Dexcom, Inc, San Diego, California.
Ann N Y Acad Sci. 2014 Apr;1311:102-23. doi: 10.1111/nyas.12431.
Recent advances in insulins, insulin pumps, continuous glucose-monitoring systems, and control algorithms have resulted in an acceleration of progress in the development of artificial pancreas devices. This review discusses progress in the development of external systems that are based on subcutaneous drug delivery and subcutaneous continuous glucose monitoring. There are two major system-level approaches to achieving closed-loop control of blood glucose in diabetic individuals. The unihormonal approach uses insulin to reduce blood glucose and relies on complex safety mitigation algorithms to reduce the risk of hypoglycemia. The bihormonal approach uses both insulin to lower blood glucose and glucagon to raise blood glucose, and also relies on complex algorithms to provide for safety of the user. There are several major strategies for the design of control algorithms and supervision control for application to the artificial pancreas: proportional-integral-derivative, model predictive control, fuzzy logic, and safety supervision designs. Advances in artificial pancreas research in the first decade of this century were based on the ongoing computer revolution and miniaturization of electronic technology. The advent of modern smartphones has created the ability to utilize smartphone technology as the engineering centerpiece of an artificial pancreas. With these advances, an artificial or bionic pancreas is within reach.
近年来，胰岛素、胰岛素泵、连续血糖监测系统和控制算法的进步加速了人工胰腺设备的发展。本综述讨论了基于皮下药物输送和皮下连续血糖监测的外部系统的进展。实现糖尿病患者血糖闭环控制有两种主要的系统级方法。单激素方法使用胰岛素降低血糖，并依赖复杂的安全缓解算法来降低低血糖风险。双激素方法使用胰岛素降低血糖和胰高血糖素升高血糖，并且还依赖于复杂的算法来保证用户的安全。控制算法和监督控制的设计有几种主要策略，可应用于人工胰腺：比例积分微分、模型预测控制、模糊逻辑和安全监督设计。本世纪人工胰腺研究的进展基于正在进行的计算机革命和电子技术的小型化。现代智能手机的出现使利用智能手机技术作为人工胰腺的工程核心成为可能。有了这些进步，人工胰腺或仿生胰腺已经触手可及。
