BACKGROUND Closed-loop insulin delivery systems linking subcutaneous insulin infusion to real-time continuous glucose monitoring need to be evaluated in humans, but progress can be accelerated with the use of in silico testing. We present a simulation environment designed to support the development and testing of closed-loop insulin delivery systems in type 1 diabetes mellitus (T1DM). METHODS...

OBJECTIVE Insulin causes capillary recruitment in muscle and adipose tissue, but the metabolic and microvascular effects of insulin in the skin have not been studied in detail. The aim of this study was to measure glucose metabolism and microvascular blood flow in the skin during local insulin delivery and after an oral glucose load. METHODS Microdialysis catheters were inserted intracutanous...

In health, insulin is secreted in discrete pulses into the portal vein, and the regulation of the rate of insulin secretion is accomplished by modulation of insulin pulse mass. Several lines of evidence suggest that the pattern of insulin delivery by the pancreas determines hepatic insulin clearance. In previous large animal studies, the amplitude of insulin pulses was related to the extent of ...

BACKGROUND Algorithms for closed-loop insulin delivery can be designed and tuned empirically; however, a metabolic model that is predictive of clinical study results can potentially accelerate the process. METHODS Using data from a previously conducted closed-loop insulin delivery study, existing models of meal carbohydrate appearance, insulin pharmacokinetics, and the effect on glucose metab...

BACKGROUND Despite potential advantages in insulin pen delivery systems (IPDSs), the percentage of patients using an IPDS is relatively low in the United States. OBJECTIVE Our aim was to investigate the trend of initiating IPDSs among patients with type 2 diabetes mellitus (T2DM) who newly initiated insulin therapy. METHODS A retrospective analysis was conducted using a U.S. database from J...

In this study, N,N-Dimethyl-N-Octyl chitosan was synthesized. Nanoparticles containing insulin were prepared using PEC method and were statistically optimized using the Box-Behnken response surface methodology. The independent factors were considered to be the insulin concentration, concentration and pH of the polymer solution, while the dependent factors were characterized as the size, zeta po...

Intrahepatic islet transplantation is an experimental therapy for type 1 diabetes. In the present studies, we sought to address the following questions: 1) In humans, do intrahepatic transplanted islets reestablish coordinated puslatile insulin secretion? and 2) To what extent is insulin secreted by intrahepatic transplanted islets delivered to the hepatic sinusoids (therefore effectively resto...

Treatment of type 1 diabetes mellitus could be greatly improved by applying a closed-loop control strategy to insulin delivery, also known as an artificial pancreas (AP). In this work, we outline the design of a fully implantable AP using intraperitoneal (IP) insulin delivery and glucose sensing. The design process utilizes the rapid glucose sensing and insulin action offered by the IP space to...

In many countries Type 1 diabetes [T1D] is the most common life-threatening disease in chil‐ dren, and nobody can be cured. For long time the incidence has increased all over the world [1]. The disease causes serious morbidity and increased mortality [2,3] in spite of an intensive treatment with multiple daily injections of insulin, adapted to regular meals with suitable content based on self-m...

La diabetes es un trastorno de muy alta prevalencia, caracterizado por un déficit de acción insulínica, que da lugar a concentraciones elevadas de glucosa en sangre. Las terapias sustitutivas son muy imperfectas: en pocos casos consiguen controlar de manera estable los valores de glucemia, se adaptan mal a las perturbaciones (ingestas, ejercicio, etc.), provocan hipoglucemias e implican un esfu...