Closed‐loop artificial endocrine pancreas from Japan

Abstract

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.

Empagliflozin versus sitagliptin for ameliorating intrahepatic lipid content and tissue‐specific insulin sensitivity in patients with early‐stage type 2 diabetes with non‐alcoholic fatty liver disease: A prospective randomized study

“…STG55 is a bedside closed‐loop artificial pancreas, which allows safer and more stable clamp tests by continuously monitoring the patient's blood glucose status (Figure S1). 27 With the patients in the supine position, three intravenous catheters were placed on their forearms. Two of the catheters were used for checking blood glucose levels on the artificial pancreas and the glucose meter (Glutest Neoα; Sanwa Kagaku Kenkyusho, Tokyo, Japan), and the remaining catheter was for tracer and insulin infusion via connection to the artificial pancreas.…”

“…25 STG55 is a bedside closed-loop artificial pancreas, which allows safer and more stable clamp tests by continuously monitoring the patient's blood glucose status (Figure S1). 27 With the patients in the supine position, three intravenous catheters were placed on their forearms.…”

Transient loss of consciousness immediately after total pancreatectomy for pancreatic metastases from renal cell carcinoma: a case report

“…In this case, earlier intravenous insulin infusion with tight glycemic control might have prevented repeated TLOC. In Japan, perioperative safe and strict glycemic control using bedside artificial pancreas system has been developed since 2010 [ 28 ]. In this case, earlier insulin administration might prevent TLOC.…”

Position statement: surgery and diabetes mellitus (Update 2023)

“…Bezüglich künstlicher Intelligenz (AI) im perioperativen Kontext gibt es rezent interessante Arbeiten: In Japan wird an sogenannten Bedside-Pankreassystemen geforscht, die perioperativ mittels AI Insulin und Glukose intravenös zuführen und in dieser Indikation eine stabile glykämische Kontrolle und reduzierte postoperative Infektionsraten zeigen konnten [ 155 ]. Die postoperative glykämische Kontrolle bei Herz-Thoraxchirurgie konnte in einer weiteren Arbeit mittels Bedside-AI verbessert werden, wobei die Ergebnisse unabhängig vom Diabetesstatus des eingeschlossenen Kollektivs waren [ 156 ].…”