New tools for children with Type 1 diabetes

September 1, 2009

C. Stephen Djedjos, MD, David W. Cooke, MD

Insulin analogs, advanced insulin pumps, and improved glucose monitoring devices make it easier to achieve glycemic control while decreasing the risk of hypoglycemia.

A little background

Pancreatic β-cells secrete insulin at a low basal rate that controls glucose levels in the fasting state; they also secrete increased amounts of insulin that control glucose levels after food intake. To normalize blood glucose levels in diabetics, administered insulin must replicate this endogenous basal-bolus pattern of insulin secretion.

Recombinant DNA technology allowed for structural modifications of insulin to alter its rate of absorption after subcutaneous injection. Thus, insulins could be designed with peaks and durations of action that would be better suited to provide either basal or bolus insulin needs.