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Closed‐loop artificial endocrine pancreas from Japan
Author(s) -
Hanazaki Kazuhiro,
Tanioka Nobuhisa,
Munekage Masaya,
Uemura Sunao,
Maeda Hiromichi
Publication year - 2021
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.14008
Subject(s) - glycemic , medicine , perioperative , hypoglycemia , artificial pancreas , intensive care medicine , diabetes mellitus , endocrine system , closed loop , insulin , emergency medicine , surgery , type 1 diabetes , endocrinology , hormone , engineering , control engineering
The development of a closed‐loop artificial pancreas (AP) in the Western countries and Japan is different. In Western countries, wearable AP with a closed‐loop glycemic control system has been developed as a treatment for patients with type 1 and type 2 diabetes. On the contrary, in Japan, bedside closed‐loop AP explored by a Japanese company (Nikkiso, Tokyo, Japan) has developed as perioperative glycemic control device in surgical patients and acute care patients with emergency. In this article, we reviewed the scientific evidence in the past and present and future prospects of perioperative glycemic control using bedside AP with a closed‐loop system in Japan. Conventional perioperative strict glycemic controls have three major problems: hyperglycemia, hypoglycemia, and variability in blood glucose concentrations. In Japan, perioperative strict glycemic control using the current bedside AP STG‐55 (Nikkiso, Tokyo, Japan) has been developed since 2010. This novel glycemic control method achieved not only stable glycemic control without hyperglycemia, hypoglycemia, and less variability of blood glucose concentrations but also reduced postoperative infectious complications in patients undergoing major surgeries. Among the rapidly increasing number of surgical or emergency patients with diabetes, frailty, and sarcopenia of intrinsic glucose intolerance, more sophisticated and smaller AP available easily in operating rooms and intensive care units will be warranted to promote improved therapeutic outcomes in such critically ill patients.