Department of Paediatrics, Uniuersity of Cambridge, Hills Road, Cambridge CB2 OQQ, UK.
Diabetes Res Clin Pract. 2011 Aug;93 Suppl 1:S131-5. doi: 10.1016/S0168-8227(11)70029-8.
To review challenges and opportunities related to closed-loop glucose control in children with type 1 diabetes (T1D).
During closed-loop glucose control, insulin infusion rates on a subcutaneous insulin pump are adjusted by a control algorithm according to subcutaneous glucose sensor readings. A literature review is performed and personal experience of work with closed-loop systems at the University of Cambridge, UK, is presented.
The main challenges in the management of T1D in children are identified together with a summary of current therapeutics options. Review of the literature recognises hypoglycaemia as a limiting factor for the attainment of optimal glycaemic control, primarily in children. Additional specific confounding issues include unpredictable eating and exercise patterns especially in the youngest age group. Closed-loop systems might be particularly helpful, but have to consider increased insulin sensitivity, lower insulin doses, and human factors such as size and usability of closed-loop components.
Closed-loop systems may represent an alternative treatment option to achieve target glucose levels whilst reducing the risk of hypoglycaemia in children with T1D.
回顾 1 型糖尿病（T1D）儿童闭环血糖控制相关的挑战和机遇。
在闭环血糖控制过程中，根据皮下葡萄糖传感器读数，皮下胰岛素泵的胰岛素输注率由控制算法进行调整。进行文献复习，并介绍英国剑桥大学使用闭环系统的个人经验。
确定了儿童 T1D 管理的主要挑战，并总结了当前的治疗选择。文献回顾认识到低血糖是实现最佳血糖控制的限制因素，主要是在儿童中。其他特定的混杂问题包括难以预测的饮食和运动模式，尤其是在年龄最小的年龄段。闭环系统可能特别有帮助，但必须考虑到胰岛素敏感性增加、胰岛素剂量降低以及闭环组件的大小和可用性等人为因素。
闭环系统可能是实现 T1D 儿童目标血糖水平的替代治疗选择，同时降低低血糖风险。
