Over the past several decades, there have been major advancements in the field of glucose sensing and insulin delivery for the treatment of type I diabetes mellitus. The introduction of closed-loop insulin delivery systems that deliver insulin in response to specific levels of glucose in the blood has shifted significantly the research in this field. These systems consist of encapsulated glucose-sensitive components such as glucose oxidase or phenylboronic acid in hydrogels, microgels or nanoparticles. Since our previous evaluation of these systems in a contribution in 2004, new systems have been developed. Important improvements in key issues, such as consistent insulin delivery over an extended period of time have been addressed. In this contribution, we discuss recent advancements over the last 5 years and present persisting issues in these technologies that must be overcome in order for these systems to be applicable in patients.
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http://dx.doi.org/10.1093/rb/rbac056 | DOI Listing |
Auton Neurosci
January 2025
Departments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. Electronic address:
During exercise circulatory adjustments to meet oxygen demands are mediated by multiple autonomic mechanisms, the skeletal muscle exercise pressor reflex (EPR), the baroreflex (BR), and by feedforward signals from central command neurons in higher brain centers. Insulin resistance in peripheral tissues includes sensitization of skeletal muscle afferents by hyperinsulinemia which is in part responsible for the abnormally heightened EPR function observed in diabetic animal models and patients. However, the role of insulin signaling within the central nervous system (CNS) is receiving increased attention as a potential therapeutic intervention in diseases with underlying insulin resistance.
View Article and Find Full Text PDFDiabetes Care
January 2025
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Objective: We investigated associations between per- and polyfluoroalkyl substances (PFAS) and changes in diabetes indicators from pregnancy to 12 years after delivery among women with a history of gestational diabetes mellitus (GDM).
Research Design And Methods: Eighty Hispanic women with GDM history were followed from the third trimester of pregnancy to 12 years after delivery. Oral and intravenous glucose tolerance tests were conducted during follow-up.
Arch Gynecol Obstet
January 2025
Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Women with a history of gestational diabetes mellitus (GDM) significantly increase the risk of developing type 2 diabetes later in life. Although the increased glucose levels typically return to normal range after delivery for most GDM women, a significant proportion of GDM women develop impaired glucose tolerance or overt diabetes after delivery. Several factors associated with postpartum glucose abnormalities have been identified, yet the link between fasting glucose levels at diagnosis of GDM and postpartum glucose abnormalities remains unclear.
View Article and Find Full Text PDFPLoS One
January 2025
Institute of Visual Informatics, The National University of Malaysia (UKM), Bangi, Malaysia.
Patients with type 1 diabetes and their physicians have long desired a fully closed-loop artificial pancreas (AP) system that can alleviate the burden of blood glucose regulation. Although deep reinforcement learning (DRL) methods theoretically enable adaptive insulin dosing control, they face numerous challenges, including safety and training efficiency, which have hindered their clinical application. This paper proposes a safe and efficient adaptive insulin delivery controller based on DRL.
View Article and Find Full Text PDFDiabetes Technol Ther
January 2025
Department of Paediatrics, University of Otago, Christchurch, New Zealand.
This study evaluated a next-generation automated insulin delivery (AID) algorithm for Omnipod in type 1 and type 2 diabetes across multiple phases: 14-day run-in with usual therapy, 48-h AID use in a hotel setting (type 1 only), and up to 6 weeks of outpatient AID use. Participants did, or did not, deliver manual boluses at alternating periods. Twelve adults with type 1 diabetes completed the hotel phase; 9 of those 12 plus 8 adults with type 2 diabetes completed the subsequent outpatient phase.
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