Current Diabetes Technology and its Challenges

Fauzi, Ayesha; YIN, Adeline Chia YOKE; Tang, Yin Quan

doi:10.25179/tjem.2021-86517

Cited by 1 publication

(2 citation statements)

References 33 publications

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“…Unquestionably, diabetes technologies have markedly improved treatment for people with diabetes ( Akturk and Garg, 2019 ). It is indeed unfortunate that the more widespread use of these valuable technologies is limited by socioeconomic inequalities ( Bellary et al, 2012 ; Scott et al, 2017 ; Alcantara-Aragon, 2019 ; Fauzi et al, 2022 ; Mishra et al, 2022 ). Novel diabetes technologies for assessing glucose levels can be classified (broadly) into three tiers; 1) CGM (or flash/intermittent monitors), 2) CGM with sensor augmented insulin pump, and 3) automated insulin delivery systems ( Ebekozien and Shah, 2023 ).…”

Section: Impaired Awareness Of Hypoglycemia (Iah) Therapiesmentioning

confidence: 99%

Section: Technologymentioning

confidence: 99%

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Current and future therapies to treat impaired awareness of hypoglycemia

Macon,

Devore,

Lin

et al. 2023

Front. Pharmacol.

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In order to achieve optimal glycemic control, intensive insulin regimes are needed for individuals with Type 1 Diabetes (T1D) and insulin-dependent Type 2 Diabetes (T2D). Unfortunately, intensive glycemic control often results in insulin-induced hypoglycemia. Moreover, recurrent episodes of hypoglycemia result in both the loss of the characteristic warning symptoms associated with hypoglycemia and an attenuated counterregulatory hormone responses. The blunting of warning symptoms is known as impaired awareness of hypoglycemia (IAH). Together, IAH and the loss of the hormonal response is termed hypoglycemia associated autonomic failure (HAAF). IAH is prevalent in up to 25% in people with T1D and up to 10% in people with T2D. IAH and HAAF increase the risk of severe hypoglycemia 6-fold and 25-fold, respectively. To reduce this risk for severe hypoglycemia, multiple different therapeutic approaches are being explored that could improve awareness of hypoglycemia. Current therapies to improve awareness of hypoglycemia include patient education and psychoeducation, the use of novel glycemic control technology, pancreas/islet transplantation, and drug therapy. This review examines both existing therapies and potential therapies that are in pre-clinical testing. Novel treatments that improve awareness of hypoglycemia, via improving the counterregulatory hormone responses or improving hypoglycemic symptom recognition, would also shed light on the possible neurological mechanisms that lead to the development of IAH. To reduce the risk of severe hypoglycemia in people with diabetes, elucidating the mechanism behind IAH, as well as developing targeted therapies is currently an unmet need for those that suffer from IAH.

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