Efficacy and safety of ultra-rapid insulin analogues in insulin pumps in patients with Type 1 Diabetes Mellitus: A systematic review and meta-analysis

Stamati, Athina; Karagiannis, Thomas; Christoforidis, Athanasios

doi:10.1016/j.diabres.2022.110144

Cited by 10 publications

(4 citation statements)

References 22 publications

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“…Lispro-aabc tends to have more insertion site reactions than insulin lispro 63. A meta-analysis including nine studies and 1156 participants reported increased infusion set changes on rapid acting insulin analogs (odds ratio 1.60, 95% confidence interval 1.26 to 2.03) 64…”

Section: Advances In Treatmentsmentioning

confidence: 99%

New advances in type 1 diabetes

Subramanian,

Khan,

Hirsch

2024

BMJ

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Type 1 diabetes is an autoimmune condition resulting in insulin deficiency and eventual loss of pancreatic β cell function requiring lifelong insulin therapy. Since the discovery of insulin more than 100 years ago, vast advances in treatments have improved care for many people with type 1 diabetes. Ongoing research on the genetics and immunology of type 1 diabetes and on interventions to modify disease course and preserve β cell function have expanded our broad understanding of this condition. Biomarkers of type 1 diabetes are detectable months to years before development of overt disease, and three stages of diabetes are now recognized. The advent of continuous glucose monitoring and the newer automated insulin delivery systems have changed the landscape of type 1 diabetes management and are associated with improved glycated hemoglobin and decreased hypoglycemia. Adjunctive therapies such as sodium glucose cotransporter-1 inhibitors and glucagon-like peptide 1 receptor agonists may find use in management in the future. Despite these rapid advances in the field, people living in under-resourced parts of the world struggle to obtain necessities such as insulin, syringes, and blood glucose monitoring essential for managing this condition. This review covers recent developments in diagnosis and treatment and future directions in the broad field of type 1 diabetes.

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Section: Advances In Treatmentsmentioning

confidence: 99%

New advances in type 1 diabetes

Subramanian,

Khan,

Hirsch

2024

BMJ

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“…The latest ultra-rapid-acting insulins introduce additional bolus insulin alternatives for individuals with type 1 or type 2 diabetes (T1D, T2D) (Avgerinos et al, 2021). Key advantages of these ultra-rapid-acting agents include potential improvements in glycemic control for patients with unmet postprandial glucose (PPG) targets, suitability for use in infusion pumps, and their availability in user-friendly pen delivery devices (Stamati et al, 2022). These ultra-rapid-acting insulins offer a rapid onset of action through accelerated insulin absorption and quicker attainment of maximum insulin concentration than traditional short-and rapid-acting insulins (Avgerinos et al, 2021; Stamati et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…Key advantages of these ultra-rapid-acting agents include potential improvements in glycemic control for patients with unmet postprandial glucose (PPG) targets, suitability for use in infusion pumps, and their availability in user-friendly pen delivery devices (Stamati et al, 2022). These ultra-rapid-acting insulins offer a rapid onset of action through accelerated insulin absorption and quicker attainment of maximum insulin concentration than traditional short-and rapid-acting insulins (Avgerinos et al, 2021; Stamati et al, 2022). However, an understanding of the kinetics of monomers or oligomers in rapid-acting insulins remains limited.…”

Section: Introductionmentioning

confidence: 99%

X-ray Crystallographic and Hydrogen Deuterium Exchange Studies Confirm Alternate Kinetic Models for Homolog Insulin Monomers

Ayan,

Türk,

Tatlı

et al. 2024

Preprint

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Despite the crucial role of various insulin analogs in achieving satisfactory glycemic control, a comprehensive understanding of their dynamic mechanisms still holds the potential to further optimize ultra-fast-acting insulin analogs, thus significantly improving the well-being of individuals with Type 1 Diabetes. Here, we present new insights derived from our 2.5 Å resolution X-ray crystal structure of modified insulin analog at ambient temperature. Furthermore, we obtained a distinctive side-chain conformation of the Asn3 residue on the B chain (AsnB3) by operating a comparative analysis with a previously available cryogenic rapid-acting insulin structure (PDB_ID: 4GBN). Additionally, we employed hydrogen-deuterium exchange mass spectrometry to decipher the molecular dynamics of these insulin analogs. A comparative analysis of H/D dynamics demonstrated that the modified insulin exchanges deuterium atoms faster and more extensively than the intact insulin aspart. The hybrid structural approach combined with computational analysis employed in this study provides novel insight into the structural dynamics of newly modified insulin and insulin aspart monomeric entities. It allows further molecular understanding of intermolecular interrelations driving dissociation kinetics and, thus, a fast action mechanism.

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“…5 Recently, there were many studies associated with islet transplantation, stem cell recovery, immune intervention, and insulin analogs, which provide new ideas in the treatment of T1DM. [5][6][7][8] However, the compliance of purely Western medical treatment is poor and easily affects the quality of life of T1DM patients, which makes it difficult for many patients to achieve strict control of blood glucose in daily life, resulting in significant blood glucose fluctuations and multiple complications. 9,10 Furthermore, T1DM has been confirmed that it is related to various molecular mechanisms, including autophagy, oxidative stress, inflammation and apoptosis of pancreatic β-cells.…”

Section: Introductionmentioning

confidence: 99%

Ginsenoside Rg1 Ameliorates Pancreatic Injuries via the AMPK/mTOR Pathway in vivo and in vitro

Chen¹,

Zhu²,

Xiao³

et al. 2023

DMSO

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Background The main propanaxatriol-type saponin found in ginseng (Panax ginseng C. A. Mey), ginsenoside Rg1 (G-Rg1), has bioactivities that include anti-inflammatory, antioxidant, and anti-diabetic properties. This study aimed to investigate the effects of G-Rg1 on streptozotocin (STZ)-induced Type 1 Diabetes mellitus (T1DM) mice and the insulin-secreting cell line in RIN-m5F cells with high-glucose (HG) treatment. Methods The STZ-induced DM mice model was treated with G-Rg1 alone or combined with 3-Methyladenine (3-MA, an autophagy inhibitor)/rapamycin (RAPA, an autophagy activator) for 8 weeks, and levels of glucose and lipid metabolism, histopathological changes, as well as autophagy and apoptosis of relevant markers were estimated. In vitro, the HG-induced RIN-m5F cells were treated with G-Rg1, 3-MA, and Compound C (CC), an AMPK inhibitor, or their combinations to estimate the influences on cell apoptosis, autophagy, and AMPK/mTOR pathway-associated target gene levels. Results G-Rg1 treatment attenuated glucose and lipid metabolism disorder and pancreatic fibrosis in diabetic mice. In addition, subdued autophagy and p-AMPK protein expression, and enhanced p-mTOR protein expression and apoptosis levels in TIDM mice and HG-induced RIN-m5F cells were ameliorated by G-Rg1 treatment. Furthermore, these anti-apoptosis effects of G-Rg1 were partially abolished by 3-MA and CC. Conclusion Our findings revealed that G-Rg1 exhibits strong anti-apoptosis ability in pancreatic tissues of type 1 diabetic mice and HG-induced RIN-m5F cells, and the mechanisms involved in activating AMPK and inhibiting mTOR-mediated autophagy, indicating that G-Rg1 may have the therapeutic and preventive potential for treating pancreatic injury in diabetic patients.

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Efficacy and safety of ultra-rapid insulin analogues in insulin pumps in patients with Type 1 Diabetes Mellitus: A systematic review and meta-analysis

Cited by 10 publications

References 22 publications

New advances in type 1 diabetes

New advances in type 1 diabetes

X-ray Crystallographic and Hydrogen Deuterium Exchange Studies Confirm Alternate Kinetic Models for Homolog Insulin Monomers

Ginsenoside Rg1 Ameliorates Pancreatic Injuries via the AMPK/mTOR Pathway in vivo and in vitro

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