Melmer Andreas, Tripyla Afroditi, Herzig David, Laimer Markus, Stettler Christoph, Bally Lia
Universitätsklinik für Diabetologie, Endokrinologie, klinische Ernährung und Metabolismus (UDEM), Inselspital, Universitätsspital Bern.
Ther Umsch. 2020 Sep;77(7):312-318. doi: 10.1024/0040-5930/a001197.
Closed-loop systems - Update 2020 The artificial pancreas (also referred to as a Closed-loop system) represents the latest development in diabetes therapy. Closed-loop systems autonomously direct subcutaneous insulin infusion via a control algorithm based on real-time continuous glucose monitoring. Closed-loop systems have been tested in clinical studies since 2011, and were shown to improve glucose control by reducing hyper- and hypoglycaemia as well as glucose variability when compared with conventional insulin pump therapy. In 2016, the US regulatory authority approved the first hybrid-closed-loop system for the treatment of type 1 diabetes. Hybrid-closed loop systems are not yet fully automated and still require the user to be actively involved for insulin dosing at mealtimes. In spite of the remarkable progress, the delayed action profile of subcutaneously administered insulin and the need to wear multiple devices on the body remain challenging. The present review article summarizes the current state of the art of closed-loop systems in diabetes care and will address technical aspects, evidence from clinical studies as well as future developments in the field.
闭环系统 - 2020年更新 人工胰腺（也称为闭环系统）代表了糖尿病治疗的最新进展。闭环系统通过基于实时连续血糖监测的控制算法自主指导皮下胰岛素输注。自2011年以来，闭环系统已在临床研究中进行了测试，与传统胰岛素泵治疗相比，其通过减少高血糖和低血糖以及血糖变异性来改善血糖控制。2016年，美国监管机构批准了首个用于治疗1型糖尿病的混合闭环系统。混合闭环系统尚未完全自动化，仍需要用户在进餐时积极参与胰岛素给药。尽管取得了显著进展，但皮下注射胰岛素的延迟作用特性以及需要在身体上佩戴多个设备仍然具有挑战性。本综述文章总结了糖尿病护理中闭环系统的当前技术水平，并将探讨技术方面、临床研究证据以及该领域的未来发展。
