用超快速胰岛素给药方法的人工胰设计、控制和临床评价

Design Control And Clinical Evaluation Of An Artificial Pancreas Utilizing Ultra-Fast Insulin Delivery Methods

 用超快速胰岛素给药方法的人工胰设计、控制和临床评价海南医学院附属医院内分泌科王新军

 

E. Dassau^1,2

¹Chemical Engineering, University of California Santa Barbara, ²Sansum Diabetes Research Institute, Santa Barbara, CA, USA

 

The design and control of an artificial pancreas (AP) has advanced significantly in the last decade from conceptual in silico evaluation to human clinical trials. A variety of control algorithms are being explored that range from Fuzzy Logic, Proportional Integral Derivative (PID) to more advance control algorithms that are based on Model Predictive Control (MPC). These AP designs are largely based on subcutaneous (SC) glucose sensing and insulin delivery.

在过去十年中，人工胰（AP）的设计和控制从在硅片评价到人体临床试验都取得了明显进步。目前正在探索多种控制算法，这包括从模糊逻辑、比例积分微分（PID）到更先进的基于模型预测控制（MPC）的控制算法。这些人工胰的设计主要基于对皮下（SC）血糖检测和胰岛素给药。

As such, these designs are facing a large actuation delay due the slow absorption of SC insulin. This results in limited success in dealing with a large positive disturbance such as an unannounced meal, as well as limiting the ability to prevent hypoglycemia by pump suspension. Use of faster insulin formulation may improve the situation but is limited due to a transport delay. One way to improve the overall performance of future AP devices is by exploring alternative insulin delivery routes for the AP as well as combination of ultra-fast insulin for meal time with the “traditional” SC AP design.

正因为如此，这些设计都面临由于皮下胰岛素吸收缓慢所致的较大驱动延迟。这使处理较大变化如突击进餐时限制了其成功控制血糖，而且胰岛素泵限制了防止低血糖的功能。使用吸收更快的胰岛素制剂可改善这种情况，但由于输注延迟，也受到一定限制。改善未来人工胰整体性能的一种方法是在“传统”人工胰设计的基础上开发人工胰的其他胰岛素输注途径，并联合餐时超短效胰岛素。

The design and evaluation of alternative AP configuration utilizing ultra-fast insulin delivery based on a combination of inhaled insulin with SC AP and AP device based on intraperitoneal delivery will be discussed.

本文将讨论在联合皮下人工胰吸入胰岛素和基于腹腔输注人工胰装置的基础上用超快速胰岛素输注的人工胰配置的设计和评价。