Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom; Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.
Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom; Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.
Metabolism. 2022 Feb;127:154953. doi: 10.1016/j.metabol.2021.154953. Epub 2021 Dec 7.
Since the discovery of insulin 100 years ago, we have seen considerable advances across diabetes therapies. The more recent advent of glucose-responsive automated insulin delivery has started to revolutionise the management of type 1 diabetes in children and adults. Evolution of closed-loop insulin delivery from research to clinical practice has been rapid, and multiple systems are now commercially available. In this review, we summarise key evidence on currently available closed-loop systems and those in development. We comment on dual-hormone and do-it-yourself systems, as well as reviewing clinical evidence in special populations such as very young children, older adults and in pregnancy. We identify future directions for research and barriers to closed-loop adoption, including how these might be addressed to ensure equitable access to this novel therapy.
自 100 年前发现胰岛素以来，我们在糖尿病治疗方面取得了重大进展。最近出现的葡萄糖响应式自动胰岛素输送开始彻底改变儿童和成人 1 型糖尿病的管理方式。闭环胰岛素输送从研究到临床实践的快速发展，多种系统现已商业化。在这篇综述中，我们总结了目前可用的闭环系统和正在开发的闭环系统的关键证据。我们对双激素和 DIY 系统进行了评论，并回顾了特殊人群（如非常年幼的儿童、老年人和孕妇）的临床证据。我们确定了未来的研究方向和闭环采用的障碍，包括如何解决这些问题，以确保公平获得这种新疗法。
