Division of Endocrinology and Metabolism, Faculty of Medicine.
Department of Biomedical Engineering, McGill University.
Diabet Med. 2018 Apr;35(4):450-459. doi: 10.1111/dme.13581. Epub 2018 Feb 11.
Technological advances have made the artificial pancreas a reality. This has the potential to improve the lives of individuals with Type 1 diabetes by reducing the risk of hypoglycaemia, achieving better overall glucose control, and enhancing quality of life. Both single-hormone (insulin-only) and dual-hormone (insulin and glucagon) systems have been developed; however, a focused review of the relative benefits of each artificial pancreas system is needed. We reviewed studies that directly compared single- and dual-hormone systems to evaluate the efficacy of each system for preventing hypoglycaemia and maintaining glycaemic control, as well as their utility in specific situations including during exercise, overnight and during the prandial period. We observed additional benefits with the dual-hormone artificial pancreas for reducing the risk of hypoglycaemic events overall and during exercise over the study duration. The single-hormone artificial pancreas was sufficient for maintenance of euglycaemia in the overnight period and for preventing late-onset post-exercise hypoglycaemia. Future comparative studies of longer duration are required to determine whether one system is superior for improving mean glucose control, eliminating severe hypoglycaemia, or improving quality of life.
技术进步使人工胰腺成为现实。这有可能通过降低低血糖风险、实现更好的整体血糖控制和提高生活质量，改善 1 型糖尿病患者的生活。已经开发出了单激素（仅胰岛素）和双激素（胰岛素和胰高血糖素）系统；然而，需要对每种人工胰腺系统的相对益处进行重点审查。我们回顾了直接比较单激素和双激素系统的研究，以评估每种系统在预防低血糖和维持血糖控制方面的效果，以及它们在特定情况下的实用性，包括运动期间、夜间和进食期间。我们观察到双激素人工胰腺在整个研究期间和运动期间降低低血糖事件风险方面具有额外的益处。单激素人工胰腺足以在夜间维持血糖正常，防止运动后晚期低血糖。需要进行更长时间的未来比较研究，以确定一种系统是否在改善平均血糖控制、消除严重低血糖或提高生活质量方面具有优势。
