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Dual-hormone artificial pancreas systems

Dual-hormone artificial pancreas systems use insulin and glucagon to control glucose in patients with diabetes - a dream is about to come true

Insulin-only closed-loop AP systems hold promise for reducing the burden of diabetes self-management, but there is still potential for improvement regarding both hypoglycaemia and hyperglycaemia. A dual-hormone AP system achieves closed–loop glycaemic control by subcutaneous infusion of insulin and of glucagon in response to glucose values detected by a continuous glucose monitoring device mimicking the physiological pattern of insulin and glucagon secretion of a healthy pancreas more closely than an insulin infusion-only system.

To reverse the insulin action when blood glucose shows a tendency to fall, glucagon is given as mini-boluses to prevent and to treat any imminent hypoglycemia [1]. Glucagon leads to a rapid conversion of hepatic glycogen (the stored form of glucose) into glucose which is then released into the bloodstream. The comprehensive technology of control algorithms and hardware and the development of long-term stable glucagon formulations have so far provided some development challenges.

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

Posted by Dr. Ulrike Hövelmann on Jul 16, 2019 5:03:00 PM
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Applications of iontophoresis in studies investigating microvasculature

People suffering from Diabetes Mellitus can develop both macrovascular and microvascular complications. Retinopathy, nephropathy and neuropathy are the main microvascular complications occurring in Diabetes Mellitus. Mechanisms include structural and functional alterations resulting from chronically elevated glucose concentrations. Therefore, assessment of the microvasculature is important for studies investigating new treatment modalities in diabetes.

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Topics: Clinical Trials in Diabetes, Treating Diabetes, Clinical Trial Methods

Posted by Dr. Jorge Arrubla on Jun 4, 2019 5:21:00 PM
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The ideal basal insulin?

Long-acting insulins have been developed for patients with diabetes to provide a basal insulin cover during the day and night. The first slow-release formulations used protamine and/or zinc to achieve a duration of action up to 16 hours. Since 2000 insulin analogues with different mechanisms of protraction are available and achieve a predictable glucose lowering effect with one daily injection. Currently, ultra-long acting insulin analogues are available that have a duration of action beyond 24 hours. This prolonged duration of action reduces day-to-day variability and offers daily dosing flexibility [1]. What further improvements in basal insulin therapy can be expected in the future and what exactly does the ideal basal insulin look like?

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Topics: Treating Diabetes

Posted by Dr. Eric Zijlstra on May 21, 2019 4:57:00 PM
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Profil is co-founder of KomIT

KomIT - the new Center of Competence for Innovative Diabetes Therapy

Profil is co-founder of a new consortium of partners from industry and academia focusing on the development and clinical implementation of new diabetes therapies. 
 

During the next three years KomIT, the new Center of Competence for Innovative Diabetes Therapy, will be established at the German Diabetes Center (DDZ) based on a total funding of about 3.5 Mio Euro. This funding is jointly provided by the Land North Rhine-Westphalia and the European Union. KomIT is coordinated by Professor Michael Roden, the scientific Managing Director of the DDZ.

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

Posted by Svenya Meister on Apr 30, 2019 5:09:00 PM
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NAFLD/NASH: a ticking bomb not yet defused

Unmet medical needs in NAFLD and NASH

NAFLD (non-alcoholic fatty liver disease) comprises a spectrum of conditions starting with adiposity of the liver (fatty liver, steatosis hepatis) and ranging up to NASH (non-alcoholic steatohepatitis). Currently about 30% of the general population and 60-80% of people with type 2 diabetes are considered to be affected by NAFLD [1].

Premature mortality from NAFLD comes from the development of diabetes and cardiovascular disease and progression of the fatty liver to the more irreversible and aggressive NASH which again predisposes for incident liver cirrhosis and hepatocellular carcinoma [2]. Despite the potentially disastrous outcome of NAFLD and an increasingly rich knowledge concerning the underlying molecular pathogenesis no rational drugs and therapies specifically dedicated to the treatment of NAFLD are available yet. 

In this blog we first provide a brief overview on the key pathogenetic drivers in NAFLD. Then we highlight the inherent opportunities and challenges for developers of lifestyle interventions and drugs tackling NAFLD. And last but not least we discuss some key issues related to the design and implementation of clinical trials in NAFLD and NASH.

If you want to learn more on Profil’s general perception of the liver’s role in health and disease you are invited to read our „Liver first? The liver in diabetes and cardiovascular disease“ series of blogs (part I, part II, part III).

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

Posted by Prof. Dr. Freimut Schliess on Apr 25, 2019 5:25:00 PM
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Profil joined iPDM-GO

Personalized Diabetes Management in Europe

In the year 2018 Profil joined the team creating the iPDM-GO (integrated Personalized Diabetes Management Goes Europe) consortium for implementing integrated Personalized Diabetes Management in Europe. Following a thorough and competitive evaluation the iPDM-GO project at the beginning of 2019 became part of the Innovation portfolio curated by EIT Health. EIT Health is a public-private knowledge and innovation community (KIC) of best-in-class health innovators backed by the European Union. The KICs Innovation ecosystem enables a collaborative multi-stakeholder approach to implementing a more effective diabetes management in Europe.

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

Posted by Prof. Dr. Freimut Schliess on Apr 16, 2019 5:07:00 PM
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Artificial pancreas in type 2 diabetes

Close the loop in diabetes care

Artificial pancreas systems are medical products that use algorithms informed by continuous glucose monitoring (CGM) data of a given patient, thereby regulating the rates of a continuous subcutaneous insulin infusion through an insulin pump. In this way, artificial pancreas systems are taking over control of the patient’s blood glucose levels.

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

Posted by Prof. Dr. Freimut Schliess on Feb 19, 2019 5:21:00 PM
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Digital Diabetes: better trials, better drugs, better care

Background

Diabetes is a multidimensional challenge for global societies. Despite the availability of drugs and technology many patients don’t reach their treatment goals.  According to the UK National Diabetes Audit data 2016-2017 only 30% of people with type 1 diabetes and 67% of people with type 2 diabetes achieved a HbA1c target of 58 mmol/l (7.5%). When considering also blood pressure and cholesterol targets, these figures dropped to 19% and 41% respectively.

The good news is that diabetes leaves a huge room for Innovation. Risk factors are modifyable, type 2 diabetes is potentially reversible and the role of the patient’s self-management is of outstanding importance. Diabetes could serve as a paradigm for cracking down treatment inertia and narrowing the gap between the efficacy of investigational medicinal products seen in well controlled clinical trials and the lower than expected effectiveness of drugs observed in real-world chronic care (E2E gap) [1].

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

Posted by Prof. Dr. Freimut Schliess on Jan 29, 2019 5:13:00 PM
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Pramlintide as adjunct therapy for the treatment of type 1 diabetes

Where are we today?

Insulin treatment for type 1 diabetes mellitus (T1D) has improved over the past decades due to advances in insulin formulations and administration techniques. Nevertheless, optimal glucose control and reaching HbA1c goals remain challenging for many patients. Consequently, the risk of subsequent micro- and macrovascular complications remains high and life expectancy is still reduced in this patient group so that there is an obvious need for improvement of current therapies or the development of new, additional treatments [1]. So what else can be done?

 

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Topics: Clinical Trials in Diabetes, Treating Diabetes

Posted by Dr. Susanne Famulla on Dec 19, 2018 5:12:00 PM
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New strategies for the treatment of obesity and metabolic dysfunctions

Targeting the incretin/glucagon system with agonists

Figure 1: Schematic representation of the effects of multi-agonists targeting the receptors for GLP-1/Glucagon, GLP-1/GIP and GLP-1/GIP/Glucagon [28]

In Part I of our blog we reported on dual receptor agonists targeting the incretin/glucagon system to treat obesity and type 2 diabetes mellitus with high efficacy. So far, it has been recognized that the concept of combined targeting of gut hormone receptors is also working in humans [1, 2]. In Part II we will focus on the twincretins GIP and GLP-1 [3] to improve glycaemic control and the tri-agonists GLP-1/GIP/Glucagon to treat obesity, type 2 diabetes mellitus and hepatosteatosis [non-alcoholic steatohepatitis (NASH)].

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Topics: Treating Diabetes

Posted by Dr. Ulrike Hövelmann on Nov 13, 2018 5:09:00 PM
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