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Diabetes Technology & Therapeutics

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https://www.readbyqxmd.com/read/28771387/minimizing-glycemic-fluctuations-in-patients-with-type-2-diabetes-approaches-and-importance
#1
Paresh Dandona
Glycemic fluctuations, characterized by short-term oscillations in plasma glucose, are important when managing type 2 diabetes (T2D) and may be considered a target of glucose-lowering therapies. Continuous glucose monitoring (CGM) has been used to evaluate the effects of different treatments on glycemic fluctuations. This review examines approaches to and the importance of minimizing glycemic fluctuations among patients with T2D. Measures of HbA1c, fructosamine, and glycated albumin reflect a long-term average of plasma glucose, and are therefore unable to provide an accurate measure of short-term glycemic oscillations...
August 3, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28767276/closed-loop-control-without-meal-announcement-in-type-1-diabetes
#2
Faye M Cameron, Trang T Ly, Bruce A Buckingham, David M Maahs, Gregory P Forlenza, Carol J Levy, David Lam, Paula Clinton, Laurel H Messer, Emily Westfall, Camilla Levister, Yan Yan Xie, Nihat Baysal, Daniel Howsmon, Stephen D Patek, B Wayne Bequette
OBJECTIVE: A fully closed-loop insulin-only system was developed to provide glucose control in patients with type 1 diabetes without requiring announcement of meals or activity. Our goal was to assess initial safety and efficacy of this system. RESEARCH DESIGN AND METHODS: The multiple model probabilistic controller (MMPPC) anticipates meals when the patient is awake. The controller used the subject's basal rates and total daily insulin dose for initialization. The system was tested at two sites on 10 patients in a 30-h inpatient study, followed by 15 subjects at three sites in a 54-h supervised hotel study, where the controller was challenged by exercise and unannounced meals...
August 2, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28749169/effects-of-sodium-glucose-cotransporter-2-inhibitors-on-serum-uric-acid-in-type-2-diabetes-mellitus
#3
Hala Ahmadieh, Sami Azar
Hyperuricemia has been linked to metabolic syndrome, cardiovascular disease, and chronic kidney disease. Hyperuricemia and type 2 diabetes mellitus were inter-related, type 2 diabetes mellitus was more at risk of having a higher serum uric acid level, and also individuals with higher serum uric acid had higher risk of developing type 2 diabetes in the future. Insulin resistance seems to play an important role in the causal relationship between metabolic syndrome, type 2 diabetes, and hyperuricemia. Oral diabetic drugs that would have additional beneficial effects on reducing serum uric acid levels are of importance...
July 27, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28722480/efficacy-and-safety-of-biosimilar-sar342434-insulin-lispro-in-adults-with-type-1-diabetes-also-using-insulin-glargine-sorella-1-study
#4
Satish Garg, Karin Wernicke-Panten, Maria Rojeski, Suzanne Pierre, Yvonne Kirchhein, Krystyna Jedynasty
BACKGROUND: SAR342434 is a biosimilar (follow-on) of insulin lispro-Humalog®. This study aimed to show similar efficacy, safety and immunogenicity of SAR342434 (SAR-Lis) versus insulin lispro-Humalog (Ly-Lis) in adult patients with type 1 diabetes (T1DM) treated with multiple daily injections while using basal insulin glargine (Lantus®; GLA100GLA-100). MATERIALS AND METHODS: SORELLA-1 was a randomized, open-label Phase 3 study (NCT02273180). Patients completing the 6-month main study continued on SAR-Lis or Ly-Lis, as randomized, for a 6-month safety extension...
July 19, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28704063/evaluation-of-accuracy-of-six-blood-glucose-monitoring-systems-and-modeling-of-possibly-related-insulin-dosing-errors
#5
Annette Baumstark, Nina Jendrike, Stefan Pleus, Cornelia Haug, Guido Freckmann
OBJECTIVE: Self-monitoring of blood glucose (BG) is an essential part of diabetes therapy. Accurate and reliable results from BG monitoring systems (BGMS) are important especially when they are used to calculate insulin doses. This study aimed at assessing system accuracy of BGMS and possibly related insulin dosing errors. RESEARCH DESIGN AND METHODS: System accuracy of six different BGMS (Accu-Chek(®) Aviva Nano, Accu-Chek Mobile, Accu-Chek Performa Nano, CONTOUR(®) NEXT LINK 2...
July 13, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28704062/flextouch-an-insulin-pen-injector-with-a-low-activation-force-across-different-insulin-formulations-needle-technologies-and-temperature-conditions
#6
Niels Gudiksen, Thibaud Hofstätter, Birgitte B Rønn, Thomas Sparre
FlexTouch® (Novo Nordisk A/S, Bagsvaerd, Denmark) is a pen-injector with a torque spring mechanism requiring a low activation force. This laboratory-based study compared the activation force of FlexTouch during the injection of insulin with different needles and at temperature conditions within the range at which the device is recommended for use. Using a tensile tester, activation force was measured at maximum dose settings for insulin detemir (100 U/mL) and insulin degludec (100 and 200 U/mL) at standard (23°C ± 5°C), cool (5°C ± 3°C), and warm (30°C ± 2°C) conditions...
July 13, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28665142/targeting-one-hour-postmeal-glucose-is-it-time-for-a-paradigm-switch-in-diabetes-management
#7
Antonio Ceriello
In the management of diabetes, postprandial glycemia (PPG) is usually targeted 2 h after the start of meal. Recent evidences, however, suggest that the value of glycemia at 1 h during an oral glucose tolerance test (OGTT) is a stronger predictor for developing diabetes than the value at 2 h and that it is an independent risk factor for cardiovascular disease. Studies in cells, animals, and humans suggest that 1-h high glucose is a sufficient stimulus for increasing several cardiovascular risk factors, such as inflammation, thrombosis, and endothelial dysfunction, with oxidative stress generation as the possible pathogenetic factor...
June 30, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28817342/hypoglycemia-risk-related-to-double-dose-is-markedly-reduced-with-basal-insulin-peglispro-versus-insulin-glargine-in-patients-with-type-2-diabetes-mellitus-in-a-randomized-trial-imagine-8
#8
Cynthia Harris, Thomas Forst, Tim Heise, Leona Plum-Mörschel, Elaine Watkins, Qianyi Zhang, Ludi Fan, Parag Garhyan, Niels Porksen
BACKGROUND: Basal insulin peglispro (BIL) has a peripheral-to-hepatic distribution of action that resembles endogenous insulin and a prolonged duration of action with a flat pharmacokinetic/pharmacodynamic profile at steady state, characteristics that tend to reduce hypoglycemia risk compared to insulin glargine (GL). The primary objective was to demonstrate that clinically significant hypoglycemia (blood glucose ≤54 mg/dL [3.0 mmol/L] or symptoms of severe hypoglycemia) occurred less frequently within 84 h after a double dose (DD) of BIL than a DD of GL...
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28817341/assessment-of-interday-glucose-variability-in-type-2-diabetes
#9
Vikash Dadlani, Yogish C Kudva
No abstract text is available yet for this article.
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28767273/advances-in-subcutaneous-glucose-sensing
#10
Jessica R Castle
No abstract text is available yet for this article.
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28700272/accuracy-of-a-fourth-generation-subcutaneous-continuous-glucose-sensor
#11
Mark P Christiansen, Satish K Garg, Ronald Brazg, Bruce W Bode, Timothy S Bailey, Robert H Slover, Ashley Sullivan, Suiying Huang, John Shin, Scott W Lee, Francine R Kaufman
BACKGROUND: This study evaluated the accuracy and performance of a fourth-generation subcutaneous glucose sensor (Guardian(™) Sensor 3) in the abdomen and arm. METHODS: Eighty-eight subjects (14-75 years of age, mean ± standard deviation [SD] of 42.0 ± 19.1 years) with type 1 or type 2 diabetes participated in the study. Subjects wore two sensors in the abdomen that were paired with either a MiniMed(™) 640G insulin pump, or an iPhone(®) or iPod(®) touch(®) running a glucose monitoring mobile application (Guardian Connect system) and a third sensor in the arm, which was connected to a glucose sensor recorder (GSR)...
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28700249/simulation-based-evaluation-of-dose-titration-algorithms-for-rapid-acting-insulin-in-subjects-with-type-2-diabetes-mellitus-inadequately-controlled-on-basal-insulin-and-oral-antihyperglycemic-medications
#12
Xiaosu Ma, Jenny Y Chien, Jennal Johnson, James Malone, Vikram Sinha
BACKGROUND: The purpose of this prospective, model-based simulation approach was to evaluate the impact of various rapid-acting mealtime insulin dose-titration algorithms on glycemic control (hemoglobin A1c [HbA1c]). METHODS: Seven stepwise, glucose-driven insulin dose-titration algorithms were evaluated with a model-based simulation approach by using insulin lispro. Pre-meal blood glucose readings were used to adjust insulin lispro doses. Two control dosing algorithms were included for comparison: no insulin lispro (basal insulin+metformin only) or insulin lispro with fixed doses without titration...
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28605286/the-durability-of-basal-insulin-affects-day-to-day-glycemic-variability-assessed-by-continuous-glucose-monitoring-in-type-2-diabetes-patients-a-randomized-crossover-trial
#13
Hiroyuki Iuchi, Masaya Sakamoto, Daisuke Matsutani, Hirofumi Suzuki, Ryuzo Horiuchi, Kazunori Utsunomiya
BACKGROUND: Not only within-day glycemic variability but also day-to-day glycemic variability is a risk factor for diabetic patients. However, the ways of controlling day-to-day glycemic variability are unclear. We hypothesized that the durability of basal insulin plays an important role in controlling day-to-day glycemic variability in type 2 diabetes patients, and we therefore aimed to evaluate whether glargine U300, which exhibits prolonged absorption compared with glargine U100 but the same composition as glargine U100, would lead to improved day-to-day glycemic variability...
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28594566/severe-hypoglycemia-before-landing-in-a-patient-with-type-1-diabetes-using-sensor-augmented-pump-therapy
#14
Clara Viñals, Adriana Pané, Carmen Quirós, Marga Giménez, Ignacio Conget
No abstract text is available yet for this article.
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28581821/randomized-controlled-trial-of-technology-assisted-case-management-in-low-income-adults-with-type-2-diabetes
#15
Leonard E Egede, Joni S Williams, Delia C Voronca, Rebecca G Knapp, Jyotika K Fernandes
OBJECTIVE: To assess the efficacy of technology-assisted case management (TACM) with medication titration by nurses using guideline-based algorithms, under physician supervision in improving glycemic control in low-income rural adults with poorly controlled type 2 diabetes. RESEARCH DESIGN AND METHODS: Adults (aged ≥18 years) from the southeastern United States with hemoglobin A1c [HbA1c] ≥8% were randomized to TACM or usual care. Evidence-based guidelines were used to develop medication titration algorithms in conjunction with clinic physicians...
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28581818/effect-of-linagliptin-versus-metformin-on-glycemic-variability-in-patients-with-impaired-glucose-tolerance
#16
Tonatiuh González-Heredia, Diana M Hernández-Corona, Manuel González-Ortiz, Esperanza Martínez-Abundis
BACKGROUND: Impaired glucose tolerance (IGT) and glycemic variability may be associated with increased risk of micro- and macrovascular complications. The aim of this study was to assess the effect of linagliptin versus metformin on glycemic variability in patients with IGT. MATERIAL AND METHODS: A randomized, double-blind clinical trial with parallel groups was carried out in 16 adult patients with IGT, overweight or obesity. All patients signed an informed consent...
August 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28731823/maternal-fetal-outcomes-in-34-pregnant-women-with-type-1-diabetes-in-sensor-augmented-insulin-pump-therapy
#17
Ana María Gómez, Lisseth Fernanda Marín Carrillo, Carol M Arévalo Correa, Oscar Mauricio Muñoz Velandia, Martín Alonso Rondón Sepúlveda, Jaime Luis Silva Herrera, Diana Cristina Henao Carrillo
BACKGROUND: Pregnancy in women with type 1 diabetes (T1D) is associated with increased risk of maternal complications and neonatal morbidity and mortality. Optimizing glycemic control improves these outcomes. OBJECTIVE: To describe the experience of using sensor-augmented insulin pump therapy (SAPT) and SAPT + low-glucose suspension (LGS) on pregnant women with T1D, including neonatal and maternal outcomes. METHODS: A prospective observational study was conducted in women with T1D who started SAPT and SAPT + LGS before or during pregnancy at the San Ignacio University Hospital Diabetes Center in Bogotá, Colombia...
July 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28704065/re-castle-et-al-2017-diabetes-technol-ther-doi-10-1089-dia-2017-0012
#18
Francine R Kaufman, John Shin
No abstract text is available yet for this article.
July 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28686045/challenges-of-diabetes-management-in-toddlers
#19
Asma Deeb
Toddlers with type 1 diabetes have distinctive combination of challenges to their families and healthcare providers. A major factor is the difficulty in achieving metabolic control without risking hypoglycemia. The rising incidence of type 1 diabetes in toddlers increases the magnitude of the problem and creates a greater need for providing specialized service to cater for this age group's unique need. Type 1 has a specific disease nature in younger children and its clinical presentation mimics common childhood diseases...
July 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28686041/relevance-of-bolus-calculators-in-current-hybrid-closed-loop-systems
#20
Gregory P Forlenza
No abstract text is available yet for this article.
July 2017: Diabetes Technology & Therapeutics
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