。这些文章中描述的新方法有望使我们更接近实现用于控制糖尿病患者血糖水平的商用闭环系统。