The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, The National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Diabetes Care. 2010 May;33(5):1072-6. doi: 10.2337/dc09-1830. Epub 2010 Feb 11.
Current state-of-the-art artificial pancreas systems are either based on traditional linear control theory or rely on mathematical models of glucose-insulin dynamics. Blood glucose control using these methods is limited due to the complexity of the biological system. The aim of this study was to describe the principles and clinical performance of the novel MD-Logic Artificial Pancreas (MDLAP) System.
The MDLAP applies fuzzy logic theory to imitate lines of reasoning of diabetes caregivers. It uses a combination of control-to-range and control-to-target strategies to automatically regulate individual glucose levels. Feasibility clinical studies were conducted in seven adults with type 1 diabetes (aged 19-30 years, mean diabetes duration 10 +/- 4 years, mean A1C 6.6 +/- 0.7%). All underwent 14 full, closed-loop control sessions of 8 h (fasting and meal challenge conditions) and 24 h.
The mean peak postprandial (overall sessions) glucose level was 224 +/- 22 mg/dl. Postprandial glucose levels returned to <180 mg/dl within 2.6 +/- 0.6 h and remained stable in the normal range for at least 1 h. During 24-h closed-loop control, 73% of the sensor values ranged between 70 and 180 mg/dl, 27% were >180 mg/dl, and none were <70 mg/dl. There were no events of symptomatic hypoglycemia during any of the trials.
The MDLAP system is a promising tool for individualized glucose control in patients with type 1 diabetes. It is designed to minimize high glucose peaks while preventing hypoglycemia. Further studies are planned in the broad population under daily-life conditions.
当前最先进的人工胰腺系统要么基于传统的线性控制理论，要么依赖于血糖-胰岛素动力学的数学模型。使用这些方法控制血糖的效果受到生物系统复杂性的限制。本研究旨在描述新型 MD-Logic 人工胰腺（MDLAP）系统的原理和临床性能。
MDLAP 应用模糊逻辑理论来模拟糖尿病护理人员的推理思路。它采用控制范围和控制目标相结合的策略，自动调节个体血糖水平。在 7 名 1 型糖尿病成人（年龄 19-30 岁，平均糖尿病病程 10 +/- 4 年，平均 A1C 6.6 +/- 0.7%）中进行了可行性临床研究。所有患者均进行了 14 次 8 小时（空腹和进餐挑战条件）和 24 小时的全闭环控制试验。
平均餐后（所有试验）峰值血糖水平为 224 +/- 22 mg/dl。餐后血糖在 2.6 +/- 0.6 小时内降至 <180 mg/dl，并在正常范围内稳定至少 1 小时。在 24 小时闭环控制期间，73%的传感器值在 70-180 mg/dl 之间，27%的传感器值 >180 mg/dl，没有传感器值 <70 mg/dl。在任何试验中均未发生症状性低血糖事件。
MDLAP 系统是 1 型糖尿病患者个体化血糖控制的有前途的工具。它旨在最大限度地减少高血糖峰值，同时预防低血糖。计划在更广泛的人群中在日常生活条件下进行进一步的研究。
