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Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

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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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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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Insulin Formulations: Types and Delivery01:27

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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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Diabetes Mellitus: Type 2 and Gestational01:22

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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...
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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.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
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Diabetes: Symptoms, Diagnosis, and Complications01:15

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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...
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First in Human Feasibility Study: Automated Insulin Delivery Utilizing a Self-Adapting Algorithm in Adults With Type

Tom Wilkinson1, Solita Donnelly2, Claire Lever2,3

  • 1Department of Pediatrics, University of Otago Christchurch, Christchurch, New Zealand.

Journal of Diabetes Science and Technology
|July 3, 2025
PubMed
Summary
This summary is machine-generated.

A novel closed-loop system for diabetes management, requiring no meal announcements, proved feasible in adults with type 1 and type 2 diabetes. The self-adapting algorithm demonstrated clinical benefits, especially when fully adjusted.

Keywords:
automated insulin deliveryfully automated closed-loop systemtype 1 diabetestype 2 diabetesunannounced meals

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Area of Science:

  • Endocrinology
  • Biomedical Engineering
  • Diabetes Technology

Background:

  • Assessing a novel self-adapting closed-loop system for diabetes management.
  • The system does not require carbohydrate announcement.
  • Feasibility study conducted in adults with type 1 and type 2 diabetes.

Purpose of the Study:

  • To evaluate the feasibility of a novel closed-loop system.
  • To assess the system's performance without carbohydrate announcement.
  • To determine clinical benefits of a self-adapting algorithm in diabetes management.

Main Methods:

  • Single-arm study design.
  • 14-day run-in with usual insulin therapy and blinded continuous glucose monitoring (CGM).
  • 12 weeks of closed-loop system use with algorithm self-adaptation at 4, 6, 8, and 10 weeks.

Main Results:

  • Improved time in range (TIR) from baseline in both type 1 (37.7% to 55.9%) and type 2 diabetes (17.6% to 51.5%).
  • Low rates of hypoglycemia (<70 mg/dL): 1.1% in type 1 and 0.0% in type 2 diabetes.
  • Significant TIR increase (median 65%) after algorithm adaptation; minimal manual bolus insulin required.

Conclusions:

  • The self-adapting closed-loop system is feasible for adults with type 1 and type 2 diabetes.
  • No meal announcement requirement simplifies system use.
  • Clinical benefits are most pronounced with the fully adapted algorithm.