Diabetes Care：新装置可自动控制1型糖尿病患者夜间血糖

<p align="center"><img src="http://www.bioon.com/biology/UploadFiles/201208/2012082822314402.jpg" alt="" width="298" height="266" border="0" /></p>
近日，研究人员发现一种自动的便携式血糖控制系统可安全控制1型糖尿病年轻成人和青少年患者的夜间血糖水平。研究结果发表于8月8日的《糖尿病护理》(<em>Diabetes Care</em>)。

Medtronic(美敦力)便携式血糖控制系统(PGCS)由两个葡萄糖皮下传感器、一个Blackberry智能计算控制器、一个蓝牙射频变换器及一个美敦力胰岛素泵构成。

<!--more-->

西澳大利亚大学的Timothy W. Jones博士和他的同事探讨了PGCS的安全性和有效性，重点在于夜间血糖的控制，共研究了8例1型糖尿病年轻成人和青少年16个夜晚的血糖水平。

PGCS控制期间的夜间血糖平均为6.4 mmol/L (115 mg/dL)。78%的时间里维持在3.9～8 mmol/L (70～144 mg/dL)，7%的时间里降至3.9 mmol/L以下，而15%的时间里超过8 mmol/L。

进行该研究前发现采用PGCS控制血糖优于家庭的开环式控制系统;闭环式控制系统在85%的夜间时段内可使血糖值维持在3.9～8 mmol/L，而开环式控制系统仅为47%(p=0.0001)。

研究人员在16晚的研究中共干预了7晚——4晚(2例受试者)由于传感器发生错误而需要手动校准，2晚蓝牙未连接(1例受试者)，1晚是由于1例受试者因晚餐前自行服用药物发生低血糖而未完成研究并随后食用碳水化合物。

“本研究说明了门诊病人采用自动便携式闭环血糖控制系统的发展趋势”研究人员在报告中称。“必须进行进一步的研究以确定最佳的故障检测设置，从而保证操作闭环血糖控制系统时最大限度提高病人的安全性并使不良影响降至最低。
<div id="ztload">
<div>
<div>

<img src="http://www.bioon.com/biology/UploadFiles/201208/2012082822272190.gif" alt="" width="113" height="149" border="0" hspace="0" />

<a title="" href="http://dx.doi.org/10.2337/dc12-0761" target="_blank">doi:10.2337/dc12-0761</a>
PMC:
PMID:

</div>
<div>

<br/><strong>The Use of an Automated, Portable, Glucose Control System for Overnight Glucose Control in Adolescents and Young Adults With Type 1 Diabetes.</strong><br/>


O'Grady MJ, Retterath AJ, Keenan DB, Kurtz N, Cantwell M, Spital G, Kremliovsky MN, Roy A, Davis EA, Jones TW, Ly TT.

OBJECTIVEA key milestone in progress towards providing an efficacious and safe closed-loop artificial pancreas system for outpatient use is the development of fully automated, portable devices with fault detection capabilities to ensure patient safety. The ability to remotely monitor the operation of the closed-loop system would facilitate future physician-supervised home studies.RESEARCH DESIGN AND METHODSThis study was designed to investigate the efficacy and safety of a fully automated, portable, closed-loop system. The Medtronic Portable Glucose Control System (PGCS) consists of two subcutaneous glucose sensors, a control algorithm based on proportional-integral-derivative with insulin feedback operating from a BlackBerry Storm smartphone platform, Bluetooth radiofrequency translator, and an off-the-shelf Medtronic Paradigm Veo insulin pump. Participants with type 1 diabetes using insulin pump therapy underwent two consecutive nights of in-clinic, overnight, closed-loop control after a baseline open-loop assessment.RESULTSEight participants attended for 16 overnight studies. The PGCS maintained mean overnight plasma glucose levels of 6.4 ± 1.7 mmol/L (115 ± 31 mg/dL). The proportion of time with venous plasma glucose &lt;3.9, between 3.9 and 8 (70 and 144 mg/dL), and &gt;8 mmol/L was 7, 78, and 15%, respectively. The proportion of time the sensor glucose values were maintained between 3.9 and 8 mmol/L was greater for closed-loop than open-loop (84.5 vs. 46.7%; P &lt; 0.0001), and time spent &lt;3.3 mmol/L was also reduced (0.9 vs. 3%; P &lt; 0.0001).CONCLUSIONSThese results suggest that the PGCS, an automated closed-loop device, is safe and effective in achieving overnight glucose control in patients with type 1 diabetes.

<br/>来源：医脉通

</div>
</div>
</div>