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Journal of Diabetes Science and Technology

Matthew P Petersen, Irl B Hirsch, Jay S Skyler, Richard E Ostlund, William T Cefalu
No abstract text is available yet for this article.
March 1, 2018: Journal of Diabetes Science and Technology
Frank L Schwartz, Cynthia R Marling, Razvan C Bunescu
Development of truly useful wearable physiologic monitoring devices for use in diabetes management is still in its infancy. From wearable activity monitors such as fitness trackers and smart watches to contact lenses measuring glucose levels in tears, we are just at the threshold of their coming use in medicine. Ultimately, such devices could help to improve the performance of sense-and-respond insulin pumps, illuminate the impact of physical activity on blood glucose levels, and improve patient safety. This is a summary of our experience attempting to use such devices to enhance continuous glucose monitoring-augmented insulin pump therapy...
March 1, 2018: Journal of Diabetes Science and Technology
Stefanie Kamann, Olivier Aerts, Lutz Heinemann
In the past decade, new diabetes technologies, including continuous glucose monitoring (CGM) systems, support patients with diabetes in their daily struggle with achieving a good glucose control. However, shortly after the first CGM systems appeared on the market, also the first concerns about adverse skin reactions were raised. Most patients claimed to suffer from (sometimes severe) skin irritation, or even allergy, which they related to the (acrylate-based) adhesive part of the device. For a long time the actual substance that caused these skin reactions with, for example, the Flash Glucose Monitoring system (iscCGM; Freestyle® Libre) could not be identified; however, recently Belgian and Swedish dermatologists reported that the majority of their patients that have developed a contact-allergic while using iscCGM react sensitively to a specific acrylate, that is, isobornyl acrylate (IBOA)...
March 1, 2018: Journal of Diabetes Science and Technology
Scott Pardo, Rimma M Shaginian, David A Simmons
BACKGROUND: Diabetes treatment is intended to maintain near-normal glycemic levels. Self-monitoring of blood glucose (SMBG) allows patients to track their BG levels compared with glycemic targets and is associated with improved health outcomes. Because of the importance of SMBG, it is essential that results are accurate to prevent errors in nutritional intake and drug dosing. This study presents a new methodology to evaluate the accuracy of BG monitoring systems (BGMSs). METHODS: Sensitivity analyses were performed using real and simulated BGMS data to compute probabilities that, for any BG value, the BGMS result would be within prescribed error bounds and confidence limits compared with laboratory reference values...
March 1, 2018: Journal of Diabetes Science and Technology
Karl-Heinz Patzer, Payam Ardjomand, Katharina Göhring, Guido Klempt, Andreas Patzelt, Markus Redzich, Mathias Zebrowski, Susanne Emmerich, Oliver Schnell
BACKGROUND: Medical practices face challenges of time and cost pressures with scarce resources. Point-of-care testing (POCT) has the potential to accelerate processes compared to central laboratory testing and can increase satisfaction of physicians, staff members, and patients. The objective of this study was to evaluate the effects of introducing HbA1c POCT in practices specialized in diabetes. METHOD: Three German practices that manage 400, 550, and 950 diabetes patients per year participated in this evaluation...
March 1, 2018: Journal of Diabetes Science and Technology
Javier Gonzalez-Durio
No abstract text is available yet for this article.
March 1, 2018: Journal of Diabetes Science and Technology
Charlotte Jones, Gareth J Dunseath, Jessica Lemon, Stephen D Luzio
BACKGROUND: Microsampling techniques are alternative methods to venous sampling for obtaining blood for measurement of circulating biomarkers, offering the convenience of reduced sample volume and elimination of the need for phlebotomists. Dried blood spot (DBS) microsampling methods have been used for many years while more recently a volumetric absorptive microsampling device (VAMS™) has been introduced. In diabetes mellitus, circulating C-peptide is commonly used as an indicator of endogenous insulin secretion and clinical measurement can aid in diagnosis as well as informing on therapy...
March 1, 2018: Journal of Diabetes Science and Technology
Wendelin Schramm
The way diabetes patients cope with their disease in day-to-day routines is decisive for the development or the prevention of medical complications. Smartphones have created the ubiquitous environment to support health care with mobile applications (mHealth). This article comments on the publication by Offringa et al in JDST, which is one of few studies that tries to isolate the effects of a diabetes app. At the same time, it is a good example to discuss general aspects of mHealth in diabetes care. Treatment context, eHealth literacy, interoperability, and efficiency will determine the success of diabetes apps...
March 1, 2018: Journal of Diabetes Science and Technology
Shuyu Zhang, Ludi Fan, Qianyi Zhang, Annette M Chang, Edward J Bastyr, Cynthia J Harris
No abstract text is available yet for this article.
March 1, 2018: Journal of Diabetes Science and Technology
Ann Connery, Sherry Martin
No abstract text is available yet for this article.
March 1, 2018: Journal of Diabetes Science and Technology
Darlene M Dreon, Trevor M Hannon, Brett Cross, Brett J Carter, Nicholas S Mercer, Jason H Nguyen, Andy Tran, Peter A Melendez, Nancy Morales, Jonathan E Nelson, Meng H Tan
BACKGROUND: A basal bolus insulin regimen requires multiple daily insulin injections, which might discourage patient adherence. As a potential solution, a mealtime insulin-delivery system-a 3-day wearable bolus-only patch-was designed to manually administer mealtime insulin discreetly by actuating buttons through clothing, without the need for multiple needle sticks. METHOD: Extensive functional testing of the patch included dose accuracy (from initial fill of the device to empty), pressure-vacuum leak testing, last-dose lockout and occlusion detection (safety alert features that lock the dosing buttons when no insulin is delivered), assessments of insulin drug stability, toxicological risk (including chemical testing), and system biocompatibility...
February 1, 2018: Journal of Diabetes Science and Technology
Roberto Visentin, Enrique Campos-Náñez, Michele Schiavon, Dayu Lv, Martina Vettoretti, Marc Breton, Boris P Kovatchev, Chiara Dalla Man, Claudio Cobelli
BACKGROUND: A new version of the UVA/Padova Type 1 Diabetes (T1D) Simulator is presented which provides a more realistic testing scenario. The upgrades to the previous simulator, which was accepted by the Food and Drug Administration in 2013, are described. METHOD: Intraday variability of insulin sensitivity (S I ) has been modeled, based on clinical T1D data, accounting for both intra- and intersubject variability of daily S I . Thus, time-varying distributions of both subject's basal insulin infusion and insulin-to-carbohydrate ratio were calculated and made available to the user...
February 1, 2018: Journal of Diabetes Science and Technology
Curtis A Parvin, Nikola A Baumann
BACKGROUND: Current laboratory risk management principles emphasize the importance of assessing laboratory quality control (QC) practices in terms of the risk of patient harm. Limited practical guidance or examples on how to do this are available. METHODS: The patient risk model described in a published laboratory risk management guideline was combined with a recently reported approach to computing the predicted probability of patient harm to produce a risk management index (RMI) that compares the predicted probability of patient harm for a QC strategy to the acceptable probability of patient harm based on the expected severity of harm caused by an erroneously reported patient result...
February 1, 2018: Journal of Diabetes Science and Technology
Andreas Pfützner, Stephanie Strobl, Filiz Demircik, Lisa Redert, Johannes Pfützner, Anke H Pfützner, Alexander Lier
BACKGROUND: Frequent blood glucose readings are the most cumbersome aspect of diabetes treatment for many patients. The noninvasive TensorTip Combo Glucometer (CoG) component employs dedicated mathematical algorithms to analyze the collected signal and to predict tissue glucose at the fingertip. This study presents the performance of the CoG (the invasive and the noninvasive components) during a standardized meal experiment. METHODS: Each of the 36 participants (18 females and males each, age: 49 ± 18 years, 14 healthy subjects, 6 type 1 and 16 type 2 patients) received a device for conducting calibration at home...
February 1, 2018: Journal of Diabetes Science and Technology
Ana M Gómez, Oscar M Muñoz, Alejandro Marin, Maria Camila Fonseca, Martin Rondon, María Alejandra Robledo Gómez, Andrei Sanko, Dilcia Lujan, Maira García-Jaramillo, Fabian Mauricio León Vargas
INTRODUCTION: Recent publications frequently introduce new indexes to measure glycemic variability (GV), quality of glycemic control, or glycemic risk; however, there is a lack of evidence supporting the use of one particular parameter, especially in clinical practice. METHODS: A cohort of type 2 diabetes mellitus (T2DM) patients in ambulatory care were followed using continuous glucose monitoring sensors (CGM). Mean glucose (MG), standard deviation, coefficient of variation (CV), interquartile range, CONGA1, 2, and 4, MAGE, M value, J index, high blood glucose index, and low blood glucose index (LBGI) were estimated...
February 1, 2018: Journal of Diabetes Science and Technology
Katharina Fritzen, Bettina Gutschek, Benedikte Coucke, Katerina Zakrzewska, Michael Hummel, Oliver Schnell
BACKGROUND: Self-monitoring of blood glucose (SMBG) using the ColourSure™ Technology to visualize target range showed improvement of metabolic control and overall diabetes self-management in insulin-treated patients. This economic analysis aimed to identify cost savings for the German health system resulting from an HbA1c reduction due to the utilization of user-friendly glucose meters. METHODS: Patient data from a recently published observational study on SMBG were used for risk evaluations using the UKPDS risk engine...
February 1, 2018: Journal of Diabetes Science and Technology
Basak Ozaslan, Stephen D Patek, Jesse H Grabman, Jaclyn A Shepard, Eyal Dassau, Marc D Breton, Yogish C Kudva, Sue A Brown, Ananda Basu, Jordan E Pinsker, Francis J Doyle, Linda Gonder-Frederick
OBJECTIVE: The objective was to investigate the relationship of body mass index (BMI) to differing glycemic responses to psychological stress in patients with type 1 diabetes. METHODS: Continuous blood glucose monitor (CGM) data were collected for 1 week from a total of 37 patients with BMI ranging from 21.5-39.4 kg/m2 (mean = 28.2 ± 4.9). Patients reported daily stress levels (5-point Likert-type scale, 0 = none, 4 = extreme), physical activity, carbohydrate intake, insulin boluses and basal rates...
February 1, 2018: Journal of Diabetes Science and Technology
Leah M Wilson, Jessica R Castle
Glycemic control is the mainstay of preventing diabetes complications at the expense of increased risk of hypoglycemia. Severe hypoglycemia negatively impacts the quality of life of patients with type 1 diabetes and can lead to morbidity and mortality. Currently available glucagon emergency kits are effective at treating hypoglycemia when correctly used, however use is complicated especially by untrained persons. Better formulations and devices for glucagon treatment of hypoglycemia are needed, specifically stable liquid glucagon...
February 1, 2018: Journal of Diabetes Science and Technology
David C Klonoff, David Kerr
No abstract text is available yet for this article.
February 1, 2018: Journal of Diabetes Science and Technology
Qing Ye, Uzma Khan, Suzanne A Boren, Eduardo J Simoes, Min Soon Kim
BACKGROUND: Diabetes self-management (DSM) applications (apps) have been designed to improve knowledge of diabetes and self-management behaviors. However, few studies have systematically examined if diabetes apps followed the American Association of Diabetes Educators (AADE) Self-Care Behaviors™ guidelines. The purpose of this study was to compare the features of current DSM apps to the AADE7™ guidelines. METHODS: In two major app stores (iTunes and Google Play), we used three search terms "diabetes," "blood sugar," and "glucose" to capture a wide range of diabetes apps...
January 1, 2018: Journal of Diabetes Science and Technology
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