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Diabetes Technology & Therapeutics

Przemysław Kucharski, Konrad Pagacz, Agnieszka Szadkowska, Wojciech Młynarski, Andrzej Romanowski, Wojciech Fendler
BACKGROUND: Continuous glucose monitoring (CGM) is a method of estimating blood glucose values from those recorded in the interstitial fluid. Because increasingly longer CGM measurements are possible, errors and data loss become more and more likely and potentially more damaging to accurate calculations of glycemic variability (GV) indices. Our research investigates the resistance of the CGM recording to data loss. METHODS: We collected 71 CGM recordings (duration of min: 2, max: 265, median: 42 days) from patients with type 1 diabetes and used three algorithms to introduce missing data...
November 7, 2018: Diabetes Technology & Therapeutics
Philippe Klee, Catherine Bussien, Montserrat Castellsague, Christophe Combescure, Mirjam Dirlewanger, Celine Girardin, Jean-Luc Mando, Luz Perrenoud, Carole Salomon, Franck Schneider, Valerie M Schwitzgebel
BACKGROUND: Prevention of type 1 diabetes mellitus (T1DM)-related complications is dependent on metabolic control. The recommended glycated hemoglobin (HbA1c) values <7.5% (58.5 mmol/mol) are met only by a minority of diabetic children and especially adolescents. The aim of this study was to evaluate the impact of an intervention comprising the use of Webdia, a patient-designed app for smartphones, on metabolic control of T1DM in children. METHODS: Fifty-five patients with T1DM, 10-18 years of age, were included in this single-center, randomized double-crossover study...
November 7, 2018: Diabetes Technology & Therapeutics
Fraya King, David Ahn, Victoria Hsiao, Travis Porco, David Klonoff
The aim of this study was to assess the accuracy of blood glucose monitors (BGMs) from studies reported in the medical literature. A literature review was performed of publications between 2010 and 2017 that presented data about the accuracy of BGMs using ISO 15197 2003 and/or ISO 15197 2013 as target standards. We found 58 publications describing the performance of 143 unique BGM systems, 59 of which were Food and Drug Administration (FDA) cleared. When compared with non-FDA-cleared BGMs, FDA-cleared BGMs were significantly more likely to pass both ISO 15197 2003 (OR = 2...
October 29, 2018: Diabetes Technology & Therapeutics
Christopher G Parkin, Anita Homberg, Rolf Hinzmann
A panel of international experts in the field of diabetes and diabetes technology met in Oslo, Norway, for the 11th Annual Symposium on Self-Monitoring of Blood Glucose. The goal of these meetings is to share current knowledge, facilitate new collaborations, and encourage further research projects that can improve the lives of people with diabetes. The 2018 meeting comprised a comprehensive scientific program and four keynote lectures.
October 4, 2018: Diabetes Technology & Therapeutics
Harold W De Valk, Sandrine Lablanche, Emanuele Bosi, Pratik Choudhary, Julien Da Silva, Javier Castaneda, Linda Vorrink, Simona De Portu, Ohad Cohen
BACKGROUND: Sensor-integrated pump systems with low-glucose suspend (also known as threshold suspend) functions have markedly transformed the management of type 1 diabetes, but most studies to date have excluded patients at high risk of hypoglycemia. The SMILE study is investigating the efficacy of the MiniMed™ 640G insulin pump with the SmartGuard™ predictive low-glucose management (PLGM) feature in the prevention of hypoglycemia in adults with type 1 diabetes, who are at high risk of hypoglycemia...
November 2018: Diabetes Technology & Therapeutics
Michael A Wood, Dorothy I Shulman, Gregory P Forlenza, Bruce W Bode, Orit Pinhas-Hamiel, Bruce A Buckingham, Kevin B Kaiserman, David R Liljenquist, Timothy S Bailey, John Shin, Suiying Huang, Xiaoxiao Chen, Toni L Cordero, Scott W Lee, Francine R Kaufman
BACKGROUND: The Medtronic predictive low-glucose management (PLGM) algorithm automatically stops insulin delivery when sensor glucose (SG) is predicted to reach or fall below a preset low-glucose value within the next 30 min, and resumes delivery after hypoglycemia recovery. The present study evaluated the PLGM algorithm performance of the MiniMed™ 670G system SmartGuard™ "suspend before low" feature in children aged 7-13 years with type 1 diabetes (T1D). METHOD: Participants (N = 105, mean ± standard deviation of 10...
November 2018: Diabetes Technology & Therapeutics
Lenka Petruzelkova, Jan Soupal, Veronika Plasova, Pavlina Jiranova, Vit Neuman, Lukas Plachy, Stepanka Pruhova, Zdenek Sumnik, Barbora Obermannova
OBJECTIVE: Officially licensed hybrid closed-loop systems are not currently available worldwide; therefore, open-source systems have become increasingly popular. Our aim was to assess the safety, feasibility, and efficacy of an open-source hybrid closed-loop system (AndroidAPS) versus SmartGuard® technology for day-and-night glucose control in children under extreme sports conditions. RESEARCH DESIGN AND METHODS: Twenty-two children (16 girls, 6-15 years of age, median HbA1c 56 ± 9 mmol/mol) were enrolled in this pivotal winter sports camp study...
November 2018: Diabetes Technology & Therapeutics
Esther M Briganti, Julia C Summers, Zachary A Fitzgerald, Leo N J Lambers, Neale D Cohen
Use of continuous subcutaneous insulin infusion (CSII) in adults with type 1 diabetes has become increasingly popular in recent years, with recent studies examining the efficacy of CSII use in pregnancy and in type 2 diabetes. However, there is very limited information on the benefit of CSII in older patients with type 1 diabetes. Electronic medical records were retrospectively analyzed for patients with type 1 diabetes undertaking structured patient education and initiated on CSII or multiple daily injections (MDI) between 2000 and 2016...
November 2018: Diabetes Technology & Therapeutics
Monika Reddy, Narvada Jugnee, Sinthuka Anantharaja, Nick Oliver
BACKGROUND: The I HART CGM study showed that real-time continuous glucose monitoring (RT-CGM) has greater beneficial impact on hypoglycemia than intermittent flash glucose monitoring (flash) in adults with type 1 diabetes (T1D) at high risk. The impact of continuing RT-CGM or switching from flash to RT-CGM for another 8 weeks was then evaluated. METHODS: Prospective randomized parallel group study with an extension phase. After a 2-week run-in with blinded CGM, participants were randomized to either RT-CGM or flash for 8 weeks...
November 2018: Diabetes Technology & Therapeutics
Mihiretu M Kebede, Hajo Zeeb, Manuela Peters, Thomas L Heise, Claudia R Pischke
BACKGROUND: Digital interventions may assist patients with type 2 diabetes in improving glycemic control. We aimed to synthesize effect sizes of digital interventions on glycated hemoglobin (HbA1c) levels and to identify effective features of digital interventions targeting patients with poorly controlled type 2 diabetes. MATERIALS AND METHODS: MEDLINE, ISI Web of Science, and PsycINFO were searched for randomized controlled trials (RCTs) comparing the effects of digital interventions with usual care...
November 2018: Diabetes Technology & Therapeutics
Pilar Isabel Beato-Víbora, Carmen Quirós-López, Lucía Lázaro-Martín, María Martín-Frías, Raquel Barrio-Castellanos, Estela Gil-Poch, Francisco Javier Arroyo-Díez, Marga Giménez-Álvarez
AIMS: The aim was to evaluate the effectiveness of sensor-augmented pump therapy with predictive low-glucose suspend function (SAP-PLGS) in real-world use in children and adults with type 1 diabetes (T1D). METHODS: Patients with T1D treated with the MiniMed 640G® pump with PLGS function at three referral hospitals were retrospectively evaluated. HbA1c at baseline and at 6, 12, 18, and 24 months was analyzed. Two weeks of data from pumps, sensors, and/or glucose meters were downloaded...
November 2018: Diabetes Technology & Therapeutics
Mateusz Jagła, Izabela Szymońska, Katarzyna Starzec, Olga Gach, Aneta Włodarczyk, Przemko Kwinta
BACKGROUND: Glucose variability (GV) is a matter of interest for researches in recent years. It is connected with oxidative stress, which is crucial in the development of multiple complication of prematurity. However, glycemic variability in preterm infants was poorly investigated. This study aims to investigate glycemic variability obtained from a continuous glucose monitoring (CGM) system in a cohort of very low-birthweight (VLBW) infants. METHODS: A prospective, single-center, open cohort study enrolled 74 VLBW infants with a mean birthweight of 1066 g and median gestational age of 28 weeks...
November 2018: Diabetes Technology & Therapeutics
Robert R Henry, Poul Strange, Rong Zhou, Jeremy Pettus, Leon Shi, Sergey B Zhuplatov, Traci Mansfield, David Klein, Arie Katz
BACKGROUND: Glycated hemoglobin (HbA1c) and measures of short-term glycemia do not fully capture daily patterns in plasma glucose dynamics. This study evaluated 24-h glycemic profiles in patients with type 2 diabetes (T2D) initiated on dapagliflozin treatment using continuous glucose monitoring (CGM). METHODS: This randomized double-blind placebo-controlled multicenter parallel-design 4-week study compared dapagliflozin (10 mg/d; n = 50) with placebo (n = 50) in adult patients with T2D uncontrolled (HbA1c 7...
November 2018: Diabetes Technology & Therapeutics
Rebecca N Adams, Molly L Tanenbaum, Sarah J Hanes, Jodie M Ambrosino, Trang T Ly, David M Maahs, Diana Naranjo, Natalie Walders-Abramson, Stuart A Weinzimer, Bruce A Buckingham, Korey K Hood
BACKGROUND: Hybrid closed loop (HCL) systems are designed to automate insulin delivery to improve type 1 diabetes (T1D) outcomes and reduce user burden and distress. Because the systems only automate some aspects of diabetes care, psychosocial and human factors remain an important consideration in their use. Thus, we examined whether psychosocial and human factors (i.e., distress related to diabetes management, fear of hypoglycemia, and technology attitudes) would (1) change after using the system and (2) predict glycemic outcomes during the trial...
October 2018: Diabetes Technology & Therapeutics
Halis Kaan Akturk, Janet K Snell-Bergeon, Amanda Rewers, Leslie J Klaff, Bruce W Bode, Anne L Peters, Timothy S Bailey, Satish K Garg
BACKGROUND: The majority of therapies have generally targeted fasting glucose control, and current mealtime insulin therapies have longer time action profiles than that of endogenously secreted insulin. The primary purpose of this study was to assess both glucose time-in-range (TIR: 70-180 mg/dL) and postprandial glucose excursions (PPGE) in 1-4 h using a real-time continuous glucose monitor (CGM) with Technosphere insulin (TI) versus insulin aspart in patients with type 1 diabetes (T1DM) on multiple daily injections (MDI)...
October 2018: Diabetes Technology & Therapeutics
Martin de Bock, Julie Dart, Michael Hancock, Grant Smith, Elizabeth A Davis, Timothy W Jones
This study investigates the performance of an iteration of the Medtronic hybrid closed-loop (HCL) algorithm, which utilizes sensor glucose values non-adjunctively for bolus advice, recognizes sustained hyperglycemia, suggests insulin bolus correction, and includes more accommodative SmartGuard™ automode parameters that aim to improve function and usability. Adolescents aged 13-17 years with type 1 diabetes >1 year, glycated hemoglobin (HbA1c ) 7.0%-10%, currently using Continuous Subcutaneous Insulin Infusion were randomized to the control Medtronic standard HCL algorithm or to the intervention Medtronic HCL with enhancements...
October 2018: Diabetes Technology & Therapeutics
Rahat Maitland, Nashita Patel, Suzanne Barr, Christina Sherry, Barbara Marriage, Paul Seed, Llenalia Garcia Fernandez, Jose M Lopez Pedrosa, Helen Murphy, Ricardo Rueda, Lucilla Poston
BACKGROUND: Obesity is a risk factor for gestational diabetes (gestational diabetes). Low-glycemic index diets attenuate hyperglycemia. We designed a study to determine whether a slow-digesting, low-glycemic load (SD-LGL) beverage improves glucose tolerance in obese pregnant women without GDM. METHODS: This was a 3-arm comparison study comparing the effects of an SD-LGL nutritional beverage (glycemic load [GL] 730), an isocaloric control beverage (GL 1124), and habitual diet on glycemia in obese pregnant women...
October 2018: Diabetes Technology & Therapeutics
Kamuran Turksoy, Iman Hajizadeh, Nicole Hobbs, Jennifer Kilkus, Elizabeth Littlejohn, Sediqeh Samadi, Jianyuan Feng, Mert Sevil, Caterina Lazaro, Julia Ritthaler, Brooks Hibner, Nancy Devine, Laurie Quinn, Ali Cinar
BACKGROUND: Exercise challenges people with type 1 diabetes in controlling their glucose concentration (GC). A multivariable adaptive artificial pancreas (MAAP) may lessen the burden. METHODS: The MAAP operates without any user input and computes insulin based on continuous glucose monitor and physical activity signals. To analyze performance, 18 60-h closed-loop experiments with 96 exercise sessions with three different protocols were completed. Each day, the subjects completed one resistance and one treadmill exercise (moderate continuous training [MCT] or high-intensity interval training [HIIT])...
October 2018: Diabetes Technology & Therapeutics
Zheng Kang Lum, Wei Yann See Toh, Sze Mian Lim, Khairul Dzakirin Bin Rusli, Shaikh Abdul Kader Kamaldeen Abdul Shakoor, Keith Yu Kei Tsou, Daniel Ek Kwang Chew, Rinkoo Dalan, Sing Cheer Kwek, Noorani Othman, Joyce Xia Lian, Joyce Yu-Chia Lee
Empowerment plays significant roles in the complex management of type 2 diabetes. International guidelines have provided recommendations on management of Muslims who fast during Ramadan. However, there remains a lack of patient-centered epistemic tool to empower healthcare providers and patients in managing diabetes during Ramadan. This study discussed the development and evaluation of such tool. The collaborative algorithm was developed with reference to the nominal group technique by a board-certified clinical pharmacist and discussed with endocrinologists, nurses, and family physicians...
October 2018: Diabetes Technology & Therapeutics
Michael P Stone, Pratik Agrawal, Xiaoxiao Chen, Margaret Liu, John Shin, Toni L Cordero, Francine R Kaufman
Real-world data from the first 3141 patients who completed 3 months of SmartGuard™ Auto Mode-enabled MiniMed™ 670G system use during the MiniMed 670G System Commercial Launch are reported. CareLink™ system data uploaded by real-world patients in the Commercial Launch from March 17, 2017 to December 31, 2017 were deidentified and analyzed. Comparisons of overall and night (10:00 PM-07:00 AM) time spent below, within, and above target glucose range (TIR) (70-180 mg/dL) between the baseline Manual Mode and closed-loop Auto Mode periods were made...
October 2018: Diabetes Technology & Therapeutics
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