Dual‐hormone artificial pancreas: benefits and limitations compared with single‐hormone systems

Dual‐hormone artificial pancreas: benefits and limitations compared with single‐hormone systems What's new?We review the literature comparing the relative efficacy and utility of single‐ and dual‐hormone artificial pancreas systems.The pharmacokinetic profile of glucagon, with rapid onset and short duration of action, confers the major benefit of the dual‐hormone artificial pancreas.The dual‐hormone artificial pancreas is superior to single‐hormone systems in reducing hypoglycaemia overall and during exercise in short‐term studies, whereas there is no strong evidence of added benefit for preventing nocturnal or post‐exercise hypoglycaemia.The relative benefit of each system over the long term for improving HbA1c, preventing severe hypoglycaemia, and affecting quality of life remains unknown.IntroductionThe benefits of tight glycaemic control for reducing microvascular complications and all‐cause mortality in Type 1 diabetes must be balanced with the increased risk of hypoglycaemia and the elevated burden of diabetes self‐management that accompanies intensive glucose control. Moreover, fear of hypoglycaemia often leads to permissive hyperglycaemia, which is reflected in suboptimal HbA1c levels in people with Type 1 diabetes .With advances in technology, including continuous glucose monitoring and continuous subcutaneous insulin infusion (CSII) pumps (‘insulin pumps’), the burden of self‐monitoring capillary blood glucose and of multiple daily subcutaneous insulin injections is reduced. Recent evidence points to increased utilization of these emerging technologies, particularly among the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Diabetic Medicine Wiley

Dual‐hormone artificial pancreas: benefits and limitations compared with single‐hormone systems

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
Diabetic Medicine © 2018 Diabetes UK
ISSN
0742-3071
eISSN
1464-5491
D.O.I.
10.1111/dme.13581
Publisher site
See Article on Publisher Site

Abstract

What's new?We review the literature comparing the relative efficacy and utility of single‐ and dual‐hormone artificial pancreas systems.The pharmacokinetic profile of glucagon, with rapid onset and short duration of action, confers the major benefit of the dual‐hormone artificial pancreas.The dual‐hormone artificial pancreas is superior to single‐hormone systems in reducing hypoglycaemia overall and during exercise in short‐term studies, whereas there is no strong evidence of added benefit for preventing nocturnal or post‐exercise hypoglycaemia.The relative benefit of each system over the long term for improving HbA1c, preventing severe hypoglycaemia, and affecting quality of life remains unknown.IntroductionThe benefits of tight glycaemic control for reducing microvascular complications and all‐cause mortality in Type 1 diabetes must be balanced with the increased risk of hypoglycaemia and the elevated burden of diabetes self‐management that accompanies intensive glucose control. Moreover, fear of hypoglycaemia often leads to permissive hyperglycaemia, which is reflected in suboptimal HbA1c levels in people with Type 1 diabetes .With advances in technology, including continuous glucose monitoring and continuous subcutaneous insulin infusion (CSII) pumps (‘insulin pumps’), the burden of self‐monitoring capillary blood glucose and of multiple daily subcutaneous insulin injections is reduced. Recent evidence points to increased utilization of these emerging technologies, particularly among the

Journal

Diabetic MedicineWiley

Published: Jan 1, 2018

References

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