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Diabetes Technology & Therapeutics

Päivi Rautiainen, Hilkka Tirkkonen, Tiina Laatikainen
BACKGROUNDS: This study aims to compare glycemic control of persons with type 1 diabetes using multiple daily injections (MDI) with insulin glargine versus insulin detemir or with continuous subcutaneous insulin infusion (CSII) in daily practice. SUBJECTS AND METHODS: All adult individuals with type 1 diabetes (n = 1053) were identified from the electronic patient database in North Karelia, Finland. The persons' individual data for insulin treatment, diabetic ketoacidosis (DKA), and hemoglobin A1c (HbA1c) measurements during the year 2014 were obtained from medical records...
May 9, 2018: Diabetes Technology & Therapeutics
Dayna E McGill, Lisa K Volkening, Deborah A Butler, Kara R Harrington, Michelle L Katz, Lori M Laffel
BACKGROUND: Consistent use of continuous glucose monitoring (CGM) has been associated with improved glycemic control in youth with type 1 diabetes (T1D). There are many barriers to device uptake and continued use. There is a need to understand patient-specific characteristics when considering CGM. We evaluated patterns of CGM use and associations between baseline psychosocial measures and frequency of CGM use over 1 year. METHODS: Youth with T1D (n = 120), ages 8-18 years, completed questionnaires at CGM initiation and after 6 and 12 months assessing depressive symptoms, diabetes burden, and diabetes-specific and generic quality of life (QOL)...
May 4, 2018: Diabetes Technology & Therapeutics
Suresh Rama Chandran, Wei Lin Tay, Weng Kit Lye, Lee Ling Lim, Jeyakantha Ratnasingam, Alexander Tong Boon Tan, Daphne S L Gardner
BACKGROUND: Hypoglycemia is the major impediment to therapy intensification in diabetes. Although higher individualized HbA1c targets are perceived to reduce the risk of hypoglycemia in those at risk of hypoglycemia, HbA1c itself is a poor predictor of hypoglycemia. We assessed the use of glycemic variability (GV) and glycemic indices as independent predictors of hypoglycemia. METHODS: A retrospective observational study of 60 type 1 and 100 type 2 diabetes subjects...
April 24, 2018: Diabetes Technology & Therapeutics
Mark W Reid, Subramanian Krishnan, Cari Berget, Cindy Cain, John Fred Thomas, Georgeanna J Klingensmith, Jennifer K Raymond
BACKGROUND: Young adults with type 1 diabetes (T1D) experience poor glycemic control, disengagement in care, and are often lost to the medical system well into their adult years. Diabetes providers need a new approach to working with the population. The goal of this study was to determine whether an innovative shared telemedicine appointment care model (CoYoT1 Clinic [pronounced as "coyote"; Colorado Young Adults with T1D]) for young adults with T1D improves care engagement, satisfaction, and adherence to American Diabetes Association (ADA) guidelines regarding appointment frequency...
April 19, 2018: Diabetes Technology & Therapeutics
Gregory P Forlenza, Faye M Cameron, Trang T Ly, David Lam, Daniel P Howsmon, Nihat Baysal, Georgia Kulina, Laurel Messer, Paula Clinton, Camilla Levister, Stephen D Patek, Carol J Levy, R Paul Wadwa, David M Maahs, B Wayne Bequette, Bruce A Buckingham
BACKGROUND: Initial Food and Drug Administration-approved artificial pancreas (AP) systems will be hybrid closed-loop systems that require prandial meal announcements and will not eliminate the burden of premeal insulin dosing. Multiple model probabilistic predictive control (MMPPC) is a fully closed-loop system that uses probabilistic estimation of meals to allow for automated meal detection. In this study, we describe the safety and performance of the MMPPC system with announced and unannounced meals in a supervised hotel setting...
April 16, 2018: Diabetes Technology & Therapeutics
Valeria Alcántara-Aragón, Susana Rodrigo-Cano, Ascension Lupianez-Barbero, María José Martinez, Carmen Martinez, José Tapia, José Manuel Iniesta, Susana Tenes, Eulalia Urgell, Gemma Navarro, M Elena Hernando, Juan Francisco Merino-Torres, Alberto de Leiva, Cintia Gonzalez
An ongoing clinical trial is testing the efficacy of web telematic support in a structured program for obesity treatment and diabetes prevention. Participants were recruited from two tertiary-care hospitals and randomized to receive either a telematic intervention (TI) supported by PREDIRCAM2 web platform or a non-telematic intervention (NTI). All receive 1-year follow-up. Both interventions consist of tailored dietary and exercise prescriptions, based on a Mediterranean dietary pattern and general WHO exercise recommendations for adults...
April 5, 2018: Diabetes Technology & Therapeutics
Arthur Bertachi, Aleix Beneyto, Charrise M Ramkissoon, Josep Vehí
BACKGROUND: Moderate physical activity improves overall health conditions in subjects with type 1 diabetes. However, insulin management during and after exercise is challenging due to the effects of exercise on glycemic control. Artificial pancreas (AP) systems aim to automatically control blood glucose levels, but exercise-induced hypoglycemia is a major challenge for these systems, especially in uni-hormonal configurations. The aim of this work was to evaluate the ability of several feed-forward (FF) actions to prevent exercise-induced hypoglycemia in a closed-loop setting...
April 2, 2018: Diabetes Technology & Therapeutics
Arndís F Ólafsdóttir, William Polonsky, Jan Bolinder, Irl B Hirsch, Sofia Dahlqvist, Hans Wedel, Thomas Nyström, Magnus Wijkman, Erik Schwarcz, Jarl Hellman, Tim Heise, Marcus Lind
BACKGROUND: To evaluate the effects of continuous glucose monitoring (CGM) on nocturnal and daytime hypoglycemia in persons with type 1 diabetes treated with multiple daily insulin injections (MDI); we also evaluated factors related to differences in hypoglycemia confidence in this population. METHODS: Evaluations were performed from the GOLD randomized trial, an open-label multicenter crossover randomized clinical trial (n = 161) over 69 weeks comparing CGM to self-measurement of blood glucose (SMBG) in persons with type 1 diabetes treated with MDI...
April 2, 2018: Diabetes Technology & Therapeutics
Carrie Lorenz, Wendolyn Sandoval, Mark Mortellaro
BACKGROUND: A variety of prescriptions and over-the-counter medications interfere with transcutaneous continuous glucose monitoring (CGM) sensors. This study characterized the interference profile of the Eversense® CGM System (Senseonics, Inc., Germantown, MD), which has a different mechanism of glucose detection than other CGM systems. MATERIALS AND METHODS: Sensor bias (sensor glucose concentration measurement - plasma glucose concentration measured by a reference test) was measured in vitro against 41 different substances at supratherapeutic/supraphysiologic plasma concentrations...
March 30, 2018: Diabetes Technology & Therapeutics
Tonya D Riddlesworth, Roy W Beck, Robin L Gal, Crystal G Connor, Richard M Bergenstal, Sooji Lee, Steven M Willi
OBJECTIVE: To determine the minimum sample of continuous glucose monitoring (CGM) data needed to accurately reflect 3 months of glycemic control. RESEARCH DESIGN AND METHODS: Three months of CGM data were collected on 257 individuals (age 10-78 years) with type 1 diabetes in two studies (one using the Abbott FreeStyle Libre Pro™ and the other using the Dexcom™ G4). Correlations were calculated between the full 3 months and incremental sampling periods of CGM data...
March 22, 2018: Diabetes Technology & Therapeutics
Vanessa Moscardó, Jorge Bondia, Francisco J Ampudia-Blasco, Carmine G Fanelli, Paola Lucidi, Paolo Rossetti
BACKGROUND: Continuous glucose monitoring (CGM) accuracy during hypoglycemia is suboptimal. This might be partly explained by insulin or hypoglycemia-induced changes in the plasma interstitial subcutaneous (SC) fluid glucose gradient. The aim of the present study was to assess the role of plasma insulin (PI) and hypoglycemia itself in the plasma and interstitial SC fluid glucose concentration in patients with type 1 diabetes mellitus. METHODS: Eleven subjects with type 1 diabetes (age 36...
March 12, 2018: Diabetes Technology & Therapeutics
David Rodbard
No abstract text is available yet for this article.
April 2018: Diabetes Technology & Therapeutics
Nina Jendrike, Annette Baumstark, Stefan Pleus, Christina Liebing, Alexandra Beer, Frank Flacke, Cornelia Haug, Guido Freckmann
BACKGROUND: Self-monitoring of blood glucose (SMBG) is important in diabetes therapy; however, not all SMBG systems are sufficiently accurate. In addition, some SMBG systems are influenced by the user's hematocrit value. METHODS: System accuracy and hematocrit influence was evaluated for four SMBG systems with built-in insulin dose advisors (Accu-Chek® Aviva Expert [1], FreeStyle InsuLinx [2], FreeStyle Precision Neo [3], MyStar DoseCoach® [4]) based on International Organization for Standardization (ISO) 15197:2013 section 6...
April 2018: Diabetes Technology & Therapeutics
(no author information available yet)
No abstract text is available yet for this article.
April 2018: Diabetes Technology & Therapeutics
Irina Gaynanova, Jacek Urbanek, Naresh M Punjabi
No abstract text is available yet for this article.
April 2018: Diabetes Technology & Therapeutics
Mercedes Rigla, Belén Pons, Pere Rebasa, Alexis Luna, Francisco Javier Pozo, Assumpta Caixàs, Maria Villaplana, David Subías, Maria Rosa Bella, Neus Combalia
BACKGROUND: Subcutaneous (s.c.) glucose sensors have become a key component in type 1 diabetes management. However, their usability is limited by the impact of foreign body response (FBR) on their duration, reliability, and accuracy. Our study gives the first description of human acute and subacute s.c. response to glucose sensors, showing the changes observed in the sensor surface, the inflammatory cells involved in the FBR and their relationship with sensor performance. METHODS: Twelve obese patients (seven type 2 diabetes) underwent two abdominal biopsies comprising the surrounding area where they had worn two glucose sensors: the first one inserted 7 days before and the second one 24 h before biopsy procedure...
April 2018: Diabetes Technology & Therapeutics
Bruce A Buckingham, Gregory P Forlenza, Jordan E Pinsker, Mark P Christiansen, R Paul Wadwa, Jennifer Schneider, Thomas A Peyser, Eyal Dassau, Joon Bok Lee, Jason O'Connor, Jennifer E Layne, Trang T Ly
BACKGROUND: The safety and feasibility of the OmniPod personalized model predictive control (MPC) algorithm in adult, adolescent, and pediatric patients with type 1 diabetes were investigated. METHODS: This multicenter, observational trial included a 1-week outpatient sensor-augmented pump open-loop phase and a 36-h inpatient hybrid closed-loop (HCL) phase with announced meals ranging from 30 to 90 g of carbohydrates and limited physical activity. Patients aged 6-65 years with HbA1c between 6...
April 2018: Diabetes Technology & Therapeutics
Benyamin Grosman, Di Wu, Diana Miller, Louis Lintereur, Anirban Roy, Neha Parikh, Francine R Kaufman
BACKGROUND: Simulations using mathematical models are important for studying, developing, and improving therapies for people with type 1 diabetes. METHODS: The Medtronic CareLink® database was used to create virtual patients with a variety of inter-insulin sensitivities, meal absorption rates, pharmacokinetics, age, and gender. In addition, intra-insulin sensitivities of the virtual patients change over a 24-h cycle. RESULTS: A total of 2087 virtual patients were developed...
March 2018: Diabetes Technology & Therapeutics
Kimberly P Garza, Aneta Jedraszko, Lindsey E G Weil, Diana Naranjo, Katharine D Barnard, Lori M B Laffel, Korey K Hood, Jill Weissberg-Benchell
BACKGROUND: This study examines the hopes and expectations that children, adolescents, and adults with type 1 diabetes and their families have for new automated insulin delivery systems. The study also aims to examine how the automated insulin delivery system may impact family functioning and individual members' psychosocial adjustment. METHODS: Forty-eight semistructured focus groups (n = 195) and 89 individual interviews were conducted with children, adolescents, and adults with type 1 diabetes and parents and partners...
March 2018: Diabetes Technology & Therapeutics
Gregory P Forlenza
No abstract text is available yet for this article.
March 2018: Diabetes Technology & Therapeutics
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