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Profil explores opportunities for artificial pancreas in type 2 diabetes

Highlighting the role of open and trans-sectoral collaboration in the advancement of artificial pancreas solutions

Profil has recently published a peer-reviewed article on the topic of “Artificial Pancreas Systems for People With Type 2 Diabetes: Conception and Design of the European CLOSE Project ” in the Journal of Diabetes Science and Technology. Profil is the organisation coordinating CLOSE. The article is authored by CLOSE industry and academic partners, representatives of the EIT Health public-private partnership management boards, and key opinion leaders in the field.

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Topics: The Science behind Diabetes, Treating Diabetes, Diabetes Technology

Posted by Prof. Dr. Freimut Schliess on Oct 2, 2018 5:18:00 PM
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Do-It-Yourself Artificial Pancreas systems (DIY APS)

The way forward to closed-loop metabolic control in diabetes care?

The challenge

Diabetes represents a huge and multidimensional challenge. Despite the availability of numerous treatment options, many patents still fail to reach their treatment goals. Administration of  the right amount of insulin at the right time still poses a great challenge for the self-management of many people with diabetes.

Accordingly there is a huge need to implement new innovative products and services improving both the effectiveness of diabetes care and the quality of life for people with diabetes. Particularly user-centered products and sercvices co-created with stakeholders including people with diabetes may have a high potential to increase treatment adherence thereby reducing the enormous pressure on healthcare systems.

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Topics: The Science behind Diabetes, Treating Diabetes, Diabetes Technology

Posted by Prof. Dr. Freimut Schliess on Sep 5, 2018 5:16:00 PM
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Clamp studies with ultra-long-acting insulins – New challenges for an old procedure

The euglycemic clamp technique has been used as a standard method for assessing time action profiles of insulins for decades. In recent years, new challenges have emerged for investigators performing glucose clamp trials. These are driven by two opposing trends in the development of novel insulins: On the one hand, drug developers are formulating insulin products with a very rapid onset of action and a short duration of action – often referred to as “ultra-rapid insulins” [1,2]. On the other hand, novel basal insulins are being developed with an “ultra-long” duration of action with flatter activity profiles than previously available products [3,4,5].

 

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Topics: The Science behind Diabetes, Clinical Trials in Diabetes, Diabetes Technology

Posted by Oliver Klein on Jul 24, 2018 5:11:00 PM
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Vitamin D supplementation – is there a role in type 1 diabetes?

The possible ‘non-calcemic’ effects of Vitamin D in numerous diseases has become a large area of research. Historically, Vitamin D is known for its regulatory role in calcium absorption and bone metabolism but the identification of vitamin D receptor (VDR) expression in more than 30 tissues led to the possibility of pleiotropic effects of vitamin D [Diabetes Forouhi 2008]. In vitro and animal studies suggested an anti-inflammatory and immunomodulatory effect of Vitamin D [The Review of Diabetic Studies, Gregoriu 2017]. Moreover, preclinical studies uncovered a potential regulatory role of Vitamin D in insulin secretion, β-cell survival and calcium flux in pancreatic β-cells [Mitri J, Endocrinol Metab Clin North Am 2014].

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Topics: The Science behind Diabetes

Posted by Dr. Susanne Famulla on May 30, 2018 4:52:37 PM
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Pancreatic ß-cell function changes in response to pharmacological or life-style interventions

Many different approaches are available for measuring Pancreatic ß-cell function (BCF). The choice of testing methodology will ultimately be determined by the research question.

Metabolic dysfunction in pre-diabetes and type 2 diabetes (T2D) leads to a decline in insulin sensitivity (IS) [capacity for glucose disposal and ability to suppress hepatic glucose production in response to insulin]. As an appropriate physiological response, insulin secretion increases in a compensatory manner. Circulating insulin concentrations are reciprocally related to IS through a hyperbolic relationship and are expressed as the “disposition index” [DI: IS * first phase (acute) insulin secretion], which was shown to be highly related to the conversion to T2D [[1]] [[2]] (Figure 1).

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Topics: The Science behind Diabetes

Posted by Dr. Ulrike Hövelmann on Feb 21, 2018 9:27:57 AM
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Advanced precision of Continuous Whole Blood Glucose concentration measurements

Continuous Glucose Concentration Measurement

A continuous glucose monitor (CGM) is a sensor that automatically determines the blood glucose concentration at regular intervals (quasi continuous). Typical intervals range from 1 to 15 minutes which equals 60 to 4 glucose values per minute. The blood glucose can be measured directly in the veins (invasive sensors or intra venous (iv)-sensors) or in other body compartments like subcutaneous tissue, tear fluid, saliva (minimal invasive sensors). The most common and commercial available CGMs measure the interstitial glucose concentration and convert the obtained interstitial glucose values to blood glucose values by a suitable calibration.

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Topics: The Science behind Diabetes, Clinical Trials in Diabetes

Posted by Dr. Carsten Benesch on Jan 23, 2018 5:17:00 PM
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Bringing glucose clamps up to speed for novel insulins

Ultra-rapid insulins in glucose clamp trials

Euglycemic glucose clamps have been widely accepted as a standard method for describing the time-action profiles of insulins for many years, and clamp results are required by regulatory authorities in the development of new insulin preparation.[1];[2]

The basic principle of a glucose clamp experiment is simple: A patient’s blood glucose (BG) is kept at a constant, predefined level after giving a test dose of insulin. This is achieved by infusing glucose intravenously at a variable rate. Close monitoring of BG levels and frequent adjustment of the glucose infusion rate (GIR) are essential for maintaining the target glucose level (or ‘clamp level’) with as little deviation as possible.

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Topics: The Science behind Diabetes, Clinical Trials in Diabetes

Posted by Oliver Klein on Jan 10, 2018 5:00:00 PM
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Health claims & the need for scientific evidence in food studies

In December 2006 EU decision makers adopted Regulation (EC) No 1924/2006 on the use of nutrition and health claims for foods. This Regulation lays down harmonised EU-wide rules for the use of health or nutritional claims on foodstuffs.

One of the key objectives of this Regulation is to ensure that any claim made on a food label in the EU is clear and substantiated by scientific evidence.

In the following, frequently asked questions about the Health Claims Regulation as well as its further implication for the conduct of evidence based food studies are provided.

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Topics: The Science behind Diabetes

Posted by Dr. Daniela Lamers on Dec 13, 2017 5:00:00 PM
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Treatment with SGLT2 inhibitors: is there hope for renal protection?

Despite treatments becoming more effective and despite more adequate control of the risk factors (e.g. smoking, inadequate glycaemic control or hypertension), patients with diabetes continue having increased risk of chronic kidney disease (CKD) (1). It is estimated that diabetic nephropathy affects approximately 30% of subjects with diabetes, who could eventually develop end-stage renal disease (2) resulting in a significant negative impact on life quality and life expectancy.

The sodium/glucose cotransporter 2 (SGLT2) inhibitors have been intensively investigated in the previous years due to their mechanism of action involving renal excretion of glucose. Large studies have shown the potential of these drugs to improve glycaemic control and also to improve cardiovascular (CV) outcomes (3, 4). The EMPA-REG OUTCOME trial (3) and the CANVAS program (4) evaluated the efficacy of SGLT2 inhibitors in reducing the occurrence of CV endpoints. Both trials had secondary endpoints to evaluate the progression of nephropathy in the subjects studied.

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Topics: The Science behind Diabetes, Clinical Trials in Diabetes

Posted by Dr. Jorge Arrubla on Nov 17, 2017 5:00:00 PM
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Can a dual-hormone closed loop delivery systems become a “technical cure” of diabetes?

The dual hormone (insulin and glucagon) ‘‘artificial pancreas’’: Promises and challenges

Achieving tight glycaemic control without severe hypoglycaemia still is a major challenge in insulin-treated diabetes. While curative cell based and immunological therapies could theoretically provide the ideal solution for patients with diabetes, there are still many issues to be solved. Closed-loop technologies may provide a more promising alternative for the near future, although various challenges will still need to be overcome to safely avoid hypoglycaemia and still achieve good blood glucose levels in a closed-loop setting.

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Topics: The Science behind Diabetes

Posted by Dr. Ulrike Hövelmann on Nov 2, 2017 9:18:15 AM
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