Elena Succurro1,2 · Giuseppe Cersosimo3 · Paola Sarnelli4 · Francesco Brisinda1 · Ilaria Gattuso1 · Valeria Mazza1 ·Giuseppe Fabiano1 · Fiorella Iorio3 · Roberta Arena3 · Giovanni Mazzitello5 · Ramona Nicotera5 · Maria Capria1 ·Gianluigi Zaza6 · Michele Andreucci1 · Raffaele Mancini5 · Francesco Andreozzi1,2
Received: 22 December 2025 / Accepted: 16 March 2026© The Author(s) 2026
Abstract
Aims To describe the main glycemic outcomes and the Quality of Life (QOL) observed in a cohort of people with type 1(T1D) or type 2 (T2D) insulin-treated diabetes under dialysis who started an Automated Insulin Delivery (AID) system.
Methods This is a longitudinal retrospective pilot real-world analysis of 14 individuals with T1D and T2D undergoingdialysis who began using an AID system to optimize glycemic control. All subjects used the MiniMed™ 780G system. Glu-cose metrics were collected at baseline, 3, 6, and 12 months after initiating the SmartGuard™ feature. The WHOQoL-Bref questionnaire was administered at the last follow-up to evaluate the QOL.
Results Out of the 14 people, 8 reached 1-year follow-up. Time in Range (TIR) increased from 63% at baseline to 69% at 12 months, Time Below Range <70 mg/dL (TBR70) decreased from 0.3% to 0%, and Time Above Range >250 mg/dL (TAR250) decreased from 6.7% to 3.9%. Seven out of eight subjects who reached a 12-month follow-up achieved all three glycemic targets for this fragile population (TIR>50%, TBR70<1% and TAR250<10%). At the last follow-up, 58.3% of the users were satisfied or very satisfied with their health status, versus only 25% with the previous treatment, and 81.7% had a good or very good QOL, whereas only 8.3% had a good QOL, and no one had a very good QOL with the previous
Conclusion This pilot real-world study showed how the use of an AID system is safe and can help to improve the glycemic outcomes and the QOL of people with diabetes in dialysis.
Keywords Automated insulin delivery system · End-stage kidney disease · Dialysis · Time in range · Diabetes mellitus · Quality of Life
Communicated by Salvatore Corrao, M.D
Elena Succurro
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1 Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro 88100, Italy
2 Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Graecia of Catanzaro, Catanzaro, Italy
3 Azienda Ospedaliera Annunziata Cosenza, Cosenza, Italy
4 ASL Viterbo, Viterbo, Italy
5 ASP Catanzaro, Catanzaro, Italy
6 Department of Civil Engineering, University of Calabria, Rende, Italy
何黎
［摘 要］ 广义的皮肤屏障包括物理屏障、神经屏障、色素屏障及免疫屏障。 狭义的皮肤屏障通常指表皮屏障。 既往研究主要集中在角质层，忽视了表皮其他层次的屏障修复。 近年研究表明，多种皮肤疾病及皮肤问题的表皮屏障受损不仅在角质层，还涉及颗粒层、棘层及基底层，且角化包膜、细胞间脂质及紧密连接蛋白变化也是表皮屏障受损的关键因素。 但迄今为止，仍缺乏对表皮屏障不同层次受损机制及干预的系统探讨。 本文提出“表皮屏障受损及分层修复”新理念，为表皮屏障受损不同层次的精准修复提供理论依据及临床应用新视角。
［关键词］ 皮肤屏障；表皮屏障；屏障修复；紧密连接蛋白
［中图分类号］ Ｒ ７５１ ［文献标志码］ Ａ ［文章编号］ １００１ － ７０８９（２０２５）０９ － ０９４５ － ０８［ＤＯＩ］ １０． １３７３５ ／ ｊ． ｃｊｄｖ． １００１⁃７０８９． ２０２５０２０２８
Ｔｈｅ Ｎｅｗ Ｃｏｎｃｅｐｔ ｏｆ “Ｅｐｉｄｅｒｍａｌ Ｂａｒｒｉｅｒ Ｄａｍａｇｅ ａｎｄ Ｓｔｒａｔｉｆｉｅｄ Ｒｅｐａｉｒ”ＨＥ Ｌｉ１，２
（１． Ｄｅｐａｒｔｍｅｎｔ ｏｆ Ｄｅｒｍａｔｏｌｏｇｙ，Ｆｉｒｓｔ Ａｆｆｉｌｉａｔｅｄ Ｈｏｓｐｉｔａｌ ｏｆ Ｋｕｎｍｉｎｇ Ｍｅｄｉｃａｌ Ｕｎｉｖｅｒｓｉｔｙ， Ｋｕｎｍｉｎｇ６５００３２，Ｃｈｉｎａ； ２． Ｌｉｗａ Ｉｎｓｔｉｔｕｔｅ ｏｆ Ｓｋｉｎ Ｈｅａｌｔｈ， Ｅａｓｔ Ｃｈｉｎａ Ｎｏｒｍａｌ Ｕｎｉｖｅｒｓｉｔｙ，Ｓｈａｎｇｈａｉ ２０００６２，Ｃｈｉｎａ）
［Ａｂｓｔｒａｃｔ］ Ｔｈｅ ｓｋｉｎ ｂａｒｒｉｅｒ ｉｎ ａ ｂｒｏａｄ ｓｅｎｓｅ ｉｎｃｌｕｄｅｓ ｔｈｅ ｐｈｙｓｉｃａｌ ｂａｒｒｉｅｒ， ｎｅｕｒａｌ ｂａｒｒｉｅｒ，ｐｉｇｍｅｎｔ ｂａｒｒｉｅｒ， ａｎｄ ｉｍｍｕｎｅ ｂａｒｒｉｅｒ， ｗｈｉｌｅ ｔｈｅ ｓｋｉｎ ｂａｒｒｉｅｒ ｉｎ ａ ｎａｒｒｏｗ ｓｅｎｓｅ ｇｅｎｅｒａｌｌｙ ｒｅｆｅｒｓ ｔｏ ｔｈｅ ｅｐｉｄｅｒｍａｌ ｂａｒｒｉｅｒ. Ｐｒｅｖｉｏｕｓ ｓｔｕｄｉｅｓ ｈａｖｅ ｍａｉｎｌｙ ｆｏｃｕｓｅｄ ｏｎ ｔｈｅｓｔｒａｔｕｍ ｃｏｒｎｅｕｍ， ｎｅｇｌｅｃｔｉｎｇ ｂａｒｒｉｅｒ ｒｅｐａｉｒ ｉｎ ｏｔｈｅｒ ｅｐｉｄｅｒｍａｌ ｌａｙｅｒｓ. Ｒｅｃｅｎｔ ｓｔｕｄｉｅｓ ｈａｖｅ ｒｅｖｅａｌｅｄ ｔｈａｔ ｅｐｉｄｅｒｍａｌ ｂａｒｒｉｅｒ ｄａｍａｇｅ ｉｎ ｖａｒｉｏｕｓ ｄｅｒｍａｔｏｓｅｓ ａｎｄ ｓｋｉｎ ｃｏｎｄｉｔｉｏｎｓ ｉｎｖｏｌｖｅｓ ｎｏｔ ｏｎｌｙ ｔｈｅ ｓｔｒａｔｕｍ ｃｏｒｎｅｕｍ ｂｕｔ ａｌｓｏ ｔｈｅ ｓｔｒａｔｕｍ ｇｒａｎｕｌｏｓｕｍ， ｓｔｒａｔｕｍ ｓｐｉｎｏｓｕｍ， ａｎｄ ｓｔｒａｔｕｍ ｂａｓａｌｅ， ｗｉｔｈ ａｌｔｅｒａｔｉｏｎｓ ｉｎ ｔｈｅ ｃｏｒｎｉｆｉｅｄ ｅｎｖｅｌｏｐｅ， ｉｎｔｅｒｃｅｌｌｕｌａｒ ｌｉｐｉｄｓ， ａｎｄ ｔｉｇｈｔ ｊｕｎｃｔｉｏｎ ｐｒｏｔｅｉｎｓ ｂｅｉｎｇ ｋｅｙ ｃｏｎｔｒｉｂｕｔｉｎｇ ｆａｃｔｏｒｓ． Ｈｏｗｅｖｅｒ， ｓｙｓｔｅｍａｔｉｃ ｉｎｖｅｓｔｉｇａｔｉｏｎｓ ｉｎｔｏ ｔｈｅ ｄａｍａｇｅ ｍｅｃｈａｎｉｓｍｓ ａｎｄ ｔａｒｇｅｔｅｄ ｉｎｔｅｒｖｅｎｔｉｏｎｓ ｆｏｒ ｄｉｆｆｅｒｅｎｔ ｅｐｉｄｅｒｍａｌ ｂａｒｒｉｅｒ ｌａｙｅｒｓ ｒｅｍａｉｎ ｌａｃｋｉｎｇ. Ｔｈｉｓ ａｒｔｉｃｌｅ ｐｒｏｐｏｓｅｓ ｔｈｅ ｎｅｗ ｃｏｎｃｅｐｔ ｏｆ “ ｅｐｉｄｅｒｍａｌ ｂａｒｒｉｅｒ ｄａｍａｇｅ ａｎｄ ｓｔｒａｔｉｆｉｅｄ ｒｅｐａｉｒ ”， ｐｒｏｖｉｄｉｎｇ ｂｏｔｈ ａ ｔｈｅｏｒｅｔｉｃａｌ ｆｒａｍｅｗｏｒｋ ａｎｄ ｎｅｗ ｃｌｉｎｉｃａｌ ｉｎｓｉｇｈｔｓ ｆｏｒ ｌａｙｅｒ⁃ｓｐｅｃｉｆｉｃ ｐｒｅｃｉｓｉｏｎ ｒｅｐａｉｒ ｏｆ ｔｈｅ ｅｐｉｄｅｒｍａｌ ｂａｒｒｉｅｒ.
［Ｋｅｙ ｗｏｒｄｓ］ Ｓｋｉｎ ｂａｒｒｉｅｒ；Ｅｐｉｄｅｒｍａｌ ｂａｒｒｉｅｒ；Ｂａｒｒｉｅｒ ｒｅｐａｉｒ；Ｔｉｇｈｔ ｊｕｎｃｔｉｏｎ ｐｒｏｔｅｉｎｓ
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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