Insulin analog preparations and their use in children and adolescents with type 1 diabetes mellitus.

Standard or 'traditional' human insulin preparations such as regular soluble insulin and neutral protamine Hagedorn (NPH) insulin have shortcomings in terms of their pharmacokinetic and pharmacodynamic properties that limit their clinical efficacy. Structurally modified insulin molecules or insulin 'analogs' have been developed with the aim of delivering insulin replacement therapy in a more physiological manner. In the last 10 years, five insulin analog preparations have become commercially available for clinical use in patients with type 1 diabetes mellitus: three 'rapid' or fast-acting analogs (insulin lispro, aspart, and glulisine) and two long-acting analogs (insulin glargine and detemir). This review highlights the specific pharmacokinetic properties of these new insulin analog preparations and focuses on their potential clinical advantages and disadvantages when used in children and adolescents with type 1 diabetes mellitus. The fast-acting analogs specifically facilitate more flexible insulin injection timing with regard to meals and activities, whereas the long-acting analogs have a more predictable profile of action and lack a peak effect. To date, clinical trials in children and adolescents have been few in number, but the evidence available from these and from other studies carried out in adults with type 1 diabetes suggest that they offer significant benefits in terms of reduced frequency of nocturnal hypoglycemia, better postprandial blood glucose control, and improved quality of life when compared with traditional insulins. In addition, insulin detemir therapy is unique in that patients may benefit from reduced risk of excessive weight, particularly during adolescence. Evidence for sustained long-term improvements in glycosylated hemoglobin, on the other hand, is modest. Furthermore, alterations to insulin/insulin-like growth factor I receptor binding characteristics have also raised theoretical concerns that insulin analogs may have an increased mitogenic potential and risk of tumor development, although evidence from both in vitro and in vivo animal studies do not support this assertion. Long-term surveillance has been recommended and further carefully designed prospective studies are needed to evaluate the overall benefits and clinical efficacy of insulin analog therapy in children and adolescents with type 1 diabetes.

Design of carbon nanotube fiber microelectrode for glucose biosensing

BACKGROUND: Carbon nanotube (CNT) fiber directly spun from an aerogel has a unique, well-aligned nanostructure (nano-pore and nano-brush), and thus provides high electro-catalytic activity and strong interaction with glucose oxidase enzyme. It shows great potential as a microelectrode for electrochemical biosensors. RESULTS: Cyclic voltammogram results indicate that post-synthesis treatments have great influence on the electrocatalytic activity of CNT fibers. Raman spectroscopy and electrical conductivity tests suggest that fibers annealed at 250 °C remove most of the impurities without damaging the graphite-like structure. This leads to a nano-porous morphology on the surface and the highest conductivity value (1.1 × 10 5 S m -1). Two CNT fiber microelectrode designs were applied to enhance their electron transfer behaviour, and it was found that a design using a 30 nm gold coating is able to linearly cover human physiological glucose level between 2 and 30 mmol L -1. The design also leads to a low detection limit of 25 μmol L -1. CONCLUSIONS: The high performance of CNT fibers not only offers exceptional mechanical and electrical properties, but also provides a large surface area and electron transfer pathway. They consequently make excellent bioactive microelectrodes for glucose biosensing, especially for potential use in implantable devices. © 2011 Society of Chemical Industry.

Enzyme-free glucose biosensor based on low density CNT forest grown directly on a Si/SiO2 substrate

A highly sensitive nonenzymatic amperometric glucose sensor was fabricated by using Ni nanoparticles homogeneously dispersed within and on the top of a vertically aligned CNT forest (CNT/Ni nanocomposite sensor), which was directly grown on a Si/SiO2 substrate. The surface morphology and elemental analysis were characterized using scanning electron microscopy and energy dispersive spectroscopy, respectively. Cyclic voltammetry and chronoamperometry were used to evaluate the catalytic activities of CNT/Ni electrode. The CNT/Ni nanocomposite sensor exhibited a great enhancement of anodic peak current after adding 5 mM glucose in alkaline solution. The sensor can also be applied to the quantification of glucose content with a linear range covering from 5 μM to 7 mM, a high sensitivity of 1433 μA mM-1 cm-2, and a low detection limit of 2 μM. The CNT/Ni nanocomposite sensor exhibits good reproducibility and long-term stability, moreover, it was also relatively insensitive to commonly interfering species, such as uric acid, ascorbic acid, acetaminophen, sucrose and d-fructose. © 2013 Elsevier B.V.