Therapy of type 1 diabetes mellitus
Pramlintide (Symlin) is an analogue of amylin, a neuroendocrine hormone that is co-secreted from the beta cell along with insulin. Pramlintide is injected prior to a meal, along with insulin, and it acts to reduce the postprandial blood glucose rise. It does this both by causing a delay in gastric emptying as well as reducing
Closed Loop SystemsA closed loop system would provide seamless blood glucose management, with the sensor feeding information to a pump, which in turn delivers insulin based on a series of algorithms. Although not yet available, such systems are being developed. A pilot study was performed using two Minimed CGMS sensors and a Minimed pump which
Insulin PensInsulin pens were first introduced in the 1980s, in an attempt to make insulin delivery more convenient and possibly less fear-inducing. By definition they contain some form of insulin, although there are also pens prefilled with pramlintide to administer along with insulin. Pens tend to be preferred by patients when compared to vials and
The side effects of insulin therapy include delayed local skin reactions to injected insulin, true or systemic insulin allergy, insulin resistance, insulin-induced lipoatrophy, and insulin-induced lipohypertrophy. Three other possible sequelae of insulin administration are considered therapeutic effects, not side effects. The most common effect is hypoglycemia.
The treatment of type 1 diabetes is simple in theory: replace the missing endogenous production of insulin with exogenous insulin in a manner that mimics normal physiology. The difficulties in doing this are myriad, however, in part stemming from the fact that endogenous insulin is delivered in intricate pulses to the portal circulation whereas exogenous