Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland.
Students' Scientific Association at the Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland.
Pediatr Endocrinol Diabetes Metab. 2023;29(1):30-36. doi: 10.5114/pedm.2023.126359.
Technological advances offer the opportunity to improve glycemic control and reduce the risk of complications and burden of type 1 diabetes while improving patient quality of life. Closed-loop insulin delivery systems take the technology to a larger scale by integrating CGM systems with an insulin pump and an algorithm that automates insulin delivery (HCL systems). Several systems using hybrid closed loop technology are currently offered in the global marketplace: the MiniMed™ 670G and MiniMed™ 780G (SmartGuard™) system from Medtronic; the T slim x2 Control IQ from Tandem; the Omnipod5 automated mode (HypoProtect™)5 from Insulet; and the CamAPS FX DanaRS or Ypso pump. Insulet's Omnipod5 automated mode (HypoProtect™) is currently in clinical trials. As technology moves forward, advanced systems are being developed that include an elaborate algorithm with individualization of major target points, automated correction bolus functionality, and increased stability of the automated mode (Advanced Hybrid Closed-Loop - AHCL systems). The AHCL systems include: MiniMed™ 780G (SmartGuard™); Tandem's T slim x2 Control IQ; Insulet's Omnipod5-Automated mode (HypoProtect™); and CamAPS FX. The purpose of this paper is to present commercial devices using HCL and AHCL in 2022, also from a scientific point of view. It is an undeniable fact that "auto-mode" systems represent a new stage that can be confidently called a revolution in diabetology.
技术进步提供了改善血糖控制、降低 1 型糖尿病并发症风险和负担、提高患者生活质量的机会。闭环胰岛素输送系统通过将 CGM 系统与胰岛素泵和自动胰岛素输送算法（HCL 系统）集成，将技术提升到更大的规模。目前，全球市场上有几种使用混合闭环技术的系统：美敦力的 MiniMed™ 670G 和 MiniMed™ 780G（SmartGuard™）系统；Tandem 的 T slim x2 Control IQ；Insulet 的 Omnipod5 自动化模式（HypoProtect™）5；以及 Ypso 泵的 CamAPS FX DanaRS 或 Ypso 泵。Insulet 的 Omnipod5 自动化模式（HypoProtect™）目前正在临床试验中。随着技术的不断发展，正在开发更先进的系统，包括具有个体化主要目标点的精细算法、自动校正推注功能以及自动化模式的稳定性提高（高级混合闭环 - AHCL 系统）。AHCL 系统包括：MiniMed™ 780G（SmartGuard™）；Tandem 的 T slim x2 Control IQ；Insulet 的 Omnipod5 自动化模式（HypoProtect™）；以及 CamAPS FX。本文旨在从科学角度介绍 2022 年使用 HCL 和 AHCL 的商业设备。不可否认的是，“自动模式”系统代表了一个新阶段，可以自信地称之为糖尿病学的革命。
