Type 1 diabetes is a disease in which autoimmune destruction of pancreatic β-cells leads to insulin deficiency. Controlling blood glucose with an acceptable range is a major goal of therapy. Measurements of hemoglobin A1c and blood glucose levels are used for both the diagnosis and the long-term management of the disease. This chapter briefly describes the pathophysiology, diagnosis, and management of type 1 diabetes.

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Diabetes mellitus type 1 (T1D) is a disorder of glucose regulation characterized by autoimmune destruction of the insulinproducing pancreatic beta cells and the need for lifelong insulin replacement therapy. Achieving and maintaining near-normal blood glucose (BG) concentrations is critical for successful long term care of patients with diabetes mellitus and prevention of diabetic complications.1-7 However, the therapy required to achieve this goal is extremely demanding. Despite state-of-the-art insulin therapy using rapidacting insulin analogs, hyperglycemia and hypoglycemia are common in most people with T1D. 5-7The availability of insulin pumps and continuous glucose monitors (CGMs) have made possible the development of systems that automatically deliver insulin in response to real time glucose measurements. [8][9][10][11][12][13] These bionic pancreas (or artificial pancreas) devices measure BG frequently, estimate the proper insulin dose, and deliver insulin. However, development of control algorithms capable of appropriately regulating insulin dosing has been challenging due to the slow and unpredictable Background: The speed of insulin absorption after subcutaneous delivery is highly variable. Incorrect assumptions about insulin pharmacokinetics compromise effective glycemic regulation. Our ultimate goal is to develop a system to monitor insulin levels in vivo continuously, allowing pharmacokinetic parameters to be calculated in real time. We hypothesize that a bead-based detection system can be run on a flow-through microfluidic platform to measure insulin in subcutaneous fluid sampled via microdialysis. As a first step in development, we focused on microsphere-based measurement of insulin.