new tech

Question 1

pros and cons of basal bolus

Answer 1

pros
- achieve tight gkycaemic control
- flexible in what you eat
- freedom
cons
- more injections
-commitemnet to adherance
- hard for young children

Question 2

DAFNE

Answer 2

dose adjustement for normal eating
strictured eductaional prgramme and social support

Also has an APP to log BG inslui taken and carbs eaten
recording can help spot patterns

Question 3

My Sugr

Answer 3

APP to log diabetes stuff also rewards you for doing well can be motivating for patients

Question 4

glucose buddy

Answer 4

support network for dianbteic patients

Question 5

pros and cons of fingerprick testing

Answer 5

pros
- helps determine which foods are best for control
- helps inform patients and doctors about what injection regime
- inctease understanding and reduce anxiety about hypo
- important for dangerous tasks like driving

cons
-hurts
-expensive to nhs
-anxiety
- have to test atleast 5 times per day more if you excersixe

Question 6

CGMS

Answer 6

continous glusocse monitoring system
-sticks capillary needle into your arm like a patch
measures glucose every 5 minutes
if hypo alarm goes off
also shows you where bg is heading
simple autoappliactor

Question 7

DEXCOM pros and cons

Answer 7

pros
-simple to use
-alarms help especially with parents of young patients (linked to phone)
cons
-not funded by nhs so expensive
-time delsy
-too much info can cause overwhelm

Question 8

Flash glusoce monitoring (freestyle libre)

Answer 8

capillary needle patch - scan the sensor to get reading
reading every minute and can link to phone
more affirdabke and avaialble through nhs
also has hypo alarm

Question 9

insulin pump therapy

Answer 9

cannula attached to body
filled device with short acting insulin which you can control how much goes in

Question 10

pros and cons of insulin pump therapy

Answer 10

pros
-no injections
-fewer large swings in BG
-improvement in hbac1
cons
- check BG every 3-4 hours
-change infusion site 2-3 days
-takes several nonths to optomise

Question 11

artificial pancreas project -minimed 780g

Answer 11

a - insulin pump
b-cannula
c- glucose sensor
d- transmitter

Question 12

smartguard tech

Answer 12

-variable personalised rate of insulin 24/7
-auto adjusts BG and corrects every 5 minutes
-can anticipate BG changes with predictive algorithm
-sensor can be worn for 7 continous days
-users have same glycaemic control of heakthy patients

Question 13

advance bolus wizard

Answer 13

can recognised regularly eaten foods and autoadjust insulin

Question 14

omnipod

Answer 14

disposable insulin pump that can connect via bluetooth to dexcom

Question 15

last line treatment : pancreas transplant

Answer 15

2nd pancreas attactched to small intestine however destruction of b cells still does occur in new pancreas

usually kidney transplant occurs at same time (shows end stage renal failure linked to diabetes)

must take immunosuppressants and corticosterioids (steroids bad for pancreas but must take for translpant)

Question 15

function of corticosteroids

Answer 15

interrupt multiple steps in immune activation because of the ubiquitous expression of corticosteroid receptors. Corticosteroids inhibit antigen presentation, cytokine production, and proliferation of lymphocytes. but delay emptying of pancreas

Question 15

immunosuppressants taken by transplant patients

Answer 15

cyclosporin, tacrolimus, sirolimus,azathioprine, mycophenilatemofeti

Question 16

pros and cons of islet transplant

Answer 16

pros
-no steroids
-only alemtuzumab
-improved HbA1c
-improved qol
-0 instances of hypo
cons
-lifelong immunosuppression (tac rolimus, sirolimus)
-islets in short supply
-transplanted cells do not provide infinite function eventually run out of steam

Question 17

islet transplant (new)

Answer 17

isolate islets from donated pancreas and purify - these cells then injecteded into hepatic portal vein and lodge in the liver, thesethen function and regulate BG as usual cells

Question 18

viacyte cell pouches

Answer 18

made of ePTFE (expanded polymer)
cells inside pouch can regukate blood glucose
release insulin
material repels immune system

Question 19

PEC-ENCAP

Answer 19

cells inside derived from stem cells and pancreatic precursors
semi permiable so blood vessels can grow around pouch

Question 20

PEC-Direct

Answer 20

blood vessels can grow insode pouch
do require immunosuppressants
suitable for uncontrolled t1D with extreme glycaemic lability

Question 21

PEC-QT

Answer 21

experiemental atm
-same as PEC -DIrect
CRISPR modified cells
immune evasive (not recognised by immune system)
for anyone with t1or2d

Question 22

crispr tech

Answer 22

allowd to modify genes within individual cells to make sell. surface apperance slightly different

uses cas9 enzyme to clip and edit genes (that we expect are causing bcell destruction)

-made with pluripotent cell cells
differentiated into pancreatic endoderm cells
-

Question 23

teplizumab-tzeild

Answer 23

cd3 directed monoclonal antibody
bin ds to cd3 antigens on surface of t cell which deactivates pancreatic b cell autoreactive t cells