British Journal of Diabetes最新文献_第4页

100 years of insulin; 50 years of diabetic life* 胰岛素100年；糖尿病患者50年的生活*

IF 0.6

British Journal of Diabetes Pub Date : 2022-12-22 DOI: 10.15277/bjd.2022.379

Maggie Loughran

引用次数: 0

Gazing into the future. The next 100 years: the Medtronic perspective 展望未来。下一个100年:美敦力的视角

IF 0.6

British Journal of Diabetes Pub Date : 2022-12-22 DOI: 10.15277/bjd.2022.376

D. Turner

{"title":"Gazing into the future. The next 100 years: the Medtronic perspective","authors":"D. Turner","doi":"10.15277/bjd.2022.376","DOIUrl":"https://doi.org/10.15277/bjd.2022.376","url":null,"abstract":"While it is difficult to predict the next 100 years of development, the current Medtronic product innovation pipeline is changing the lives of people with diabetes. The MiniMedTM 780G system with GuardianTM 4 sensor and extended wear infusion set is the advanced hybrid closed-loop pump system currently available in the UK from Medtronic. It has been clinically proven to achieve >70% time in range and to lower HbA1c levels in people with diabetes. Medtronic continues to innovate in the hybrid closed-loop and insulin pump and sensor area. The company is developing new sensor technology and personalised closed-loop options for future patients. Medtronic recognises that not all people with diabetes will want to use an insulin pump and therefore is launching a Smart MDI system for people looking for more from MDI therapy. The Smart MDI system brings together a collection of tools that provides real-time insights and comprehensive reports. These make it easier for people with diabetes to manage life on multiple daily injections. The system combines predictive glucose management with the GuardianTM 4 sensor, with no finger pricks and personalised high and low alerts up to 60 minutes in advance. Personalised insulin management with the inpen device allows informed insulin dosing with integrated real-time glucose data trends and shareable insight reports. The Medtronic extended-wear infusion set is due to launch in the UK soon. It is focused on improving user experience. It is the only infusion set approved for longer wear (with a wear twice as long as standard infusion sets) without compromising comfort, safety or insulin delivery. This new set will also reduce traditional infusion set plastic waste by half.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43976330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

brief history of the UK Prospective Diabetes Study 英国前瞻性糖尿病研究简史

IF 0.6

British Journal of Diabetes Pub Date : 2022-12-22 DOI: 10.15277/bjd.2022.359

R. Holman

{"title":"brief history of the UK Prospective Diabetes Study","authors":"R. Holman","doi":"10.15277/bjd.2022.359","DOIUrl":"https://doi.org/10.15277/bjd.2022.359","url":null,"abstract":"The UK Prospective Diabetes Study (UKPDS) epidemiological ﬁndings conﬁrmed that T2DM is not a “mild” disease, with roughly 50% of patients having clinically evident complica- tions at diagnosis, emphasising the need for its early detection and treatment. Hyperglycaemia was identiﬁed as an independent coronary heart disease risk factor, with progressive hyperglycaemia shown to be a major pathophysiological feature of T2DM, driven by declining beta-cell function. People with T2DM and hypertension were found to be at double jeopardy for any diabetes endpoint, and worsening kidney function was shown to increase the risk of death substantially.\u0000The UKPDS 20-year trial results were the ﬁrst to demon- strate that diabetic complications are not inevitable but can be prevented by more intensive blood glucose control and by metformin therapy, changing T2DM management guide- lines worldwide. The UKPDS also showed that tighter blood pressure control prevents diabetic complications; the beneﬁts of the glucose and blood pressure interventions are additive. The UKPDS 10-year post-trial monitoring study was the ﬁrst to identify the T2DM glycaemic and metformin legacy effects, with early more intensive therapy having continuing beneﬁts long after the trial terminated. The trial demon- strated the need to achieve good glycaemic control as early as possible to minimise the risk of future complications.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48656482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Islet cell transplantation 胰岛细胞移植

IF 0.6

British Journal of Diabetes Pub Date : 2022-12-22 DOI: 10.15277/bjd.2022.364

Y. Cheah

引用次数: 0

Reﬂections on 60 years of caring for people with diabetes 糖尿病患者60年护理回顾

IF 0.6

British Journal of Diabetes Pub Date : 2022-12-22 DOI: 10.15277/bjd.2022.362

A. Wright

引用次数: 0

beginning of the end for insulin? – enter immunotherapy for T1DM 胰岛素的终结开始了吗?-进入T1DM的免疫治疗

IF 0.6

British Journal of Diabetes Pub Date : 2022-12-22 DOI: 10.15277/bjd.2022.369

C. Dayan

{"title":"beginning of the end for insulin? – enter immunotherapy for T1DM","authors":"C. Dayan","doi":"10.15277/bjd.2022.369","DOIUrl":"https://doi.org/10.15277/bjd.2022.369","url":null,"abstract":"Although we have treated type 1 diabetes (T1DM) with insulin for more than 100 years, it has been apparent since the discovery of insulitis in the 1960s and islet cell antibodies in 1974 that T1DM is fundamentally an autoimmune disease, not a metabolic disease.1 Almost all other autoimmune diseases, from inflammatory bowel disease to rheumatoid arthritis, are treated with immunotherapy but not T1DM. In large part this is because of the discovery of insulin: unlike most other autoimmune diseases, a replacement therapy exists for T1DM. As a result, the discovery of insulin can be viewed as both a blessing and a curse. It is a “curse” because most of the major drug companies have developed their large immunotherapy portfolios of drugs for autoimmune diseases other than T1DM, including some such as psoriasis or alopecia areata that might be considered less life-threatening. And it is likely that diabetes practitioners are also partly to blame since they fear immunotherapy since it is a treatment with which they are not familiar. It is important to remind ourselves of the challenges of insulin therapy. It is not a drug without risk: deaths still occur from underdosage (DKA) and overdosage (hypoglycaemia). According to ONS data, in 2021 in England and Wales, 44 people under the age of 50 died of DKA and 154 died of hypoglycaemia.2 Set against this, even despite the introduction of CGM and insulin pumps, fewer than 30% of adults and children with diabetes achieve a target HbA1c < 7.0%, or 53 mmol/mol which obviates the risks of longterm complications.3 Furthermore, insulin management consumes millions of hours of patients and healthcare professional time in training, adjustments, testing and decision-making. Despite this, 36% of children and families continue to need psychological support more than five years after diagnosis (NPDA national audit 2018-2019,3 and up to 50% of adults with T1DM report significant diabetes-related distress. 4 There is a large and expanding world of highly selective immunotherapies that does not include the classic immunosuppressents (e.g. cyclosporin, tacrolimus) used in transplantation. Rather, it includes many drugs known as “biologics” that have been widely used and have been very well tolerated in other autoimmune diseases for more than 20 years. Many are monoclonal antibodies, but small molecule inhibitors such as JAK kinase inhibitors are being introduced.5 At least seven selective immunotherapies have shown efficacy in Phase 2 studies in preserving beta cell function from diagnosis compared to controls.6,7 These treatments reduce progression of the underlying disease process but do not cause regrowth of beta cells. In current clinical practice, T1DM is diagnosed at the time that insulin replacement is required. This is late in the disease course, when it is estimated that more than 80% of functional beta cells have been lost. When selective immunotherapy is given at this stage, some impact on insulin dose (and in some","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43790790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What does the next 100 years hold? The perspective of a patient with T1DM 未来100年会怎样？T1DM患者的观点

IF 0.6

British Journal of Diabetes Pub Date : 2022-12-22 DOI: 10.15277/bjd.2022.380

Tim J. Street

引用次数: 0

ﬂash glucose monitoring revolution: the Sat Nav journey 血糖监测革命：卫星导航之旅

IF 0.6

British Journal of Diabetes Pub Date : 2022-12-22 DOI: 10.15277/bjd.2022.372

E. Wilmot

引用次数: 0

Sanger, Hodgkin, Yalow and the impact of insulin analogues Sanger, Hodgkin, yellow和胰岛素类似物的影响