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Related Concept Videos

Diabetes: Management and Pharmacotherapy01:15

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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.
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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.
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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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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
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Diabetes Mellitus: Overview and Type I Subtype01:22

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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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A Method for Mouse Pancreatic Islet Isolation and Intracellular cAMP Determination
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Closed-Loop Artificial Pancreas Therapy for Type 1 Diabetes.

Keren Zhou1, Diana Isaacs2

  • 1Endocrinology and Metabolism Institute, Cleveland Clinic, 9500 Euclid Avenue, F20, Cleveland, OH, 44195, US. zhouk2@ccf.org.

Current Cardiology Reports
|June 21, 2022
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Approved artificial pancreas systems improve diabetes management by enhancing time in range and reducing hypoglycemia. Future research aims for full automation without user input for advanced insulin delivery.

Keywords:
Artificial PancreasClosed-Loop Insulin PumpType 1 Diabetes

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Area of Science:

  • Endocrinology
  • Biomedical Engineering
  • Diabetes Technology

Background:

  • Closed-loop insulin pump systems, also known as the artificial pancreas, are at the forefront of diabetes management technology.
  • Current FDA-approved systems in the USA include MiniMed 670G/770G, t:slim X2 Control IQ, and Omnipod 5.

Purpose of the Study:

  • To review currently approved artificial pancreas systems available in the USA.
  • To discuss the advancements and future directions in closed-loop insulin pump technology.

Main Methods:

  • Review of multicenter prospective trials for approved closed-loop insulin pump systems.
  • Comparative analysis of system performance and user experience.

Main Results:

  • All approved systems show improvements in time in range, HbA1c, and reduced hypoglycemia.
  • Newer systems offer enhanced automation, though direct comparisons are challenging due to trial design variations.
  • Significant differences in user experience exist among the systems.

Conclusions:

  • Closed-loop insulin pump systems have rapidly advanced, offering significant benefits for diabetes control.
  • Further research is necessary to achieve complete system automation requiring no user input.