人工膵臓の最前線とその展望

Diabetes is characterized as a chronic hyperglycemic status caused by insulin insufficiency from pancreatic beta cells. The artificial pancreas is consisted of Continuous Glucose Monitoring (CGM) and insulin delivery according to the sensor glucose monitoring values. CGM does not monitor blood glucose concentration, but monitors subcutaneous glucose concentration, which is dispersed from blood vessel. The delay of glucose values of CGM is approximately 5 to 10 minutes compared with blood glucose values. Sensor augmented insulin pump 620G, which combines insulin pump and real time CGM is available from February 2015 in Japan. There are two more functions available from spring of 2017 in the United States, in addition to the 620G pump ; i.e. predictive low glucose suspend function, which suspend insulin delivery when hypoglycemia is predicted, and automated basal insulin increase when sensor glucose is high. The development of insulin infusion algorithm is still on the way, however, automated meal time insulin delivery will be introduced near future.