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Diabetes Technology & Therapeutics

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https://www.readbyqxmd.com/read/28099035/-let-the-algorithm-do-the-work-reduction-of-hypoglycemia-using-sensor-augmented-pump-therapy-with-predictive-insulin-suspension-smartguard-in-pediatric-type-1-diabetes-patients
#1
Torben Biester, Olga Kordonouri, Martin Holder, Kerstin Remus, Dorothee Kieninger-Baum, Tanja Wadien, Thomas Danne
BACKGROUND: A sensor-augmented insulin pump (SAP) using the MiniMed(®) 640G system with SmartGuard™ technology allows an automatic stop of insulin delivery based on prediction of low glucose levels. Since pediatric patients are particularly prone to hypoglycemia, this device may offer additional protection beyond conventional sensor-augmented therapy. METHODS: This prospective, pediatric multicenter user evaluation assessed 6 weeks of SAP with SmartGuard (threshold setting for hypoglycemia: 70 mg/dL) compared to a preceding period of 2 weeks with SAP only...
January 18, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28080132/ranting-in-2017-is-it-working
#2
Irl B Hirsch
No abstract text is available yet for this article.
January 12, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28005401/improved-algorithm-for-automated-glucose-clamps
#3
Mareike Kuhlenkötter, Tim Heise, Carsten Benesch
BACKGROUND: In glucose clamp experiments, blood glucose concentrations (BGs) are kept as close as possible to a predefined target level using variable glucose infusion rates (GIRs). In automated clamps, GIRs are calculated by algorithms implemented in the device (e.g., the Biostator). Low BG- and GIR-variability is needed for high clamp quality. We therefore tried to reduce oscillations in both BG and GIR with an improved algorithm implemented in ClampArt, a modern clamp device. SUBJECTS AND METHODS: The Biostator algorithm was first improved by numerical simulations of glucose clamps (in silico)...
December 22, 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28001445/long-term-efficacy-and-safety-of-sensor-augmented-insulin-pump-therapy-with-low-glucose-suspend-feature-in-patients-with-type-1-diabetes
#4
Ana María Gómez, Lisseth Fernanda Marín Carrillo, Oscar Mauricio Muñoz Velandia, Martín Alonso Rondón Sepúlveda, Carol M Arévalo Correa, Edwin Mora Garzón, Maria Camila Cuervo Diaz, Diana Cristina Henao Carrillo
BACKGROUND: Literature supports short-term efficacy and safety of Sensor Augmented Insulin Pump (SAP) therapy in patients with type 1 diabetes (T1D). However, no data are available showing long-term outcomes. Our study describes the long-term outcomes of SAP therapy with low-glucose suspend feature (SAP+LGS) in hypoglycemia in a Colombian population with T1D and hypoglycemia. METHODS: A cohort study was conducted with T1D patients receiving SAP+LGS therapy who initiated this therapy because of hypoglycemia at San Ignacio University Hospital diabetes center in Bogotá, Colombia...
December 21, 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27997217/investigating-hypoglycemic-confidence-in-type-1-and-type-2-diabetes
#5
William H Polonsky, Lawrence Fisher, Danielle Hessler, Steven V Edelman
BACKGROUND: While research designed to understand the concerns about hypoglycemia among patients with diabetes has been primarily focused on the investigation of fear and anxiety, recent evidence suggests a potentially important and conceptually distinct element-hypoglycemic confidence. To investigate this dimension, we developed the Hypoglycemic Confidence Scale (HCS); herein, we describe the construction and validation of the HCS and examine how key patient factors are associated with hypoglycemic confidence...
December 20, 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28099052/mhealth-intervention-elements-and-user-characteristics-determine-utility-a-mixed-methods-analysis
#6
Lyndsay A Nelson, Shelagh A Mulvaney, Kevin B Johnson, Chandra Y Osborn
BACKGROUND: Mobile health (mHealth) interventions are improving the medication adherence of adults with type 2 diabetes mellitus (T2DM), but few studies examine how users experience these interventions. Therefore, we used a mixed-methods approach to understand how T2DM users experience a text messaging and interactive voice response (IVR)-delivered medication adherence intervention called MEssaging for Diabetes (MED). METHODS: Adults with T2DM used MED as part of a 3-month pilot study...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28099051/mobile-health-mhealth-for-diabetes-care-opportunities-and-challenges
#7
Farhad Fatehi, Leonard C Gray, Anthony W Russell
No abstract text is available yet for this article.
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28099050/lipohypertrophy-in-china-prevalence-risk-factors-insulin-consumption-and-clinical-impact
#8
Linong Ji, Zilin Sun, Qifu Li, Guijun Qin, Zheng Wei, Junhao Liu, Arthi B Chandran, Laurence J Hirsch
BACKGROUND: Lipohypertrophy (LH) is a complication of insulin therapy. We assessed LH prevalence, risk factors, insulin usage, and clinical and health economic effects in China. METHODS: In four cities, 401 adult patients injecting insulin ≥1 year were surveyed for diabetes/insulin injection history and practices, pen needle reimbursement (PNR), and health resource utilization, followed by structured examination and HbA1c testing. Differences between those with and without LH were evaluated by Student's t-test or the Wilcoxon rank sum test...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28060528/-learning-can-improve-the-blood-glucose-control-performance-for-type-1-diabetes-mellitus
#9
Youqing Wang, Jinping Zhang, Fanmao Zeng, Na Wang, Xiaoping Chen, Bo Zhang, Dong Zhao, Wenying Yang, Claudio Cobelli
BACKGROUND: A learning-type artificial pancreas has been proposed to exploit the repetitive nature in the blood glucose dynamics. We clinically evaluated the efficacy of the learning-type artificial pancreas. METHODS: We conducted a pilot clinical study in 10 participants of mean age 36.1 years (standard deviation [SD] 12.7; range 16-58) with type 1 diabetes. Each trial was conducted for eight consecutive mornings. The first two mornings were open-loop to obtain the individualized parameters...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28055259/coverage-of-prandial-insulin-requirements-an-elusive-goal
#10
Lutz Heinemann, Douglas Muchmore
No abstract text is available yet for this article.
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28055230/improved-postprandial-glycemic-control-with-faster-acting-insulin-aspart-in-patients-with-type-1-diabetes-using-continuous-subcutaneous-insulin-infusion
#11
Bruce W Bode, Joseph A Johnson, Liselotte Hyveled, Søren C Tamer, Marek Demissie
BACKGROUND: Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp. METHODS: This double-blind, randomized, crossover active-controlled trial compared 2-h postprandial plasma glucose (PPG) response, following 2 weeks of CSII with faster aspart or IAsp. Primary endpoint: mean change in PPG 2 h after a standardized meal test (ΔPGav,0-2h)...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28055224/in-home-closed-loop-control-for-artificial-pancreas-patient-and-provider-perspective
#12
Laya Ekhlaspour, David M Maahs
No abstract text is available yet for this article.
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28001434/efficacy-and-safety-of-insulin-therapy-in-patients-with-type-2-diabetes-treated-at-different-grades-of-hospitals-in-china-subgroup-analysis-of-the-real-world-seas-study
#13
Xiaoling Guan, Yiming Mu, Xiaojun Zhou, Shaohua Chen, Jianjun Dong, Lin Liao
BACKGROUNDS: As patients attending hospitals of different grades in China may receive different medical care, we investigated the clinical efficacy and safety of routine insulin therapy in patients with type 2 diabetes who were treated at grade 2 and grade 3 (highest grade) hospitals in China. METHODS: 2683 patients with type 2 diabetes were enrolled in a multicenter, nonrandomized, open-label, noninterventional, 12-week clinical trial performed at 62 Chinese hospitals...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27982707/feasibility-of-long-term-closed-loop-control-a-multicenter-6-month-trial-of-24-7-automated-insulin-delivery
#14
Boris Kovatchev, Peiyao Cheng, Stacey M Anderson, Jordan E Pinsker, Federico Boscari, Bruce A Buckingham, Francis J Doyle, Korey K Hood, Sue A Brown, Marc D Breton, Daniel Chernavvsky, Wendy C Bevier, Paige K Bradley, Daniela Bruttomesso, Simone Del Favero, Roberta Calore, Claudio Cobelli, Angelo Avogaro, Trang T Ly, Satya Shanmugham, Eyal Dassau, Craig Kollman, John W Lum, Roy W Beck
BACKGROUND: In the past few years, the artificial pancreas-the commonly accepted term for closed-loop control (CLC) of blood glucose in diabetes-has become a hot topic in research and technology development. In the summer of 2014, we initiated a 6-month trial evaluating the safety of 24/7 CLC during free-living conditions. RESEARCH DESIGN AND METHODS: Following an initial 1-month Phase 1, 14 individuals (10 males/4 females) with type 1 diabetes at three clinical centers in the United States and one in Italy continued with a 5-month Phase 2, which included 24/7 CLC using the wireless portable Diabetes Assistant (DiAs) developed at the University of Virginia Center for Diabetes Technology...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27929674/glucose-exposure-and-variability-with-empagliflozin-as-adjunct-to-insulin-in-patients-with-type-1-diabetes-continuous-glucose-monitoring-data-from-a-4-week-randomized-placebo-controlled-trial-ease-1
#15
Susanne Famulla, Thomas R Pieber, Jens Eilbracht, Dietmar Neubacher, Nima Soleymanlou, Hans J Woerle, Uli C Broedl, Stefan Kaspers
BACKGROUND: We evaluated the effect of empagliflozin as adjunct to insulin on 24-h glucose exposure and variability in patients with type 1 diabetes. METHODS: Patients (N = 75) with HbA1c ≥7.5% to ≤10.5% were randomized to receive empagliflozin 2.5 mg, empagliflozin 10 mg, empagliflozin 25 mg, or placebo once daily as adjunct to insulin for 4 weeks. Insulin dose was to be kept as stable as possible during week 1 of treatment and was freely adjustable thereafter...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27996322/minimally-disruptive-diabetes-care-for-the-elderly
#16
Gabriela Spencer-Bonilla, Rene Rodriguez-Gutierrez, Victor M Montori
No abstract text is available yet for this article.
December 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27996321/measures-of-glycemic-variability-in-type-1-diabetes-and-the-effect-of-real-time-continuous-glucose-monitoring
#17
Ahmed H El-Laboudi, Ian F Godsland, Desmond G Johnston, Nick S Oliver
OBJECTIVE: To report the impact of continuous glucose monitoring (CGM) on glycemic variability (GV) indices, factors predictive of change, and to correlate variability with conventional markers of glycemia. METHODS: Data from the JDRF study of CGM in participants with type 1 diabetes were used. Participants were randomized to CGM or self-monitored blood glucose (SMBG). GV indices at baseline, at 26 weeks in both groups, and at 52 weeks in the control group were analyzed...
December 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27996320/mitigating-reductions-in-glucose-during-exercise-on-closed-loop-insulin-delivery-the-ex-snacks-study
#18
Neha S Patel, Michelle A Van Name, Eda Cengiz, Lori R Carria, Eileen M Tichy, Kate Weyman, Stuart A Weinzimer, William V Tamborlane, Jennifer L Sherr
OBJECTIVE: To assess whether snacking could be used with closed-loop (CL) insulin delivery to avoid exercise-induced reductions in plasma glucose (PG), as well as elevations in PG at the end of exercise. RESEARCH DESIGN AND METHODS: Twelve type 1 diabetes (T1D) subjects (age 13-36 years, duration 10.7 ± 8.4 years, A1c 7.4% ± 0.8% [57 ± 8.7 mmol/mol]) underwent two 105-min exercise studies while under CL control: CL alone and CL+snack. Exercise, commenced at 3 PM, consisted of four 15-min periods of brisk treadmill walking to 65%-70% HRmax (separated by three 5-min rest periods), followed by a 30-min recovery period...
December 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27996319/hypoglycemia-in-older-adults-with-type-1-diabetes
#19
Stephanie N DuBose, Ruth S Weinstock, Roy W Beck, Anne L Peters, Grazia Aleppo, Richard M Bergenstal, Henry Rodriguez, Joseph F Largay, Elaine M Massaro, Irl B Hirsch
BACKGROUND: Hypoglycemia is a major concern in older adults with type 1 diabetes (T1D) and there is limited knowledge in this population. We examined data from 199 adults, ≥60 years of age, who participated in a T1D Exchange study assessing factors associated with severe hypoglycemia (SH) in older adults with T1D: 100 with SH in the prior year and 99 with no SH in prior 3 years (mean age 68; mean diabetes duration 40 years; 47% female; 92% non-Hispanic white). Hypoglycemia was assessed with up to 14 days of blinded continuous glucose monitoring (CGM)...
December 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27922760/nervecheck-for-the-detection-of-sensory-loss-and-neuropathic-pain-in-diabetes
#20
Georgios Ponirakis, Maria N Odriozola, Samantha Odriozola, Ioannis N Petropoulos, Shazli Azmi, Maryam Ferdousi, Hassan Fadavi, Uazman Alam, Andrew Marshall, Maria Jeziorska, Anthony Miro, Ahmad Kheyami, Mitra Tavakoli, Ahmed Al-Ahmar, Maria B Odriozola, Ariel Odriozola, Rayaz A Malik
BACKGROUND: Accurate and economic detection of nerve damage in diabetes is key to more widespread diagnosis of patients with diabetic peripheral neuropathy (DPN) and painful diabetic neuropathy. This study examined the diagnostic performance of NerveCheck, an inexpensive ($500) quantitative sensory testing (QST) device. METHODS: One hundred forty-four subjects (74 with and 70 without diabetes) underwent assessment with NerveCheck, neuropathy disability score (NDS), nerve conduction studies (NCS), intraepidermal and corneal nerve fiber density (IENFD and CNFD), and McGill questionnaire for neuropathic pain...
December 2016: Diabetes Technology & Therapeutics
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