Advanced Metabolic Care & Research, Escondido, California, U.S.A.
The advances in diabetes care we see today are the product of years of technological advances in glucose measurement and insulin replacement coupled with a fundamental shift in the model of care—from provider-directed to self-management by the patient. The major obstacle to the normalization of glucose levels in type 1 diabetes continues to be the physiologic replacement of insulin. Chapter 5 in this book will discuss the latest strategies for insulin therapy.
This chapter will focus on technological breakthroughs in measuring biochemical markers of glucose control and their integration into the daily care of type 1 diabetes. These techniques for glycemic assessment have the potential to be exploited by persons with diabetes and those who care for them. However, all of this technology has yet to be harnessed to automatically calculate and deliver the correct insulin doses (i.e., "closed-loop" insulin therapy). Until such automation has been accomplished, there will be an increase in complexity and a commensurate increase in the need for education for all involved in diabetes care. For the near future, successful diabetes care will depend on educating and engaging our patients to employ the most appropriate available methods.
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