Levy Brian L, McCann Thomas W, Finan Daniel A
Animas Corporation, Wayne, USA.
Eur Endocrinol. 2016 Mar;12(1):18-23. doi: 10.17925/EE.2016.12.01.18. Epub 2016 Mar 15.
Living with type 1 diabetes (T1D) presents many challenges in terms of daily living. Insulin users need to frequently monitor their blood glucose levels and take multiple injections per day and/or multiple boluses through an insulin infusion pump, with the consequences of failing to match the insulin dose to the body's needs resulting in hypoglycaemia and hyperglycaemia. The former can result in seizures, coma and even death; the latter can have both acute and long-term health implications. Many patients with T1D also fail to meet their treatment goals. In order to reduce the burdens of self-administering insulin, and improve efficacy and safety, there is a need to at least partially remove the patient from the loop via a closed-loop 'artificial pancreas' system. The Hypoglycaemia-Hyperglycaemia Minimizer (HHM) System, comprising a continuous, subcutaneous insulin infusion pump, continuous glucose monitor (CGM) and closed-loop insulin dosing algorithm, is able to predict changes in blood glucose and adjust insulin delivery accordingly to help keep the patient at normal glucose levels. Early clinical data indicate that this system is feasible, effective and safe, and has the potential to dramatically improve the therapeutic outcomes and quality of life for people with T1D.
对于1型糖尿病(T1D)患者来说,日常生活面临诸多挑战。胰岛素使用者需要频繁监测血糖水平,每天多次注射胰岛素和/或通过胰岛素输注泵多次推注胰岛素,若胰岛素剂量与身体需求不匹配,会导致低血糖和高血糖。前者可能引发癫痫、昏迷甚至死亡;后者会对健康产生急性和长期影响。许多T1D患者也未能达到治疗目标。为了减轻自我注射胰岛素的负担,提高疗效和安全性,有必要通过闭环“人工胰腺”系统至少部分地让患者脱离这一过程。低血糖-高血糖最小化(HHM)系统由一个持续皮下胰岛素输注泵、连续血糖监测仪(CGM)和闭环胰岛素给药算法组成,能够预测血糖变化并相应调整胰岛素输送,以帮助患者维持正常血糖水平。早期临床数据表明,该系统可行、有效且安全,有可能显著改善T1D患者的治疗效果和生活质量。