title: Evaluation of a novel artificial pancreas: closed loop glycemic control system with continuous blood glucose monitoring.
abstract: A closed-loop glycemic control system using an artificial pancreas has been applied with many clinical benefits in Japan since 1987. To update this system incorporating user-friendly features, we developed a novel artificial pancreas (STG-55). The purpose of this study was to evaluate STG-55 for device usability, performance of blood glucose measurement, glycemic control characteristics in vivo in animal experiments, and evaluate its clinical feasibility. There are several features for usability improvement based on the design concepts, such as compactness, display monitor, batteries, guidance function, and reduction of the preparation time. All animal study data were compared with a clinically available artificial pancreas system in Japan (control device: STG-22). We examined correlations of both blood glucose levels between two groups (STG-55 vs. control) using Clarke's error grid analysis, and also compared mean glucose infusion rate (GIR) during glucose clamp. The results showed strong correlation in blood glucose concentrations (Pearson's product-moment correlation coefficient: 0.97; n = 1636). Clarke's error grid analysis showed that 98.4% of the data fell in Zones A and B, which represent clinically accurate or benign errors, respectively. The difference in mean GIRs was less than 0.2 mg/kg/min, which was considered not significant. Clinical feasibility study demonstrated sufficient glycemic control maintaining target glucose range between 80 and 110 (mg/dL), and between 140 and 160 without any hypoglycemia. In conclusion, STG-55 was a clinically acceptable artificial pancreas with improved interface and usability. A closed-loop glycemic control system with STG-55 would be a useful tool for surgical and critical patients in intensive care units, as well as diabetic patients.
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kochi 783-8505, Japan.
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Tsukamoto
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Masaya
authors.initials: M
authors.lastname: Munekage
authors.forename: Eri
authors.initials: E
authors.lastname: Munekage
authors.forename: Yuka
authors.initials: Y
authors.lastname: Takezaki
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Yatabe
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Tarumi
authors.forename: Masaki
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Suguru
authors.initials: S
authors.lastname: Mishina
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000032:analysis*; D004285:Dogs; D004867:Equipment Design; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood; D008991:Monitoring, Physiologic / Q000295:instrumentation; D019397:Pancreas, Artificial
chemical_list: D001786:Blood Glucose