Lakshman Rama, Boughton Charlotte, Hovorka Roman
Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK.
Cambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, UK.
Endocr Connect. 2023 Jul 31;12(8):e230132. doi: 10.1530/EC-23-0132.
Automated insulin delivery systems, also known as closed-loop or 'artificial pancreas' systems, are transforming the management of type 1 diabetes. These systems consist of an algorithm which responds to real-time glucose sensor levels by automatically modulating insulin delivery through an insulin pump. We review the rapidly changing landscape of automated insulin-delivery systems over recent decades, from initial prototypes to the different hybrid closed-loop systems commercially available today. We discuss the growing body of clinical trials and real-world evidence demonstrating their glycaemic and psychosocial benefits. We also address future directions in automated insulin delivery such as dual-hormone systems and adjunct therapy as well as the challenges around ensuring equitable access to closed-loop technology.
自动胰岛素输送系统，也被称为闭环或“人工胰腺”系统，正在改变1型糖尿病的管理方式。这些系统由一种算法组成，该算法通过胰岛素泵自动调节胰岛素输送，以响应实时葡萄糖传感器水平。我们回顾了近几十年来自动胰岛素输送系统迅速变化的情况，从最初的原型到如今市面上不同的混合闭环系统。我们讨论了越来越多的临床试验和真实世界证据，这些证据证明了它们在血糖和心理社会方面的益处。我们还探讨了自动胰岛素输送的未来方向，如双激素系统和辅助治疗，以及确保公平获得闭环技术所面临的挑战。
