Artificial pancreas systems for people with type 2 diabetes: Conception and design of the european CLOSE project

In the last 10 years tremendous progress has been made in the development of artificial pancreas (AP) systems for people with type 1 diabetes (T1D). The pan-European consortium CLOSE (Automated Glucose Control at Home for People with Chronic Disease) is aiming to develop integrated AP solutions (APplus) tailored to the needs of people with type 2 diabetes (T2D). APplus comprises a product and service package complementing the AP system by obligatory training as well as home visits and telemedical consultations on demand. Outcome predictors and performance indicators shall help to identify people who could benefit most from AP usage and facilitate the measurement of AP impact in diabetes care. In a first step CLOSE will establish a scalable APplus model case working at the interface between patients, homecare service providers, and payers in France. CLOSE will then scale up APplus by pursuing geographic distribution, targeting additional audiences, and enhancing AP functionalities and interconnectedness. By being part of the European Institute of Innovation and Technology (EIT) Health public-private partnership, CLOSE is committed to the EIT “knowledge triangle” pursuing the integrated advancement of technology, education, and business creation. Putting stakeholders, education, and impact into the center of APplus advancement is considered key for achieving wide AP use in T2D care

Positive correlation between serum omentin and thrombospondin-1 in gestational diabetes despite lack of correlation with insulin resistance indices

Gestational Diabetes (GDM) is characterized by insulin resistance and a pro-inflammatory state, both factors possible related to adipokine expression. Subjects and Methods: The study included 20 women with GDM, diagnosed according to the WHO criteria, and 23 matched for age and BMI women with normal glucose tolerance. Omentin and TSP-1 were measured by ELISA assays. Insulin resistance was assessed by NOMA and Insulin Resistance Index (IRI). Results: There were no significant differences in omen tin and TSP-1 levels between subjects with GDM and controls (48.0 +/- 12.0ng/ml versus 50.2 +/- 7.9ng/ml and 2150 +/- 1661ng/ml versus 1569 +/- 1160ng/ml, p=0.64 and p=0.29, for omentin and TSP-1 in GDM and control subjects, respectively). There was no significant correlation between either omen tin or TSP-1 with HOMA or IRI, however there was a significant positive correlation between thrombospondin-1 and omentin (r=0.49, p=0.010). There was also a positive correlation between serum omentin and glucose levels at 60 and 90 minutes of OGTT, however in the control group only (p<0.05). Conclusions: Concentrations of omen tin and thrombospondin-1 seem to be inter-related in pregnancy however there are no differences in serum levels between women with normal glucose tolerance and those with glucose intolerance. These observations suggest that regulation of concentrations of these adipokines in pregnancy might be mediated though different mechanisms than in non-pregnant subjects