Unmet needs in the treatment of type 1 diabetes: why is it so difficult to achieve an improvement in metabolic control?
Humans
Diabetes Mellitus, Type 1
/ drug therapy
Insulin Resistance
/ physiology
Insulin
/ therapeutic use
Glycemic Control
/ methods
Hypoglycemic Agents
/ therapeutic use
Hypoglycemia
/ prevention & control
Blood Glucose
/ metabolism
Insulin Infusion Systems
Quality of Life
Glycated Hemoglobin
/ metabolism
Journal
Nutrition & diabetes
ISSN: 2044-4052
Titre abrégé: Nutr Diabetes
Pays: England
ID NLM: 101566341
Informations de publication
Date de publication:
02 Aug 2024
02 Aug 2024
Historique:
received:
18
01
2024
accepted:
23
07
2024
revised:
17
07
2024
medline:
3
8
2024
pubmed:
3
8
2024
entrez:
2
8
2024
Statut:
epublish
Résumé
The development of advanced diabetes technology has permitted persons with type 1 diabetes mellitus to improve metabolic control significantly, particularly with the development of advanced hybrid closed-loop systems which have improved the quality of life by reducing hypoglycemia, decreasing macroangiopathy and microangiopathy-related complications, ameliorating HbA1c and improving glycemic variability. Despite the progression made over the past few decades, there is still significant margin for improvement to be made in terms of attaining appropriate metabolic control. Various factors are responsible for poor glycemic control including inappropriate carbohydrate counting, repeated bouts of hypoglycemia, hypoglycemia unawareness, cutaneous manifestations due to localized insulin use and prolonged use of diabetes technology, psychosocial comorbidities such as eating disorders or 'diabulimia', the coexistence of insulin resistance among people with type 1 diabetes and the inability to mirror physiological endogenous pancreatic insulin secretion appropriately. Hence, the aim of this review is to highlight and overcome the barriers in attaining appropriate metabolic control among people with type 1 diabetes by driving research into adjunctive treatment for coexistent insulin resistance and developing new advanced diabetic technologies to preserve β cell function and mirror as much as possible endogenous pancreatic functions.
Identifiants
pubmed: 39095349
doi: 10.1038/s41387-024-00319-w
pii: 10.1038/s41387-024-00319-w
doi:
Substances chimiques
Insulin
0
Hypoglycemic Agents
0
Blood Glucose
0
Glycated Hemoglobin
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
58Informations de copyright
© 2024. The Author(s).
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