PDF(Pubmed)
Abstract：
The development of advanced diabetes technology has permitted persons with type 1 diabetes mellitus to improve metabolic control significantly, particularly with the development of advanced hybrid closed-loop systems which have improved the quality of life by reducing hypoglycemia, decreasing macroangiopathy and microangiopathy-related complications, ameliorating HbA1c and improving glycemic variability. Despite the progression made over the past few decades, there is still significant margin for improvement to be made in terms of attaining appropriate metabolic control. Various factors are responsible for poor glycemic control including inappropriate carbohydrate counting, repeated bouts of hypoglycemia, hypoglycemia unawareness, cutaneous manifestations due to localized insulin use and prolonged use of diabetes technology, psychosocial comorbidities such as eating disorders or \'diabulimia\', the coexistence of insulin resistance among people with type 1 diabetes and the inability to mirror physiological endogenous pancreatic insulin secretion appropriately. Hence, the aim of this review is to highlight and overcome the barriers in attaining appropriate metabolic control among people with type 1 diabetes by driving research into adjunctive treatment for coexistent insulin resistance and developing new advanced diabetic technologies to preserve β cell function and mirror as much as possible endogenous pancreatic functions.
摘要：
先进的糖尿病技术的发展使1型糖尿病患者的代谢控制显着改善，特别是随着先进的混合闭环系统的发展，这些系统通过减少低血糖改善了生活质量，减少大血管病变和微血管病变相关并发症，改善HbA1c和改善血糖变异性。尽管过去几十年取得了进展，在获得适当的代谢控制方面，仍有很大的改善余地。各种因素是导致血糖控制不佳的原因，包括不适当的碳水化合物计数，反复发作的低血糖,低血糖意识不足，由于局部使用胰岛素和长期使用糖尿病技术引起的皮肤表现，心理社会合并症，如饮食失调或“糖尿病”，1型糖尿病患者中胰岛素抵抗并存，不能适当反映生理性内源性胰腺胰岛素分泌。因此，这篇综述的目的是通过推动对共存胰岛素抵抗的辅助治疗的研究，以及开发新的先进的糖尿病技术来保护β细胞功能并尽可能反映内源性胰腺功能，从而强调并克服1型糖尿病患者在获得适当代谢控制方面的障碍。
