闭环胰岛素输送系统的研究进展

Progress in closed-loop insulin delivery systems

关键词:  药物递送  闭环治疗  胰岛素输送系统  1型糖尿病  糖响应

Key words:  drug delivery  closed-loop therapies  insulin delivery system  type 1 diabetes  glucose responsive

摘要:

1型糖尿病和进展型2型糖尿病患者胰岛素分泌不足,表现出高血糖症状。为了维持血糖正常,此类糖尿病患者需每天多次注射胰岛素。然而,胰岛素的需求受饮食、运动、疾病等多重因素影响,加之胰岛素本身治疗指数极窄,因此胰岛素剂量难以估算准确,若胰岛素注射过量可危及生命。此外,每日多次注射胰岛素给患者带来了较大的生理和心理负担。为了解决以上问题,研究人员着手开发闭环胰岛素输送系统,使胰岛素剂量能够依据糖尿病患者实时血糖水平变化进行调整,从而提升控制血糖的安全性和有效性。本综述按照闭环胰岛素输送系统的组成属性,将闭环胰岛素输送系统分为电子类闭环胰岛素输送系统和剂型类闭环胰岛素输送系统。从两种闭环胰岛素输送系统的组成元件、发展历程、临床应用、目前优劣以及后续的发展方向等几个方面进行阐述,着重对比了两类闭环胰岛素输送系统的相对优势。

Abstract:

Individuals with type 1 diabetes or advanced type 2 diabetes suffer insufficient insulin secretion, leading to symptoms of hyperglycemia. To maintain the normal blood glucose levels, those with Type 1 or advanced type 2 diabetes must administer insulin multiple times a day. However, insulin requirements are influenced by several factors such as diet, exercise, and illness, combined with the narrow therapeutic index, making accurate insulin dosage challenging. Excessive insulin administration can even pose life-threatening risks. In addition, frequent daily insulin injections place considerable physiological and psychological burdens on patients. To tackle these challenges, researchers have embarked on the development of closed-loop insulin delivery systems. These systems adjust insulin dosages in real-time changes based on the patient’s blood glucose levels, therefore enhancing both the safety and effectiveness of insulin therapy. This review categorizes closed-loop insulin delivery systems into two types: electronic-based and material-based systems, based on their compositional attributes. The exploration of both types covers their components, developmental history, clinical applications, current pros and cons, and future directions. The relative strengths and limitations of these two categories of closed-loop insulin delivery systems are also compared and discussed.