Pinnaro Catherina T, Tansey Michael J
University of Iowa Stead Family Department of Pediatrics.
Fraternal Order of Eagles Diabetes Research Center.
J Diabetes Mellitus. 2021 Nov;11(5):249-277. doi: 10.4236/jdm.2021.115021. Epub 2021 Nov 17.
Insulin has been utilized in the treatment of type 1 diabetes (T1D) for 100 years. While there is still no cure for T1D, insulin administration has undergone a remarkable evolution which has contributed to improvements in quality of life and life expectancy in individuals with T1D. The advent of faster-acting and longer-acting insulins allowed for the implementation of insulin regimens more closely resembling normal insulin physiology. These improvements afforded better glycemic control, which is crucial for limiting microvascular complications and improving T1D outcomes. Suspension of insulin delivery in response to actual and forecasted hypoglycemia has improved quality of life and mitigated hypoglycemia without compromising glycemic control. Advances in continuous glucose monitoring (CGM) and insulin pumps, efforts to model glucose and insulin kinetics, and the application of control theory to T1D have made the automation of insulin delivery a reality. This review will summarize the past, present, and future of insulin administration in T1D.
胰岛素已用于1型糖尿病（T1D）的治疗长达100年。虽然T1D仍无法治愈，但胰岛素给药方式经历了显著演变，这有助于改善T1D患者的生活质量和预期寿命。速效和长效胰岛素的出现使胰岛素治疗方案更接近正常胰岛素生理状态得以实施。这些改进实现了更好的血糖控制，这对于限制微血管并发症和改善T1D治疗效果至关重要。根据实际和预测的低血糖情况暂停胰岛素输注，在不影响血糖控制的情况下提高了生活质量并减轻了低血糖症状。连续血糖监测（CGM）和胰岛素泵的进展、对葡萄糖和胰岛素动力学建模的努力以及控制理论在T1D中的应用，已使胰岛素输注自动化成为现实。本综述将总结T1D胰岛素给药的过去、现在和未来。
