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Related Concept Videos

Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

269
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...
269
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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Open and closed-loop control systems01:17

Open and closed-loop control systems

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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.
An open-loop control system operates without feedback from the output. It consists of two primary elements: the controller and the controlled process. The controller receives an input signal...
972
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

249
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...
249
Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

412
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.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
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Drug Delivery: Overview01:16

Drug Delivery: Overview

407
The selection of a drug's delivery route depends upon its physicochemical properties, including lipid or water solubility and ionization, as well as the therapeutic requirement, such as immediate or sustained effect. These routes can be divided into three primary categories: enteral, parenteral, and topical.
Enteral delivery involves administering drugs directly through swallowing, sublingual placement, or buccal application. Orally administered drugs predominantly navigate the...
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Improving IV Insulin Administration in a Community Hospital
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Closed-Loop Insulin Delivery Systems: Past, Present, and Future Directions.

Sophie Templer1

  • 1Department of Endocrinology, St Vincent's Hospital, Sydney, NSW, Australia.

Frontiers in Endocrinology
|June 23, 2022
PubMed
Summary

Closed-loop systems for automated insulin delivery represent a significant advancement in diabetes management. Modern hybrid systems utilize continuous glucose monitoring and insulin pumps, with future innovations aiming for fully automated control and glucagon integration.

Keywords:
artificial pancreasclosed-loop systemsglycemic controlmedical devicestype 1 diabetes

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Area of Science:

  • Endocrinology
  • Biomedical Engineering
  • Diabetes Technology

Background:

  • Closed-loop (artificial pancreas) systems aim to automate insulin delivery for diabetes management.
  • Early systems in the 1960s-1970s used venous glucose measurements for intravenous insulin/dextrose infusions.
  • Modern systems have evolved into miniaturized, wearable devices using interstitial glucose sensing and subcutaneous insulin pumps.

Purpose of the Study:

  • To review the evolution and current state of closed-loop systems for automated insulin delivery.
  • To discuss the efficacy and future challenges in artificial pancreas technology.

Main Methods:

  • Review of historical development and current technological advancements in closed-loop insulin delivery.
  • Analysis of the growing evidence supporting the efficacy of hybrid closed-loop systems.

Main Results:

  • Commercial availability of hybrid closed-loop systems has increased.
  • Evidence supporting the efficacy of these systems is growing.
  • Technological progression from bedside to wearable devices.

Conclusions:

  • Closed-loop systems have advanced significantly, offering improved diabetes management.
  • Future research focuses on fully closed-loop systems without user input for meals and carbohydrate counting.
  • Integration of glucagon is being explored to mitigate hypoglycemia and enable more aggressive insulin dosing.