Type 1 Diabetes—A Clinical Perspective

Type 1 diabetes mellitus is a disorder of glucose regulation characterized by autoimmune destruction of the insulin-producing pancreatic β-cells and the need for lifelong insulin replacement therapy. Both glucose and HbA1c criteria are available for the diagnosis of diabetes. Achieving and maintaining near-normal blood glucose concentrations with appropriate administration of insulin is critical for successful long-term care of patients with diabetes mellitus and prevention of diabetic complications, but it is very difficult to achieve. Efforts to intensify therapy usually result in hypoglycemia. Point-of-care blood glucose testing provides the information needed by patients for clinical decision-making. Despite the ease of use and rapid reporting of modern point-of-care glucose monitoring devices, they provide measurements only intermittently. Continuous glucose monitoring devices can provide new glucose measurements every 5 minutes and may facilitate better glucose control. The development of new technologies that integrate continuous glucose monitoring technology with insulin pumps and a control algorithm to create a system for automated insulin delivery has the potential to significantly improve glycemic control, reduce hypoglycemia, and reduce the burden of care in type 1 diabetes mellitus.