Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK.
Nat Rev Endocrinol. 2011 Feb 22;7(7):385-95. doi: 10.1038/nrendo.2011.32.
Automated closed-loop insulin delivery, also referred to as the 'artificial pancreas', has been an important but elusive goal of diabetes treatment for many decades. Research milestones include the conception of continuous glucose monitoring in the early 1960s, followed by the production of the first commercial hospital-based artificial pancreas in the late 1970s that combined intravenous glucose sensing and insulin delivery. In the past 10 years, research into the artificial pancreas has gained substantial momentum and focused on the subcutaneous route for glucose measurement and insulin delivery, which reflects technological advances in interstitial glucose monitoring and the increasing use of the continuous subcutaneous insulin infusion. This Review discusses the design of an artificial pancreas, its components and clinical results, as well as the advantages and disadvantages of different types of automated closed-loop systems and potential future advances. The introduction of the artificial pancreas into clinical practice will probably occur gradually, starting with simpler approaches, such as overnight control of blood glucose concentration and temporary pump shut-off, that are adapted to more complex situations, such as glycemic control during meals and exercise.
自动化闭环胰岛素输送，也被称为“人工胰腺”，几十年来一直是糖尿病治疗的一个重要但难以实现的目标。研究里程碑包括 20 世纪 60 年代早期连续血糖监测的概念提出，随后是 20 世纪 70 年代末第一款结合静脉内葡萄糖感应和胰岛素输送的商业化医院用人工胰腺问世。在过去 10 年中，人工胰腺的研究取得了实质性进展，研究重点是皮下途径的葡萄糖测量和胰岛素输送，这反映了间质葡萄糖监测技术的进步和连续皮下胰岛素输注的日益普及。本文讨论了人工胰腺的设计、组成和临床结果，以及不同类型的自动化闭环系统的优缺点和潜在的未来进展。人工胰腺将逐渐引入临床实践，首先是更简单的方法，如夜间血糖浓度控制和临时泵关闭，然后逐渐适应更复杂的情况，如进餐和运动期间的血糖控制。
