diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM2015332-45diaendo-7228Research ArticleВопросы патогенезаPathogenesisИнтраперитонеальная инфузия инсулина при сахарном диабете: на пути к искусственной поджелудочной железеIntraperitoneal insulin infusion: on the way to the artificial pancreasКарпельевВладимир АлександровичKarpel'evVladimir Aleksandrovich

научный сотрудник Института диабета ФГБУ ЭНЦ

Research associate, Institute of Diabetes, Endocrinology Research Centre

enprt@mail.ruФедороваЕлена АнатольевнаFedorovaElena Anatol'evna

научный сотрудник отделения программного обучения и лечения Института диабета ФГБУ ЭНЦ

MD, Research associate, Department of Program Education and Treatment, Diabetes institute, Endocrinology Research Centre

alyonafedorova1@gmail.comhttps://orcid.org/0000-0002-0317-6592ФилипповЮрий ИвановичPhilippovYury Ivanovich

научный сотрудник отделения програмного обучения и лечения Института диабета ФГБУ ЭНЦ

MD, Research associate, Department of Program Education and Treatment, Diabetes institute, Endocrinology Research Centre

yuriyivanovich@gmail.comМайоровАлександр ЮрьевичMayorovAleksandr Yur'evich

доктор медицинских наук, заведующий отделением программного обучения и лечения Института диабета ФГБУ ЭНЦ

MD, PhD, Head of Department of Program Education and Treatment, Diabetes institute, Endocrinology Research Centre

education@endocrincentr.ruШестаковаМарина ВладимировнаShestakovaMarina Vladimirovna

доктор медицинских наук, профессор, член-корр. РАН, директор Института диабета ФГБУ ЭНЦ, заведующая кафедрой эндокринологии и диабетологии педиатрического факультета ГБОУ ВПО Первый МГМУ им. И.М.Сеченова

MD, PhD, professor, corresponding member of Russian Academy of Sciences, Director of Diabetes Institute in Endocrinology Research Centre, Head of the Endocrinology and Diabetology Department of Pediatric Faculty in Sechenov First MSMU

nephro@endocrincentr.ruФГБУ "Эндокринологический научный центр" Минздрава РоссииРоссияEndocrinology Research CentreRussian FederationФГБУ "Эндокринологический научный центр" Минздрава России; ГБОУ ВПО Первый МГМУ им. И.М.СеченоваРоссияEndocrinology Research Centre; Sechenov First Moscow State Medical UniversityRussian Federation2015290620151833245Copyright © Карпельев В.А., Федорова Е.А., Филиппов Ю.И., Майоров А.Ю., Шестакова М.В., 20152015Карпельев В.А., Федорова Е.А., Филиппов Ю.И., Майоров А.Ю., Шестакова М.В.Karpel'ev V.A., Fedorova E.A., Philippov Y.I., Mayorov A.Y., Shestakova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/7228

Создание «искусственной поджелудочной железы» (ИПЖ) – устройства или технологии, позволяющей людям с сахарным диабетом (СД) автоматически управлять гликемией благодаря восполнению утраченных функций эндокринной регуляции здоровой поджелудочной железы, – одна из наиболее перспективных задач современной медицинской инженерии и кибернетики. Механистическая реализация концепции ИПЖ на основе носимой инсулиновой помпы и подкожной инфузии инсулина, самостоятельно управляющей введением инсулина с учетом изменений гликемии в режиме реального времени по принципу «замкнутого контура», продолжает наталкиваться на трудности, обусловленные, в том числе, медленной фармакокинетикой инсулина. Внутривенное введение инсулина, позволяющее с помощью ИПЖ эффективно поддерживать эугликемию у больных на постельном режиме в условиях стационара, имеет очевидные преимущества с точки зрения фармакокинетики и фармакодинамики, но не может быть использовано в амбулаторной практике. Интраперитонеальный способ введения, до сих пор сравнительно редко используемый во всем мире, является перспективной альтернативой обоим способам благодаря более физиологическому профилю действия, быстрой фармакокинетике инсулина, сравнительно высокой безопасности и доступности для применения в амбулаторных условиях.

Настоящий обзор посвящен описанию интраперитонеального способа введения инсулина пациентам с СД с позиции перспектив его использования для создания ИПЖ.

Creating an "artificial pancreas" (a "closed loop" insulin pump, with self-adjusting insulin abilities, based on real time continuous glucose monitoring data) – is one of the most actual medical challenges of modern engineering and cybernetics.

Artificial pancreas (AP) prototypes based on wearable insulin pump with subcutaneous insulin delivery are still problematic, mainly because of slow insulin pharmacokinetics. Intravenous insulin infusion via AP allows effectively maintain euglycaemia for inpatients, due to insulin pharmacokinetics and pharmacodynamics advantages. Unfortunately, it can’t be used for outpatients. Intraperitoneal insulin infusion is still relatively infrequently used in the world, but it is a promising alternative, compared to both previous methods due to a physiological action profile, fast insulin pharmacokinetics, relatively better safety and availability for outpatient usage.

The purpose of this review is to describe the intraperitoneal insulin infusion features for diabetes patients at a point of AP creation perspectives.

 

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The authors declare that there are no conflicts of interest present.