A perspective of sensor-augmented insulin pump therapy in the treatment of type 1 diabetes

• Published in: Endocrine practice Vol. 21; no. 1; pp. 91 - 92
• Main Author: Rayfield, Elliot J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 01.01.2015
• Subjects: Blood Glucose; Diabetes Mellitus, Type 1 - drug therapy; Glycated Hemoglobin A; Humans; Hypoglycemic Agents - therapeutic use; Insulin - therapeutic use; Insulin Infusion Systems; Insulins
• ISSN: 1530-891X; 1934-2403
• DOI: 10.4158/EP14443.CO

The holy grail for the treatment of type 1 diabetes is stem cell therapy (1,2) or the closed-loop artificial pancreas (3,4). Whereas several groups are currently developing these treatment modalities, they are not there yet. The first step in the process has been met with the low-glucose suspend pump, which stops insulin delivery for up to 2 hours when the interstitial glucose concentration reaches 70 mg/dL. The Diabetes Control and Complications Trial first showed a clear relationship between diabetic microvascular complications and glycemic control. Others have posited data supporting a relationship between macrovascular disease and glycemic control. In addition to achieving an optimum glycated hemoglobin (HbA1c) level of <6.5% (AACE), or <7.0% (ADA, EASD), one should not forget the role of glycemic variability. Not only does a minimal degree of glycemic variability improve the patient's quality of life, but increased glycemic variability correlates with the urinary excretion of 8-iso prostaglandin F2α, increased oxidative stress, and a presumed increase in the rate of diabetic complication.