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Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes

Introduction: Nocturnal glucose control remains challenging in children and adolescents with type 1 diabetes due to highly variable overnight insulin requirements. The issue may be addressed by glucose responsive insulin delivery based on real-time continuous glucose measurements. Areas covered: Thi...

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Autores principales: Tauschmann, Martin, Hovorka, Roman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942151/
https://www.ncbi.nlm.nih.gov/pubmed/28819992
http://dx.doi.org/10.1080/17425247.2017.1360866
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author Tauschmann, Martin
Hovorka, Roman
author_facet Tauschmann, Martin
Hovorka, Roman
author_sort Tauschmann, Martin
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description Introduction: Nocturnal glucose control remains challenging in children and adolescents with type 1 diabetes due to highly variable overnight insulin requirements. The issue may be addressed by glucose responsive insulin delivery based on real-time continuous glucose measurements. Areas covered: This review outlines recent developments of glucose responsive insulin delivery systems from a paediatric perspective. We cover threshold-based suspend application, predictive low glucose suspend, and more advanced single hormone and dual-hormone closed-loop systems. Approaches are evaluated in relation to nocturnal glucose control particularly during outpatient randomised controlled trials. Expert opinion: Significant progress translating research from controlled clinical centre settings to free-living unsupervised home studies have been achieved over the past decade. Nocturnal glycaemic control can be improved whilst reducing the risk of hypoglycaemia with closed-loop systems. Following the US regulatory approval of the first hybrid closed-loop system in non-paediatric population, large multinational closed-loop clinical trials and pivotal studies including paediatric populations are underway or in preparation to facilitate the use of closed-loop systems in clinical practice.
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spelling pubmed-59421512018-05-18 Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes Tauschmann, Martin Hovorka, Roman Expert Opin Drug Deliv Review Introduction: Nocturnal glucose control remains challenging in children and adolescents with type 1 diabetes due to highly variable overnight insulin requirements. The issue may be addressed by glucose responsive insulin delivery based on real-time continuous glucose measurements. Areas covered: This review outlines recent developments of glucose responsive insulin delivery systems from a paediatric perspective. We cover threshold-based suspend application, predictive low glucose suspend, and more advanced single hormone and dual-hormone closed-loop systems. Approaches are evaluated in relation to nocturnal glucose control particularly during outpatient randomised controlled trials. Expert opinion: Significant progress translating research from controlled clinical centre settings to free-living unsupervised home studies have been achieved over the past decade. Nocturnal glycaemic control can be improved whilst reducing the risk of hypoglycaemia with closed-loop systems. Following the US regulatory approval of the first hybrid closed-loop system in non-paediatric population, large multinational closed-loop clinical trials and pivotal studies including paediatric populations are underway or in preparation to facilitate the use of closed-loop systems in clinical practice. Taylor & Francis 2017-08-18 /pmc/articles/PMC5942151/ /pubmed/28819992 http://dx.doi.org/10.1080/17425247.2017.1360866 Text en © 2017 Informa UK Limited, trading as Taylor & Francis Group
spellingShingle Review
Tauschmann, Martin
Hovorka, Roman
Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes
title Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes
title_full Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes
title_fullStr Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes
title_full_unstemmed Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes
title_short Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes
title_sort insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942151/
https://www.ncbi.nlm.nih.gov/pubmed/28819992
http://dx.doi.org/10.1080/17425247.2017.1360866
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