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[摘要]：Near-normal glucose control without hypoglycemia remains on elusive goal for patients with diabetes who require chronic insulin treatment. Building an electromechanical replacement for lost beta cell function has been a target for more than 40 years. Recent progress has been mode with the advent of reasonably reliable continuous glucose sensing, miniaturized insulin infusion devices and powerful microcomputers. An important limitation remains with the need to sense glucose and infuse insulin subcutaneously, as this compartment delays both information about blood glucose and changes to insulin exposure. This has shifted the focus of research onto the development of computer programs that can forecast metabolic requirements to compensate for the lack of immediate access to metabolic information and delayed insulin effects. Recently developed tools for in silico testing of these algorithms will hopefully accelerate the emergence of effective and safe computer-assisted insulin infusion systems and remove the hypoglycemia threat from insulin therapy, while enabling closer-to-normal glycemic control throughout the day and requiring no or only limited user inputs. |
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