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人工胰腺系统的最新进展:临床证据的综合评价。

Current Advances of Artificial Pancreas Systems: A Comprehensive Review of the Clinical Evidence.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Diabetes Metab J. 2021 Nov;45(6):813-839. doi: 10.4093/dmj.2021.0177. Epub 2021 Nov 22.

Abstract

Since Banting and Best isolated insulin in the 1920s, dramatic progress has been made in the treatment of type 1 diabetes mellitus (T1DM). However, dose titration and timely injection to maintain optimal glycemic control are often challenging for T1DM patients and their families because they require frequent blood glucose checks. In recent years, technological advances in insulin pumps and continuous glucose monitoring systems have created paradigm shifts in T1DM care that are being extended to develop artificial pancreas systems (APSs). Numerous studies that demonstrate the superiority of glycemic control offered by APSs over those offered by conventional treatment are still being published, and rapid commercialization and use in actual practice have already begun. Given this rapid development, keeping up with the latest knowledge in an organized way is confusing for both patients and medical staff. Herein, we explore the history, clinical evidence, and current state of APSs, focusing on various development groups and the commercialization status. We also discuss APS development in groups outside the usual T1DM patients and the administration of adjunct agents, such as amylin analogues, in APSs.

摘要

自 20 世纪 20 年代班廷和贝斯特(Banting and Best)分离出胰岛素以来,1 型糖尿病(T1DM)的治疗取得了显著进展。然而,由于 T1DM 患者及其家属需要频繁进行血糖检查,因此剂量滴定和及时注射以维持最佳血糖控制常常具有挑战性。近年来,胰岛素泵和连续血糖监测系统的技术进步在 T1DM 治疗方面带来了范式转变,正在扩展到开发人工胰腺系统(APS)。大量研究表明,APS 在血糖控制方面优于传统治疗方法,这些研究仍在不断发表,并且已经开始迅速商业化并在实际中使用。鉴于这种快速发展,患者和医务人员都难以以有组织的方式跟上最新知识。在此,我们探讨了 APS 的历史、临床证据和现状,重点介绍了各个开发小组和商业化状况。我们还讨论了 T1DM 患者以外的群体中 APS 的开发以及在 APS 中添加辅助药物(如胰淀素类似物)的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab64/8640161/4b221ef741ff/dmj-2021-0177f1.jpg

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