SLIDE 1
4/18/2013 1
Type 1 Diabetes: A Techy Disease
Saleh Adi, MD Director, Madison Clinic for Pediatric Diabetes UCSF
Why is it a Techy Disease?
In normal physiology, glucose metabolism is exquisitely controlled;
– Blood Glucose (BG) has a tight range – BG levels are sensed continuously – Instantaneous response in the β‐cells – Almost immediate and quick effect of insulin – Short lived effect
We’re not even close
- We check BG every few hours
- We deliver insulin every few hours
- Insulin action is still too slow
- Deliver insulin in subcutaneous space
(it takes a while to reach circulation)
What makes insulin rapid vs long? Time to circulation Custom Designed Insulins
Lispro Regular
A‐chain B‐chain
Reversed to create Lispro
Custom insulins
- Rapid
– Lispro – Aspart – Glulisine
- Long acting (slow)