首页 > 最新文献

TouchREVIEWS in endocrinology最新文献

英文 中文
Advances and Emerging Therapies in the Treatment of Non-alcoholic Steatohepatitis. 非酒精性脂肪性肝炎治疗的进展和新疗法。
Pub Date : 2022-11-01 DOI: 10.17925/EE.2022.18.2.148
Paul N Brennan, John F Dillon, Rory McCrimmon

Non-alcoholic steatohepatitis (NASH) now represents one of the most prevalent forms of cirrhosis and hepatocellular carcinoma. A number of treatment agents have undergone assessment in humans following promising results in animal models. Currently, about 50 therapeutic agents are in various stages of development. Recently, however, there have been a number of exciting and positive developments in this landscape, although there are inherent challenges ahead. In this article, we review the aetiological and pathological basis of NASH progression and describe putative targets for current therapies. We also discuss some of the likely future directions and difficulties around this complex and challenging disease paradigm.

非酒精性脂肪性肝炎(NASH)现在是肝硬化和肝细胞癌最常见的形式之一。在动物模型取得令人满意的结果后,一些治疗药物已在人类身上进行了评估。目前,大约有50种治疗药物处于不同的开发阶段。然而,最近在这方面出现了一些令人兴奋和积极的事态发展,尽管前面存在着固有的挑战。在本文中,我们回顾了NASH进展的病因和病理基础,并描述了当前治疗的假定靶点。我们还讨论了围绕这种复杂和具有挑战性的疾病范式的一些可能的未来方向和困难。
{"title":"Advances and Emerging Therapies in the Treatment of Non-alcoholic Steatohepatitis.","authors":"Paul N Brennan,&nbsp;John F Dillon,&nbsp;Rory McCrimmon","doi":"10.17925/EE.2022.18.2.148","DOIUrl":"https://doi.org/10.17925/EE.2022.18.2.148","url":null,"abstract":"<p><p>Non-alcoholic steatohepatitis (NASH) now represents one of the most prevalent forms of cirrhosis and hepatocellular carcinoma. A number of treatment agents have undergone assessment in humans following promising results in animal models. Currently, about 50 therapeutic agents are in various stages of development. Recently, however, there have been a number of exciting and positive developments in this landscape, although there are inherent challenges ahead. In this article, we review the aetiological and pathological basis of NASH progression and describe putative targets for current therapies. We also discuss some of the likely future directions and difficulties around this complex and challenging disease paradigm.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10619891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Non-albuminuric Diabetic Kidney Disease Phenotype: Beyond Albuminuria. 非白蛋白尿糖尿病肾病的表型:超越白蛋白尿。
Pub Date : 2022-11-01 DOI: 10.17925/EE.2022.18.2.102
Luis D'Marco, Xavier Guerra-Torres, Iris Viejo, Luis Lopez-Romero, Alejandra Yugueros, Valmore Bermídez

Diabetic kidney disease (DKD) is the leading cause of chronic and end-stage kidney disease worldwide. Its pathogenic mechanism is complex, and it can affect the entire structures of the kidneys such as the glomerulus, tubules and interstitium. Currently, the urinary albumin excretion rate and the estimated glomerular filtration rate are widely accepted as diagnostic criteria. However, some studies have reported a different or non-classical clinical course of DKD, with some patients showing declined kidney function with normal levels of albuminuria, known as the 'non-albuminuric DKD' phenotype. The pathogenesis of this phenotype remains unclear, but some clinical and pathological features have been postulated. This review explores the evidence regarding this topic.

糖尿病肾病(DKD)是世界范围内慢性和终末期肾病的主要原因。其致病机制复杂,可累及肾小球、肾小管、肾间质等整个肾脏结构。目前,尿白蛋白排泄率和估算的肾小球滤过率被广泛接受为诊断标准。然而,一些研究报道了不同的或非经典的DKD临床病程,一些患者表现出肾功能下降,蛋白尿水平正常,被称为“非蛋白尿DKD”表型。这种表型的发病机制尚不清楚,但一些临床和病理特征已被假设。这篇综述探讨了关于这一主题的证据。
{"title":"Non-albuminuric Diabetic Kidney Disease Phenotype: Beyond Albuminuria.","authors":"Luis D'Marco,&nbsp;Xavier Guerra-Torres,&nbsp;Iris Viejo,&nbsp;Luis Lopez-Romero,&nbsp;Alejandra Yugueros,&nbsp;Valmore Bermídez","doi":"10.17925/EE.2022.18.2.102","DOIUrl":"https://doi.org/10.17925/EE.2022.18.2.102","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD) is the leading cause of chronic and end-stage kidney disease worldwide. Its pathogenic mechanism is complex, and it can affect the entire structures of the kidneys such as the glomerulus, tubules and interstitium. Currently, the urinary albumin excretion rate and the estimated glomerular filtration rate are widely accepted as diagnostic criteria. However, some studies have reported a different or non-classical clinical course of DKD, with some patients showing declined kidney function with normal levels of albuminuria, known as the 'non-albuminuric DKD' phenotype. The pathogenesis of this phenotype remains unclear, but some clinical and pathological features have been postulated. This review explores the evidence regarding this topic.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10619896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical Evidence and Proposed Mechanisms for Cardiovascular and Kidney Benefits from Sodium-Glucose Co-transporter-2 Inhibitors. 钠-葡萄糖共转运体-2 抑制剂对心血管和肾脏有益的临床证据和拟议机制。
Pub Date : 2022-11-01 Epub Date: 2022-11-29 DOI: 10.17925/EE.2022.18.2.106
Joshua J Neumiller, Fredrick J Lienhard, Radica Z Alicic, Katherine R Tuttle

The number of people living with type 2 diabetes (T2D) and its complications worldwide is increasing at an alarming rate. Fortunately, our understanding of the benefits of glucose-lowering agents from the sodium-glucose co-transporter-2 (SGLT2) inhibitor and glucagon-like peptide-1 (GLP-1) receptor agonist classes on cardiovascular and kidney outcomes is advancing; this means we now have new options to mitigate the risks of these complications in patients with T2D. The SGLT2 inhibitors have consistently demonstrated benefits on atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD) and heart failure (HF) events in dedicated outcome trials. Large guidelines groups now recommend SGLT2 inhibitors as a standard of care in patients with T2D and comorbid ASCVD, CKD and/ or HF. Evolving evidence additionally indicates kidney and HF benefits of SGLT2 inhibitors in populations without diabetes. These agents likely provide heart and kidney benefits through multiple mechanisms, as their impact on heart and kidney outcomes cannot be fully explained by their direct metabolic effects. On-going work to elucidate the beneficial mechanisms at play with SGLT2 inhibitors will help further optimize these life-saving therapies in patients with and without T2D.

全球 2 型糖尿病(T2D)患者及其并发症的人数正以惊人的速度增长。幸运的是,我们对钠-葡萄糖共转运体-2(SGLT2)抑制剂和胰高血糖素样肽-1(GLP-1)受体激动剂类降糖药物对心血管和肾脏功能的益处有了更深入的了解;这意味着我们现在有了新的选择来降低 T2D 患者出现这些并发症的风险。在专门的结果试验中,SGLT2 抑制剂已持续显示出对动脉粥样硬化性心血管疾病(ASCVD)、慢性肾脏疾病(CKD)和心力衰竭(HF)事件的益处。目前,大型指南小组推荐将 SGLT2 抑制剂作为并发 ASCVD、CKD 和/或 HF 的 T2D 患者的标准治疗方法。不断发展的证据还表明,SGLT2 抑制剂对无糖尿病人群的肾脏和心房颤动也有益处。这些药物可能通过多种机制为心脏和肾脏带来益处,因为它们对心脏和肾脏预后的影响不能完全通过其直接代谢作用来解释。目前正在进行的阐明 SGLT2 抑制剂获益机制的工作将有助于进一步优化这些拯救糖尿病患者和非糖尿病患者生命的疗法。
{"title":"Clinical Evidence and Proposed Mechanisms for Cardiovascular and Kidney Benefits from Sodium-Glucose Co-transporter-2 Inhibitors.","authors":"Joshua J Neumiller, Fredrick J Lienhard, Radica Z Alicic, Katherine R Tuttle","doi":"10.17925/EE.2022.18.2.106","DOIUrl":"10.17925/EE.2022.18.2.106","url":null,"abstract":"<p><p>The number of people living with type 2 diabetes (T2D) and its complications worldwide is increasing at an alarming rate. Fortunately, our understanding of the benefits of glucose-lowering agents from the sodium-glucose co-transporter-2 (SGLT2) inhibitor and glucagon-like peptide-1 (GLP-1) receptor agonist classes on cardiovascular and kidney outcomes is advancing; this means we now have new options to mitigate the risks of these complications in patients with T2D. The SGLT2 inhibitors have consistently demonstrated benefits on atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD) and heart failure (HF) events in dedicated outcome trials. Large guidelines groups now recommend SGLT2 inhibitors as a standard of care in patients with T2D and comorbid ASCVD, CKD and/ or HF. Evolving evidence additionally indicates kidney and HF benefits of SGLT2 inhibitors in populations without diabetes. These agents likely provide heart and kidney benefits through multiple mechanisms, as their impact on heart and kidney outcomes cannot be fully explained by their direct metabolic effects. On-going work to elucidate the beneficial mechanisms at play with SGLT2 inhibitors will help further optimize these life-saving therapies in patients with and without T2D.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10619889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thyroid Function During and After COVID-19 Infection: A Review. COVID-19感染前后甲状腺功能的研究进展
Pub Date : 2022-06-01 Epub Date: 2022-06-13 DOI: 10.17925/EE.2022.18.1.58
Sabri Artun Çabuk, Ayşe Zeynep Cevher, Yaşar Küçükardalı

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to multiorgan dysfunction through pulmonary and systemic inflammation. Infection also affects the thyroid gland directly via cytopathological effects of the virus or indirectly through cytokines, complement systems and coagulation mechanisms. The thyroid gland regulates innate and adaptive immune systems by genomic and nongenomic pathways. During or after SARS-CoV-2 infection, Graves' disease and subacute thyroiditis might be triggered resulting in hyperthyroidism; alternatively, the effect of the virus on the hypophyseal.hypothalamic axis might cause central hypothyroidism. Severe cases of coronavirus disease 2019 (COVID-19) can present with hypoxia, which requires the use of dexamethasone. This can depress basal serum concentrations of 3,5,3'-triiodothyronine. Thyroid function should be monitored when using dexamethasone in patients with COVID-19. This article briefly reviews the direct and indirect effects of SARS-CoV-2 on the thyroid gland and function.

严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染可通过肺部和全身炎症导致多器官功能障碍。感染还通过病毒的细胞病理学作用直接影响甲状腺,或通过细胞因子、补体系统和凝血机制间接影响甲状腺。甲状腺通过基因组和非基因组途径调节先天和适应性免疫系统。在感染SARS-CoV-2期间或之后,可能引发Graves病和亚急性甲状腺炎,导致甲状腺功能亢进;或者,病毒对垂体的影响。下丘脑轴可能引起中枢性甲状腺功能减退。2019冠状病毒病(COVID-19)的严重病例可能出现缺氧,这需要使用地塞米松。这可以降低3,5,3'-三碘甲状腺原氨酸的基础血清浓度。COVID-19患者使用地塞米松时应监测甲状腺功能。本文就SARS-CoV-2对甲状腺及功能的直接和间接影响作一综述。
{"title":"Thyroid Function During and After COVID-19 Infection: A Review.","authors":"Sabri Artun Çabuk,&nbsp;Ayşe Zeynep Cevher,&nbsp;Yaşar Küçükardalı","doi":"10.17925/EE.2022.18.1.58","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.58","url":null,"abstract":"<p><p>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to multiorgan dysfunction through pulmonary and systemic inflammation. Infection also affects the thyroid gland directly via cytopathological effects of the virus or indirectly through cytokines, complement systems and coagulation mechanisms. The thyroid gland regulates innate and adaptive immune systems by genomic and nongenomic pathways. During or after SARS-CoV-2 infection, Graves' disease and subacute thyroiditis might be triggered resulting in hyperthyroidism; alternatively, the effect of the virus on the hypophyseal.hypothalamic axis might cause central hypothyroidism. Severe cases of coronavirus disease 2019 (COVID-19) can present with hypoxia, which requires the use of dexamethasone. This can depress basal serum concentrations of 3,5,3'-triiodothyronine. Thyroid function should be monitored when using dexamethasone in patients with COVID-19. This article briefly reviews the direct and indirect effects of SARS-CoV-2 on the thyroid gland and function.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Tirzepatide: A Novel, Once-weekly Dual GIP and GLP-1 Receptor Agonist for the Treatment of Type 2 Diabetes. 替西肽:一种治疗2型糖尿病的新型、每周一次的双GIP和GLP-1受体激动剂。
Pub Date : 2022-06-01 Epub Date: 2022-06-16 DOI: 10.17925/EE.2022.18.1.10
Shizuka Kaneko

Gastrointestinal hormones are currently used to treat type 2 diabetes mellitus (T2D). Incretin preparations with gastric inhibitory polypeptide (GIP) activity or glucagon-like peptide-1 (GLP-1) provide new means for controlling blood glucose levels, body weight, and lipid metabolism. GIP, an incretin, has not been used due to lack of promising action against diabetes. However, recent studies have shown that GIP has an important effect on glucagon and insulin secretion under normoglycaemic conditions. Co-existence of GIP with GLP-1 and glucagon signalling leads to a stronger effect than that of GLP-1 stimulation alone. The development of a GIP/GLP-1R unimolecular dual agonist with affinity for both GIP and GLP-1 receptors is under investigation, and the drug is expected to be clinically available in the near future. Tirzepatide, a GIP/GLP-1R unimolecular dual agonist, regulates metabolism via both peripheral organs and the central nervous system. The SURPASS phase III clinical trials conducted for tirzepatide comprise 10 clinical trials, including five global trials and the global SURPASS-CVOT trial, with >13,000 patients with T2D (ClinicalTrials.gov Identifier: NCT04255433). The clinical application of tirzepatide as a therapy for T2D may provide new insights into diabetic conditions and help clarify the role of GIP in its pathogenesis.

胃肠激素目前用于治疗2型糖尿病(T2D)。具有胃抑制多肽(GIP)活性或胰高血糖素样肽-1 (GLP-1)活性的肠促胰岛素制剂为控制血糖水平、体重和脂质代谢提供了新的手段。GIP是一种肠促胰岛素,由于缺乏对糖尿病有希望的作用而没有使用。然而,最近的研究表明,在正常血糖条件下,GIP对胰高血糖素和胰岛素的分泌有重要影响。GIP与GLP-1和胰高血糖素信号同时存在,比单独刺激GLP-1的作用更强。目前正在研究一种对GIP和GLP-1受体都具有亲和力的GIP/GLP-1R单分子双激动剂,该药物有望在不久的将来投入临床使用。tizepatide是一种GIP/GLP-1R单分子双激动剂,通过外周器官和中枢神经系统调节代谢。替西帕肽的transcend III期临床试验包括10项临床试验,包括5项全球试验和全球SURPASS- cvot试验,共有超过13,000名T2D患者(ClinicalTrials.gov Identifier: NCT04255433)。替西帕肽治疗T2D的临床应用可能为糖尿病提供新的认识,并有助于阐明GIP在其发病机制中的作用。
{"title":"Tirzepatide: A Novel, Once-weekly Dual GIP and GLP-1 Receptor Agonist for the Treatment of Type 2 Diabetes.","authors":"Shizuka Kaneko","doi":"10.17925/EE.2022.18.1.10","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.10","url":null,"abstract":"<p><p>Gastrointestinal hormones are currently used to treat type 2 diabetes mellitus (T2D). Incretin preparations with gastric inhibitory polypeptide (GIP) activity or glucagon-like peptide-1 (GLP-1) provide new means for controlling blood glucose levels, body weight, and lipid metabolism. GIP, an incretin, has not been used due to lack of promising action against diabetes. However, recent studies have shown that GIP has an important effect on glucagon and insulin secretion under normoglycaemic conditions. Co-existence of GIP with GLP-1 and glucagon signalling leads to a stronger effect than that of GLP-1 stimulation alone. The development of a GIP/GLP-1R unimolecular dual agonist with affinity for both GIP and GLP-1 receptors is under investigation, and the drug is expected to be clinically available in the near future. Tirzepatide, a GIP/GLP-1R unimolecular dual agonist, regulates metabolism via both peripheral organs and the central nervous system. The SURPASS phase III clinical trials conducted for tirzepatide comprise 10 clinical trials, including five global trials and the global SURPASS-CVOT trial, with >13,000 patients with T2D (ClinicalTrials.gov Identifier: NCT04255433). The clinical application of tirzepatide as a therapy for T2D may provide new insights into diabetic conditions and help clarify the role of GIP in its pathogenesis.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care. 神经危重症患者血、脑脊液中垂体前叶激素的变化。
Pub Date : 2022-06-01 Epub Date: 2022-06-13 DOI: 10.17925/EE.2022.18.1.71
Henriette Beyer, Nicole Lange, Armin H Podtschaske, Jan Martin, Lucia Albers, Alexander von Werder, Jürgen Ruland, Gerhard Schneider, Bernhard Meyer, Simone M Kagerbauer, Jens Gempt

Background: Anterior pituitary hormones in blood follow a circadian rhythm, which may be influenced by various factors such as intracranial pathologies. In cerebrospinal fluid (CSF), pituitary hormones have been collected only selectively and circadian rhythm has not yet been investigated. This pilot study analysed diurnal variations of anterior pituitary hormones in patients in neurocritical care to determine whether circadian rhythmicity exists in these patients. Possible influences of intracranial pathologies were also investigated. Blood and CSF concentrations were assessed simultaneously to explore the value of blood concentrations as a surrogate parameter for CSF levels.

Methods: Blood and CSF samples of 20 non-sedated patients were collected at 06:00, noon, 18:00 and midnight, and analysed for adrenocorticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1) concentrations at each of the four time points. ACTH and IGF-1 were measured by sandwich chemiluminescence immunoassay. Cortisol and TSH were measured by electrochemiluminescence immunoassay.

Results: Results showed inconsistent circadian rhythms. Less than 50% of the patients showed a circadian rhythmicity of ACTH, cortisol, TSH or IGF-1. Significance of diurnal variations was only present for blood concentrations of TSH. Correlations between blood and CSF concentrations were strong for cortisol and TSH.

Conclusions: CSF concentrations were only in the measurable range in some of the patients. No clear circadian rhythmicity could be identified, except for TSH in blood. Absence of significant diurnal variations could be explained by the underlying pathologies or disturbing influences of the intensive care unit. Blood concentrations of cortisol and TSH may be suitable surrogate parameters for CSF.

背景:血液中垂体前叶激素遵循昼夜节律,可能受到颅内病理等多种因素的影响。在脑脊液(CSF)中,垂体激素仅被选择性地收集,昼夜节律尚未被调查。本初步研究分析了神经危重症患者垂体前叶激素的日变化,以确定这些患者是否存在昼夜节律性。颅内病变可能的影响也进行了探讨。同时评估血液和脑脊液浓度,以探讨血液浓度作为脑脊液水平的替代参数的价值。方法:20例非镇静患者于06:00、中午、18:00和午夜采集血液和脑脊液,分析促肾上腺皮质激素(ACTH)、皮质醇、促甲状腺激素(TSH)和胰岛素样生长因子-1 (IGF-1)浓度。采用夹心化学发光免疫法检测ACTH和IGF-1。电化学发光免疫法测定皮质醇和TSH。结果:结果显示昼夜节律不一致。不到50%的患者表现出ACTH、皮质醇、TSH或IGF-1的昼夜节律性。日变化的意义只存在于血液中TSH浓度。皮质醇和TSH在血液和脑脊液浓度之间的相关性很强。结论:部分患者脑脊液浓度仅在可测范围内。除了血液中的TSH外,没有明确的昼夜节律性。没有明显的日变化可以解释为潜在的病理或重症监护病房的干扰影响。血中皮质醇和TSH浓度可能是CSF的合适替代参数。
{"title":"Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care.","authors":"Henriette Beyer,&nbsp;Nicole Lange,&nbsp;Armin H Podtschaske,&nbsp;Jan Martin,&nbsp;Lucia Albers,&nbsp;Alexander von Werder,&nbsp;Jürgen Ruland,&nbsp;Gerhard Schneider,&nbsp;Bernhard Meyer,&nbsp;Simone M Kagerbauer,&nbsp;Jens Gempt","doi":"10.17925/EE.2022.18.1.71","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.71","url":null,"abstract":"<p><strong>Background: </strong>Anterior pituitary hormones in blood follow a circadian rhythm, which may be influenced by various factors such as intracranial pathologies. In cerebrospinal fluid (CSF), pituitary hormones have been collected only selectively and circadian rhythm has not yet been investigated. This pilot study analysed diurnal variations of anterior pituitary hormones in patients in neurocritical care to determine whether circadian rhythmicity exists in these patients. Possible influences of intracranial pathologies were also investigated. Blood and CSF concentrations were assessed simultaneously to explore the value of blood concentrations as a surrogate parameter for CSF levels.</p><p><strong>Methods: </strong>Blood and CSF samples of 20 non-sedated patients were collected at 06:00, noon, 18:00 and midnight, and analysed for adrenocorticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1) concentrations at each of the four time points. ACTH and IGF-1 were measured by sandwich chemiluminescence immunoassay. Cortisol and TSH were measured by electrochemiluminescence immunoassay.</p><p><strong>Results: </strong>Results showed inconsistent circadian rhythms. Less than 50% of the patients showed a circadian rhythmicity of ACTH, cortisol, TSH or IGF-1. Significance of diurnal variations was only present for blood concentrations of TSH. Correlations between blood and CSF concentrations were strong for cortisol and TSH.</p><p><strong>Conclusions: </strong>CSF concentrations were only in the measurable range in some of the patients. No clear circadian rhythmicity could be identified, except for TSH in blood. Absence of significant diurnal variations could be explained by the underlying pathologies or disturbing influences of the intensive care unit. Blood concentrations of cortisol and TSH may be suitable surrogate parameters for CSF.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utilizing the New Glucometrics: A Practical Guide to Ambulatory Glucose Profile Interpretation. 利用新的葡萄糖测量:一个实用的指南,动态葡萄糖剖面解释。
Pub Date : 2022-06-01 Epub Date: 2022-06-13 DOI: 10.17925/EE.2022.18.1.20
John Doupis, Edward S Horton

Traditional continuous glucose monitoring and flash glucose monitoring systems are proven to lower glycated haemoglobin levels, decrease the time and impact of hypoglycaemia or hyperglycaemia and, consequently, improve the quality of life for children and adults with type 1 diabetes mellitus (T1DM) and adults with type 2 diabetes mellitus (T2DM). These glucose-sensing devices can generate large amounts of glucose data that can be used to define a detailed glycaemic profile for each user, which can be compared with targets for glucose control set by an International Consensus Panel of diabetes experts. Targets have been agreed upon for adults, children and adolescents with T1DM and adults with T2DM; separate targets have been agreed upon for older adults with diabetes, who are at higher risk of hypoglycaemia, and women with pregestational T1DM during pregnancy. Along with the objective measures and targets identified by the International Consensus Panel, the dense glucose data delivered by traditional continuous glucose monitoring and flash glucose monitoring systems is used to generate an ambulatory glucose profile, which summarizes the data in a visually impactful format that can be used to identify patterns and trends in daily glucose control, including those that raise clinical concerns. In this article, we provide a practical guide on how to interpret these new glucometrics using a straightforward algorithm, and clear visual examples that demystify the process of reviewing the glycaemic health of people with T1DM or T2DM such that forward-looking goals for diabetes management can be agreed.

传统的连续血糖监测和瞬时血糖监测系统被证明可以降低糖化血红蛋白水平,减少低血糖或高血糖的时间和影响,从而改善儿童和成人1型糖尿病(T1DM)和成人2型糖尿病(T2DM)的生活质量。这些血糖传感设备可以产生大量的葡萄糖数据,这些数据可以用来为每个用户定义详细的血糖概况,这些数据可以与国际糖尿病专家共识小组设定的血糖控制目标进行比较。已就成人、儿童和青少年T1DM和成人T2DM的目标达成一致;对于低血糖风险较高的老年糖尿病患者和妊娠期患有T1DM的妇女,已经达成了单独的目标。与国际共识小组确定的客观测量和目标一起,传统连续血糖监测和快速血糖监测系统提供的密集血糖数据被用于生成动态血糖概况,该数据以视觉上有影响力的格式总结,可用于识别日常血糖控制的模式和趋势,包括那些引起临床关注的模式和趋势。在这篇文章中,我们提供了一个实用的指南,说明如何使用一个简单的算法来解释这些新的血糖测量,并提供了清晰的视觉示例,揭示了审查1型糖尿病或2型糖尿病患者血糖健康的过程,从而可以就糖尿病管理的前瞻性目标达成一致。
{"title":"Utilizing the New Glucometrics: A Practical Guide to Ambulatory Glucose Profile Interpretation.","authors":"John Doupis,&nbsp;Edward S Horton","doi":"10.17925/EE.2022.18.1.20","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.20","url":null,"abstract":"<p><p>Traditional continuous glucose monitoring and flash glucose monitoring systems are proven to lower glycated haemoglobin levels, decrease the time and impact of hypoglycaemia or hyperglycaemia and, consequently, improve the quality of life for children and adults with type 1 diabetes mellitus (T1DM) and adults with type 2 diabetes mellitus (T2DM). These glucose-sensing devices can generate large amounts of glucose data that can be used to define a detailed glycaemic profile for each user, which can be compared with targets for glucose control set by an International Consensus Panel of diabetes experts. Targets have been agreed upon for adults, children and adolescents with T1DM and adults with T2DM; separate targets have been agreed upon for older adults with diabetes, who are at higher risk of hypoglycaemia, and women with pregestational T1DM during pregnancy. Along with the objective measures and targets identified by the International Consensus Panel, the dense glucose data delivered by traditional continuous glucose monitoring and flash glucose monitoring systems is used to generate an ambulatory glucose profile, which summarizes the data in a visually impactful format that can be used to identify patterns and trends in daily glucose control, including those that raise clinical concerns. In this article, we provide a practical guide on how to interpret these new glucometrics using a straightforward algorithm, and clear visual examples that demystify the process of reviewing the glycaemic health of people with T1DM or T2DM such that forward-looking goals for diabetes management can be agreed.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic Test Accuracy of Urine C-peptide Creatinine Ratio for the Correct Identification of the Type of Diabetes: A Systematic Review. 尿c肽肌酐比值对正确识别糖尿病类型的诊断试验准确性:一项系统评价。
Pub Date : 2022-06-01 Epub Date: 2022-05-23 DOI: 10.17925/EE.2022.18.1.2
Joseph M Pappachan, Bhuvana Sunil, Cornelius J Fernandez, Ian M Lahart, Ambika P Ashraf

Objective: To examine the accuracy of urine c-peptide creatinine ratio (UCPCR) for identifying the type of diabetes in appropriate clinical settings. Design: Systematic review of test accuracy studies on patients with different forms of diabetes. Data sources: Medline, Embase and Cochrane library databases from 1 January 2000 to 15 November 2020. Eligibility criteria: Studies reporting the use of UCPCR for diagnosing patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) and monogenic forms of diabetes (categorized as maturity-onset diabetes of the young [MODY]). Study selection and data synthesis: Two reviewers independently assessed articles for inclusion and assessed the methodological quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, with input from a third reviewer to reach consensus when there was a dispute. Meta-analysis was performed with the studies reporting complete data to derive the pooled sensitivity, specificity and diagnostic odds ratio (DOR), and narrative synthesis only for those with incomplete data. Results: Nine studies with 4,488 patients were included in the qualitative synthesis, while only four of these (915 patients) had complete data and were included in the quantitative synthesis. All the studies had moderate risk of bias and applicability concerns. Meta-analysis of three studies (n=130) revealed sensitivity, specificity and DOR of 84.4% (95% confidence interval [CI] 68.1-93.2%), 91.6% (82.8-96.1%) and 59.9 (32.8-106.0), respectively, for diagnosing T1DM using a UCPCR cut-off of <0.2 nmol/mmol. For participants with T2DM (three studies; n=739), UCPCR >0.2 nmol/mmol was associated with sensitivity, specificity and DOR of 92.8% (84.2-96.9%), 81.6% (61.3-92.5%) and 56.9 (31.3-103.5), respectively. For patients with MODY in the appropriate clinical setting, a UCPCR cut-off of >0.2 nmol/mmol showed sensitivity, specificity and DOR of 85.2% (73.1-92.4%), 98.0% (92.4-99.5%) and 281.8 (57.5-1,379.7), respectively. Conclusions: Based on studies with moderate risk of bias and applicability concerns, UCPCR confers moderate to high sensitivity, specificity, and DOR for correctly identifying T1DM, T2DM and monogenic diabetes in appropriate clinical settings. Large multinational studies with multi-ethnic participation among different age groups are necessary before this test can be routinely used in clinical practice. Study registration: Protocol was registered as PROSPERO CRD42017060633.

目的:探讨尿c肽肌酐比值(UCPCR)在临床诊断糖尿病时的准确性。设计:对不同类型糖尿病患者的检测准确性研究进行系统回顾。数据来源:Medline, Embase和Cochrane图书馆数据库,2000年1月1日至2020年11月15日。入选标准:研究报告使用UCPCR诊断1型糖尿病(T1DM)、2型糖尿病(T2DM)和单基因型糖尿病(归类为年轻人的成熟型糖尿病[MODY])。研究选择和数据综合:两位审稿人使用诊断准确性研究质量评估-2工具独立评估文章的纳入和评估研究的方法学质量,当有争议时,第三位审稿人会提供意见以达成共识。对报告完整数据的研究进行荟萃分析,得出汇总敏感性、特异性和诊断优势比(DOR),并仅对数据不完整的研究进行叙事综合。结果:9项研究共4488例患者被纳入定性综合,其中只有4项研究(915例)数据完整,被纳入定量综合。所有研究均存在中等偏倚风险和适用性问题。3项研究(n=130)的荟萃分析显示,使用0.2 nmol/mmol的UCPCR截止值诊断T1DM的敏感性、特异性和DOR分别为84.4%(95%可信区间[CI] 68.1-93.2%)、91.6%(82.8-96.1%)和59.9(32.8-106.0),敏感性、特异性和DOR分别为92.8%(84.2-96.9%)、81.6%(61.3-92.5%)和56.9(31.3-103.5)。对于MODY患者,在合适的临床环境下,UCPCR截止值>0.2 nmol/mmol的敏感性、特异性和DOR分别为85.2%(73.1-92.4%)、98.0%(92.4-99.5%)和281.8(57.5- 1379.7)。结论:基于具有中等偏倚风险和适用性问题的研究,在适当的临床环境中,UCPCR在正确识别T1DM、T2DM和单基因糖尿病方面具有中等至高的敏感性、特异性和DOR。在该测试常规应用于临床实践之前,需要在不同年龄组中进行多民族参与的大型多国研究。研究注册:协议注册号为PROSPERO CRD42017060633。
{"title":"Diagnostic Test Accuracy of Urine C-peptide Creatinine Ratio for the Correct Identification of the Type of Diabetes: A Systematic Review.","authors":"Joseph M Pappachan,&nbsp;Bhuvana Sunil,&nbsp;Cornelius J Fernandez,&nbsp;Ian M Lahart,&nbsp;Ambika P Ashraf","doi":"10.17925/EE.2022.18.1.2","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.2","url":null,"abstract":"<p><p><b>Objective</b>: To examine the accuracy of urine c-peptide creatinine ratio (UCPCR) for identifying the type of diabetes in appropriate clinical settings. <b>Design</b>: Systematic review of test accuracy studies on patients with different forms of diabetes. <b>Data sources</b>: Medline, Embase and Cochrane library databases from 1 January 2000 to 15 November 2020. <b>Eligibility criteria</b>: Studies reporting the use of UCPCR for diagnosing patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) and monogenic forms of diabetes (categorized as maturity-onset diabetes of the young [MODY]). <b>Study selection and data synthesis</b>: Two reviewers independently assessed articles for inclusion and assessed the methodological quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, with input from a third reviewer to reach consensus when there was a dispute. Meta-analysis was performed with the studies reporting complete data to derive the pooled sensitivity, specificity and diagnostic odds ratio (DOR), and narrative synthesis only for those with incomplete data. <b>Results</b>: Nine studies with 4,488 patients were included in the qualitative synthesis, while only four of these (915 patients) had complete data and were included in the quantitative synthesis. All the studies had moderate risk of bias and applicability concerns. Meta-analysis of three studies (n=130) revealed sensitivity, specificity and DOR of 84.4% (95% confidence interval [CI] 68.1-93.2%), 91.6% (82.8-96.1%) and 59.9 (32.8-106.0), respectively, for diagnosing T1DM using a UCPCR cut-off of <0.2 nmol/mmol. For participants with T2DM (three studies; n=739), UCPCR >0.2 nmol/mmol was associated with sensitivity, specificity and DOR of 92.8% (84.2-96.9%), 81.6% (61.3-92.5%) and 56.9 (31.3-103.5), respectively. For patients with MODY in the appropriate clinical setting, a UCPCR cut-off of >0.2 nmol/mmol showed sensitivity, specificity and DOR of 85.2% (73.1-92.4%), 98.0% (92.4-99.5%) and 281.8 (57.5-1,379.7), respectively. <b>Conclusions</b>: Based on studies with moderate risk of bias and applicability concerns, UCPCR confers moderate to high sensitivity, specificity, and DOR for correctly identifying T1DM, T2DM and monogenic diabetes in appropriate clinical settings. Large multinational studies with multi-ethnic participation among different age groups are necessary before this test can be routinely used in clinical practice. <b>Study registration</b>: Protocol was registered as PROSPERO CRD42017060633.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Indian Phenotype Characteristics Among Patients with Type 2 Diabetes Mellitus: Insights from a Non-interventional Nationwide Registry in India. 2型糖尿病患者的印度表型特征:来自印度非干预性全国登记的见解
Pub Date : 2022-06-01 Epub Date: 2022-05-30 DOI: 10.17925/EE.2022.18.1.63
Sanjay Kalra, Ambrish Mithal, Abdul Hamid Zargar, Bipin Sethi, Mala Dharmalingam, Sujoy Ghosh, Ranjini Sen

Background: Indian patients with type 2 diabetes mellitus (T2D) constitute one-sixth of affected adults globally. Here, we evaluate the association of body mass index (BMI) with body fat percentage (BF%) and glycated haemoglobin (HbA1c) levels among patients with T2D in India. Method: This was a cross-sectional Indian registry study across 845 geographically diverse zones between December 2017 and August 2019. Results: Of 37,927 patients, 55.6% were men, with a mean ± standard deviation age of 54.2 ± 11.5 years and HbA1c of 8.3 ± 1.71%. Mean ± standard deviation BMI and BF% were 27.0 ± 4.6 kg/m2 and 32.0 ± 8.0%, respectively. Overall, 15.4% of patients were overweight, and 25.0% were obese. Despite fewer males (20.7%) having BMI-based obesity than females (31.2%), around three-quarters of both sexes had BF%-defined obesity (males 77.2%; females 71.2%). One-third of males (34.6%) and 41.9% of females had BF%-defined obesity despite normal BMI. The association was substantiated by a moderately significant correlation (r=0.51) between BMI and BF% in the overall population (p<0.0001). Conclusion: This pan-India registry presents a real-world reflection of the Asian Indian phenotype: high BF% despite lower BMI in people with T2D. This highlights the importance of primordial and primary prevention, and may guide decisions on the choice of agents for glycaemic control, with a preference for drugs that promote weight loss or are weight neutral.

背景:印度2型糖尿病(T2D)患者占全球受影响成人的六分之一。在这里,我们评估了印度t2dm患者的身体质量指数(BMI)与体脂率(BF%)和糖化血红蛋白(HbA1c)水平的关系。方法:这是一项横断面印度登记研究,涵盖2017年12月至2019年8月期间845个地理上不同的地区。结果:37927例患者中,男性占55.6%,平均±标准差年龄为54.2±11.5岁,HbA1c为8.3±1.71%。BMI和BF%的均值±标准差分别为27.0±4.6 kg/m2和32.0±8.0%。总体而言,15.4%的患者超重,25.0%的患者肥胖。尽管男性(20.7%)比女性(31.2%)更少患有基于bmi的肥胖,但男女中约有四分之三的人患有BF%定义的肥胖(男性77.2%;女性71.2%)。三分之一的男性(34.6%)和41.9%的女性患有BF%定义的肥胖,尽管BMI正常。在总体人群中,BMI和BF%之间存在中等显著相关性(r=0.51),证实了这种关联。结论:这个泛印度注册表反映了亚洲印度人的真实表型:T2D患者的BF%高,BMI低。这突出了原始预防和初级预防的重要性,并可能指导血糖控制药物的选择,优先选择促进体重减轻或体重中性的药物。
{"title":"Indian Phenotype Characteristics Among Patients with Type 2 Diabetes Mellitus: Insights from a Non-interventional Nationwide Registry in India.","authors":"Sanjay Kalra,&nbsp;Ambrish Mithal,&nbsp;Abdul Hamid Zargar,&nbsp;Bipin Sethi,&nbsp;Mala Dharmalingam,&nbsp;Sujoy Ghosh,&nbsp;Ranjini Sen","doi":"10.17925/EE.2022.18.1.63","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.63","url":null,"abstract":"<p><p><b>Background</b>: Indian patients with type 2 diabetes mellitus (T2D) constitute one-sixth of affected adults globally. Here, we evaluate the association of body mass index (BMI) with body fat percentage (BF%) and glycated haemoglobin (HbA1c) levels among patients with T2D in India. <b>Method</b>: This was a cross-sectional Indian registry study across 845 geographically diverse zones between December 2017 and August 2019. <b>Results</b>: Of 37,927 patients, 55.6% were men, with a mean ± standard deviation age of 54.2 ± 11.5 years and HbA1c of 8.3 ± 1.71%. Mean ± standard deviation BMI and BF% were 27.0 ± 4.6 kg/m2 and 32.0 ± 8.0%, respectively. Overall, 15.4% of patients were overweight, and 25.0% were obese. Despite fewer males (20.7%) having BMI-based obesity than females (31.2%), around three-quarters of both sexes had BF%-defined obesity (males 77.2%; females 71.2%). One-third of males (34.6%) and 41.9% of females had BF%-defined obesity despite normal BMI. The association was substantiated by a moderately significant correlation (r=0.51) between BMI and BF% in the overall population (p<0.0001). <b>Conclusion</b>: This pan-India registry presents a real-world reflection of the Asian Indian phenotype: high BF% despite lower BMI in people with T2D. This highlights the importance of primordial and primary prevention, and may guide decisions on the choice of agents for glycaemic control, with a preference for drugs that promote weight loss or are weight neutral.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Review of Automated Insulin Delivery Systems for Type 1 Diabetes and Associated Time in Range Outcomes. 1 型糖尿病自动胰岛素输送系统及相关时间范围结果回顾。
Pub Date : 2022-06-01 Epub Date: 2022-05-20 DOI: 10.17925/EE.2022.18.1.27
Armaan Nallicheri, Katherine M Mahoney, Hanna A Gutow, Natalie Bellini, Diana Isaacs

Automated insulin delivery (AID) systems play an important role in the management of type 1 diabetes mellitus (T1DM). These systems include three components: a continuous glucose monitor (CGM), an insulin pump and an algorithm that adjusts the pump based on the CGM sensor glucose readings. They are not fully automated and still require the user to administer bolus insulin doses for food. Some AID systems have automatic correction boluses, while others only have automatic basal or background insulin adjustments. As CGM has become more accurate and the technology has evolved, AID systems have demonstrated improved glycaemic outcomes. The clinical evaluation of AID systems in randomized controlled trials and real-world studies have shown their utility in helping glycaemic management. In this review, we compare AID systems that are commercially available in the US and summarize the literature, with a special focus on time in range in T1DM. The review also discusses new AID systems on the horizon and explores considerations for personalized care.

胰岛素自动给药系统(AID)在 1 型糖尿病(T1DM)的治疗中发挥着重要作用。这些系统包括三个组成部分:连续血糖监测仪(CGM)、胰岛素泵和根据 CGM 传感器血糖读数调整泵的算法。这些系统并非完全自动化,仍需要用户为食物注射胰岛素。有些 AID 系统具有自动校正胰岛素剂量的功能,而有些则只有自动调整基础或背景胰岛素的功能。随着 CGM 的精确度提高和技术的发展,AID 系统的血糖治疗效果也得到了改善。在随机对照试验和实际研究中对 AID 系统进行的临床评估表明,它们在帮助进行血糖管理方面非常有用。在这篇综述中,我们比较了美国市售的 AID 系统,并总结了相关文献,特别关注了 T1DM 患者的血糖控制时间。综述还讨论了即将推出的新型 AID 系统,并探讨了个性化护理的注意事项。
{"title":"Review of Automated Insulin Delivery Systems for Type 1 Diabetes and Associated Time in Range Outcomes.","authors":"Armaan Nallicheri, Katherine M Mahoney, Hanna A Gutow, Natalie Bellini, Diana Isaacs","doi":"10.17925/EE.2022.18.1.27","DOIUrl":"10.17925/EE.2022.18.1.27","url":null,"abstract":"<p><p>Automated insulin delivery (AID) systems play an important role in the management of type 1 diabetes mellitus (T1DM). These systems include three components: a continuous glucose monitor (CGM), an insulin pump and an algorithm that adjusts the pump based on the CGM sensor glucose readings. They are not fully automated and still require the user to administer bolus insulin doses for food. Some AID systems have automatic correction boluses, while others only have automatic basal or background insulin adjustments. As CGM has become more accurate and the technology has evolved, AID systems have demonstrated improved glycaemic outcomes. The clinical evaluation of AID systems in randomized controlled trials and real-world studies have shown their utility in helping glycaemic management. In this review, we compare AID systems that are commercially available in the US and summarize the literature, with a special focus on time in range in T1DM. The review also discusses new AID systems on the horizon and explores considerations for personalized care.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
TouchREVIEWS in endocrinology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1