El control autom\u00e1tico de la glucosa es un problema de ingenier\u00eda complejo y como tal se ha abordado desde diferentes perspectivas por los diferentes investigadores. No se puede hablar \u201cdel\u201d p\u00e1ncreas artificial, sino que p\u00e1ncreas artificiales hay muchos, cada uno con sus peculiaridades. Un reciente estudio reporta un total de 18 sistemas en diferentes etapas de desarrollo en 2015, entre los cuales hay dos de marca espa\u00f1ola. Hablamos aqu\u00ed de la diferencia entre un p\u00e1ncreas artificial unihormonal y otro bihormonal.<\/p>\n
\u00bfTodos los p\u00e1ncreas artificiales se basan en la infusi\u00f3n de insulina como \u00fanica acci\u00f3n para el control de la glucosa? La respuesta es no. <\/p><\/blockquote>\n
De forma natural cuando pensamos en control de glucosa pensamos en la infusi\u00f3n de insulina ya que en eso consiste el tratamiento actual. Un sistema de p\u00e1ncreas artificial que usa s\u00f3lo insulina se llama unihormonal<\/strong>. Sin embargo, no debemos olvidar que la insulina tiene el efecto de disminuir la glucosa. \u00bfC\u00f3mo puedo entonces responder a una hipoglucemia tras haber suspendido totalmente la infusi\u00f3n de insulina? El organismo secreta la hormona glucag\u00f3n, que pone a trabajar al h\u00edgado para aumentar la glucosa, evitando as\u00ed las hipoglucemias. Sin embargo en diabetes tipo 1 dicho rescate tambi\u00e9n se da\u00f1a con el tiempo. \u00bfPor qu\u00e9 no sustituirlo mediante una infusi\u00f3n externa al igual que se hace con la insulina? Ello da lugar a un sistema de p\u00e1ncreas artificial bihormonal<\/strong>, que usa insulina y glucag\u00f3n para el control de la glucosa.<\/p>\n
Actualmente la mayor\u00eda de sistemas en desarrollo son unihormonales, debido a su mayor simplicidad pues s\u00f3lo requieren una bomba de insulina y es la extensi\u00f3n m\u00e1s natural al tratamiento actual. Es tema de discusi\u00f3n en la comunidad cient\u00edfica si realmente el glucag\u00f3n es necesario, ya que aumenta la complejidad. Se necesita una nueva bomba de infusi\u00f3n, o bien una \u00fanica bomba con dos c\u00e1maras para alojar insulina y glucag\u00f3n, actualmente en desarrollo. Se necesitan formulaciones nuevas de glucag\u00f3n que se puedan usar en una bomba, aunque tambi\u00e9n diversas farmac\u00e9uticas trabajan en ello. Los estudios comparativos entre unihormonal y bihormonal no han sido hasta el momento muy contundentes a favor de los sistemas bihormonales. Se demuestra por ejemplo que para el control durante la noche la insulina basta. Una excepci\u00f3n es el control ante ejercicio donde un estudio reciente en Canad\u00e1 ha demostrado por primera vez un beneficio claro del uso del glucag\u00f3n, reduciendo el riesgo de hipoglucemia inducida por el ejercicio. Ser\u00e1n necesarias por tanto m\u00e1s investigaciones.<\/p>\n
Lo que s\u00ed es claro es que la primera generaci\u00f3n de p\u00e1ncreas artificial ser\u00e1 unihormonal. <\/p>\n
\u00bfQuieres conocer m\u00e1s? No te olvides de seguirnos y transmitirnos tus dudas e intereses.<\/p>\n
\nReferencias bibliogr\u00e1ficas:<\/strong>
\nTrevitt, S., Simpson, S., & Wood, A. (2016). Artificial Pancreas Device Systems for the Closed-Loop Control of Type 1 Diabetes: What Systems Are in Development?<\/a> Journal of Diabetes Science and Technology, 10(3):714-23
\nTaleb, N., Emami, A., Suppere, C., Messier, V., Legault, L., Ladouceur, M., et al. (2016). Efficacy of single-hormone and dual-hormone artificial pancreas during continuous and interval exercise in adult patients with type 1 diabetes: randomised controlled crossover trial<\/a>. Diabetologia, 59(12):2561-2571<\/p>\nFoto:<\/strong> Daniel Costa, Instituto ai2, Universitat Polit\u00e8cnica de Val\u00e8ncia<\/p>\n","protected":false},"excerpt":{"rendered":"
El control autom\u00e1tico de la glucosa es un problema de ingenier\u00eda complejo y como tal se ha abordado desde diferentes perspectivas por los diferentes investigadores. No se puede hablar \u201cdel\u201d p\u00e1ncreas artificial, sino que p\u00e1ncreas artificiales hay muchos, cada uno con sus peculiaridades. Un reciente estudio reporta un total de 18 sistemas en diferentes etapas […]<\/p>\n","protected":false},"author":6,"featured_media":1353,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"footnotes":""},"categories":[61,56],"tags":[],"class_list":["post-1072","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pancreas-artificial","category-tecnoescuela"],"yoast_head":"\n
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