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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.
Short-acting insulins are divided into...
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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.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
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Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

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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.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
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Oral Drug Delivery Systems: Continuous-Release Systems01:26

Oral Drug Delivery Systems: Continuous-Release Systems

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Continuous-release drug delivery systems offer a strategic approach to maintaining therapeutic drug levels over extended periods following oral administration. By modulating the release rate of active pharmaceutical ingredients, these systems minimize fluctuations in plasma concentrations, which enhances clinical efficacy and reduces the need for frequent dosing. Such characteristics make them particularly advantageous in managing chronic diseases where patient adherence and stable drug...
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Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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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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Closed loop insulin delivery in diabetes.

Tadej Battelino1, Jasna Šuput Omladič2, Moshe Phillip3

  • 1Department of Endocrinology, Diabetes and Metabolism, UMC - University Children's Hospital, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia.

Best Practice & Research. Clinical Endocrinology & Metabolism
|June 9, 2015
PubMed
Summary
This summary is machine-generated.

Closed-loop systems for type 1 diabetes management improve glucose control and reduce the burden of daily self-care. These automated insulin delivery systems offer a promising approach to overcoming the limitations of current treatments.

Keywords:
artificial pancreasclosed loop insulin deliverycontinuous glucose monitoringglucose variabilityglycaemic rangehypoglycaemiamean blood glucosesensor augmented insulin pump

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Area of Science:

  • Endocrinology
  • Biomedical Engineering
  • Diabetes Technology

Background:

  • Type 1 diabetes treatment aims for near-normal glucose levels, which remain challenging despite advanced therapies.
  • Current treatments like insulin analogues and continuous glucose monitoring have limitations, including hypoglycemia risk and patient burden.
  • Patient burnout from intensive daily management can reduce the effectiveness of existing diabetes technologies.

Purpose of the Study:

  • To summarize data from randomized controlled trials on closed-loop insulin delivery in type 1 diabetes patients.
  • To provide an evidence-based perspective on the potential routine use of closed-loop systems.
  • To evaluate the impact of automated insulin delivery on glycemic control and self-management burden.

Main Methods:

  • Review of randomized controlled trials (RCTs) involving type 1 diabetes populations and closed-loop insulin delivery systems.
  • Analysis of data focusing on glycemic control metrics and patient-reported outcomes.
  • Synthesis of evidence to inform future clinical implementation.

Main Results:

  • Automated insulin delivery systems have demonstrated significant improvements in glycemic control.
  • Closed-loop systems have been shown to reduce the risk of hypoglycemia in various patient groups.
  • These systems considerably lessen the burden of routine diabetes self-management for patients.

Conclusions:

  • Closed-loop insulin delivery represents a significant advancement in type 1 diabetes management.
  • Automated insulin delivery can enhance glycemic control while mitigating the challenges of manual management.
  • Evidence supports the potential for routine clinical utilization of closed-loop systems in type 1 diabetes care.