Boughton Charlotte K, Hovorka Roman
Wellcome-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
Diabetologia. 2024 Oct;67(10):2034-2044. doi: 10.1007/s00125-024-06165-w. Epub 2024 May 13.
The role of automated insulin delivery systems in diabetes is expanding. Hybrid closed-loop systems are being used in routine clinical practice for treating people with type 1 diabetes. Encouragingly, real-world data reflects the performance and usability observed in clinical trials. We review the commercially available hybrid closed-loop systems, their distinctive features and the associated real-world data. We also consider emerging indications for closed-loop systems, including the treatment of type 2 diabetes where variability of day-to-day insulin requirements is high, and other challenging applications for this technology. We discuss issues around access and implementation of closed-loop technology, and consider the limitations of present closed-loop systems, as well as innovative approaches that are being evaluated to improve their performance.
自动胰岛素输送系统在糖尿病治疗中的作用正在不断扩大。混合闭环系统已在常规临床实践中用于治疗1型糖尿病患者。令人鼓舞的是，真实世界数据反映了临床试验中观察到的性能和可用性。我们回顾了市售的混合闭环系统、它们的独特特征以及相关的真实世界数据。我们还考虑了闭环系统的新兴适应症，包括治疗日常胰岛素需求变化较大的2型糖尿病以及该技术的其他具有挑战性的应用。我们讨论了围绕闭环技术的获取和实施的问题，并考虑了当前闭环系统的局限性以及正在评估的旨在改善其性能的创新方法。
