New technical approach to the diabetes therapy
Klemen Dovc1,2, Tadej Battelino3,2
1Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, Ljubljana, Slovenia.
Minerva Pediatrica
|May 19, 2020
Summary
Continuous glucose monitoring and closed-loop systems significantly improve type 1 diabetes management. These technologies are increasingly used in routine practice, offering promising advancements for patients.
Area of Science:
- Endocrinology
- Biomedical Engineering
- Health Technology
Background:
- Optimal glycemic control is a persistent challenge for individuals with type 1 diabetes.
- Continuous glucose monitoring (CGM) and insulin pumps have demonstrated safety and efficiency.
- The integration of these technologies into closed-loop systems is rapidly advancing diabetes care.
Purpose of the Study:
- To review the technological advancements in type 1 diabetes management.
- To summarize clinical evidence supporting the use of CGM and closed-loop systems.
- To discuss human factors and health economics related to technology implementation.
Main Methods:
- Review of clinical evidence for continuous glucose monitoring (CGM) and closed-loop systems.
- Analysis of commercialized devices and systems in development.
- Consideration of human factors and health economic aspects.
Main Results:
- CGM and intermittently scanned CGM have improved diabetes management outcomes in large populations.
- Closed-loop systems have transitioned from clinical trials to routine practice.
- Promising results are reported from real-world use in both children and adults with type 1 diabetes.
Conclusions:
- Closed-loop systems represent a significant advancement in type 1 diabetes treatment, though not a cure.
- The adoption of advanced diabetes technologies is increasing due to proven efficacy and safety.
- Implementation requires consideration of human factors and economic viability.
Related Concept Videos
01:15Diabetes: Management and Pharmacotherapy
781
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
781
01:22Diabetes Mellitus: Overview and Type I Subtype
4.7K
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.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
4.7K
01:22Diabetes Mellitus: Type 2 and Gestational
4.2K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.2K
01:16Insulin: Dosing Regimen and Adverse Effects
574
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...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
574
01:36Carbohydrate Metabolism
13.5K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
13.5K
01:15Diabetes: Symptoms, Diagnosis, and Complications
1.9K
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
1.9K