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Related Concept Videos

Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

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Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
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Open and closed-loop control systems01:17

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Control systems are foundational elements in automation and engineering. They are broadly categorized into open-loop and closed-loop systems. These classifications hinge on the presence or absence of feedback mechanisms, significantly influencing the system's performance, complexity, and application.
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Insulin: Biosynthesis, Chemistry, and Preparation01:25

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The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
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Feedback Loops01:01

Feedback Loops

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In most cases, excessive hormone production is prevented by negative feedback—a loop that starts with a stimulus inducing the release of a particular substance, like a hormone, to maintain a certain level before triggering a signal that results in a decrease in further release of the hormone.
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Insulin: The Receptor and Signaling Pathways01:28

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Insulin action is mediated through a receptor tyrosine kinase, akin to the IGF-1 receptor. The number of receptors per cell varies significantly, from 40 on erythrocytes to 300,000 on adipocytes and hepatocytes. The insulin receptor consists of linked α/β subunit dimers, forming a heterotetramer glycoprotein with two extracellular α subunits and two β subunits spanning the membrane. The α subunits inhibit the inherent tyrosine kinase activity of the β subunits, but...
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Insulin: Dosing Regimen and Adverse Effects01:16

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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
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Related Experiment Video

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Three-dimensional Printing of Thermoplastic Materials to Create Automated Syringe Pumps with Feedback Control for Microfluidic Applications
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Bringing closed-loop home: recent advances in closed-loop insulin delivery.

Hood Thabit1, Roman Hovorka

  • 1Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.

Current Opinion in Endocrinology, Diabetes, and Obesity
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Closed-loop insulin delivery systems show promise for improving glycemic control in type 1 diabetes, reducing hypoglycemia, and advancing toward home use. Research is progressing from clinical settings to real-world patient applications.

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Area of Science:

  • Endocrinology
  • Biomedical Engineering
  • Diabetes Technology

Background:

  • Hypoglycemia remains a significant challenge in type 1 diabetes management, despite modern insulin therapies.
  • Suboptimal glycemic control and the risk of diabetes complications are linked to hypoglycemia.
  • Closed-loop systems offer a potential solution to improve glycemic control while minimizing hypoglycemia.

Purpose of the Study:

  • To review recent advancements in closed-loop research.
  • To discuss the development and progress of closed-loop systems for home use outside clinical settings.
  • To highlight the transition of closed-loop technology from supervised research to real-world patient environments.

Main Methods:

  • Review of current literature on closed-loop insulin delivery systems.
  • Analysis of studies involving automated and bihormonal closed-loop systems in clinical research.
  • Evaluation of ambulatory closed-loop prototype studies in free-living conditions at patients' homes.

Main Results:

  • Closed-loop systems have demonstrated efficacy in improving glycemic control and reducing hypoglycemia in type 1 diabetes.
  • Progress has been made in transitioning closed-loop systems from clinical settings to home-based use.
  • Different patient populations and control algorithms have been studied, with varying challenges and outcomes in transitional and home studies.

Conclusions:

  • Experience with closed-loop insulin delivery is encouraging for future development.
  • Further improvements are needed to make closed-loop systems suitable for widespread clinical practice.
  • Enhanced glucose sensor reliability and faster insulin analogues are key factors for accelerating clinical adoption.