‘Smart’ insulin-delivery technologies and intrinsic glucose-responsive insulin analogues
| العنوان: | ‘Smart’ insulin-delivery technologies and intrinsic glucose-responsive insulin analogues |
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| المؤلفون: | Deepak Chatterjee, Mark A. Jarosinski, Balamurugan Dhayalan, Michael A. Weiss, Nischay K. Rege |
| المصدر: | Diabetologia |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Blood Glucose, Pancreas, Artificial, 0301 basic medicine, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Pharmacology, Glucose responsive, Artificial pancreas, Article, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Therapeutic index, Inventions, Diabetes mellitus, Internal Medicine, medicine, Humans, Insulin, biology, business.industry, Blood Glucose Self-Monitoring, Type 2 Diabetes Mellitus, medicine.disease, Insulin receptor, Diabetes Mellitus, Type 1, Glucose, 030104 developmental biology, Diabetes Mellitus, Type 2, biology.protein, business, Hormone |
| الوصف: | Insulin replacement therapy for diabetes mellitus seeks to minimise excursions in blood glucose concentration above or below the therapeutic range (hyper- or hypoglycaemia). To mitigate acute and chronic risks of such excursions, glucose-responsive insulin-delivery technologies have long been sought for clinical application in type 1 and long-standing type 2 diabetes mellitus. Such ‘smart’ systems or insulin analogues seek to provide hormonal activity proportional to blood glucose levels without external monitoring. This review highlights three broad strategies to co-optimise mean glycaemic control and time in range: (1) coupling of continuous glucose monitoring (CGM) to delivery devices (algorithm-based ‘closed-loop’ systems); (2) glucose-responsive polymer encapsulation of insulin; and (3) mechanism-based hormone modifications. Innovations span control algorithms for CGM-based insulin-delivery systems, glucose-responsive polymer matrices, bio-inspired design based on insulin’s conformational switch mechanism upon insulin receptor engagement, and glucose-responsive modifications of new insulin analogues. In each case, innovations in insulin chemistry and formulation may enhance clinical outcomes. Prospects are discussed for intrinsic glucose-responsive insulin analogues containing a reversible switch (regulating bioavailability or conformation) that can be activated by glucose at high concentrations. |
| تدمد: | 1432-0428 0012-186X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d2225e21e72676d79f8bb4bfabbac9bbTest https://doi.org/10.1007/s00125-021-05422-6Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d2225e21e72676d79f8bb4bfabbac9bb |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14320428 0012186X |
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