Еволюція штучної підшлункової залози: компоненти та інтеграція — безперервний моніторинг глюкози, інсулін та системи AP*

Річард М. Бергенстал, Адам Геллер, Марк Д. Бретон, Роберт Вігерський,

Сьюзан А. Браун, Грегорі П. Форленза, Дженніфер Л. Шерр, Роман Говорка,

Стівен Дж. Рассел, Едвард Р. Даміано, Мелісса С. Путман, Рой В. Бек,

Ерік Ренард, Райхан Лал, Клаудіо Кобеллі, Еял Дассау, Халіс К. Актурк,

Майкл А. Вайс, Джей С. Скайлер

DOI :

Резюме

Знакове дослідження «Контроль діабету та його ускладнень» (DCCT) показав, що контроль глюкози має вирішальне значення для зниження ризику ускладнень, пов’язаних з діабетом. В цієї статті описано низку інновацій та досліджень, що були проведені після DCCT з метою мінімізації ризику гіпоглікемії та подальшого поліпшення контролю глюкози. У розділі наведено приклади інновацій у технології дротових ферментів, які сприяли переходу від капілярного моніторингу глюкози до безперервного моніторингу глюкози (CGM) і, зрештою, до першої заводської каліброваної системи CGM. Наступною інновацією в управлінні глікемією стало підключення даних CGM до інсулінової помпи, що містить алгоритм, здатний регулювати подачу інсуліну на основі змін рівня глюкози. Представлено основні особливості систем автоматизованої подачі інсуліну (AID), які на даний момент затверджені в США. У зведеній таблиці AID наведено тип помпи, тип і функцію алгоритму подачі інсуліну, систему управління даними та показання до застосування. У наступному розділі розглядається інновація альтернативних шляхів подачі інсуліну для досягнення мети створення повністю автоматизованої системи подачі інсуліну. Підсумовуються основні випробування з розробки та впровадження імплантованої внутрішньочеревної програмованої системи. В останньому розділі розглядається питання, чи може інформація, що над- ходить від датчиків, крім рівня глюкози, така як безперервне вимірювання рівня кетонів, лактату або інсуліну, надати цінну інформацію, яка наблизить нас до повністю автономної системи AID. Більша частина цієї інноваційної та дослідницької роботи в галузі діабету протягом останніх 75 років підтримувалася Національним інститутом діабету, захворювань травної системи та нирок.

Ключові слова: безперервний моніторинг глюкози, автоматичне введення інсуліну, штучна підшлункова залоза, внутрішньочеревне введення інсуліну, склад інсуліну, метаболічні сенсори.

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Опубліковано: 2025

Як цитувати:

Річард М. Бергенстал, Адам Геллер, Марк Д. Бретон, Роберт Вігерський,Сьюзан А. Браун, Грегорі П. Форленза, Дженніфер Л. Шерр, Роман Говорка,Стівен Дж. Рассел, Едвард Р. Даміано, Мелісса С. Путман, Рой В. Бек,Ерік Ренард, Райхан Лал, Клаудіо Кобеллі, Еял Дассау, Халіс К. Актурк,Майкл А. Вайс, Джей С. Скайлер (2025). Еволюція штучної підшлункової залози: компоненти та інтеграція — безперервний моніторинг глюкози, інсулін та системи AP*. Діабет Ожиріння Метаболічний синдром 5(14), 8-21.