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Journal of Diabetes Science and Technology

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https://www.readbyqxmd.com/read/28786320/digital-diabetes-congress-2017
#1
David C Klonoff, David Kerr, Jenise C Wong, Yarmela Pavlovic, Suneil Koliwad, Julia Hu, Patricia Salber, Adrian Aguilera, William Long, Giles Hamilton, Kong Y Chen, Saleh Adi
The purpose of developing mobile applications for diabetes is generally to: (1) provide enhanced access to timely information for patients, health care professionals, and researchers; (2) facilitate remote monitoring and diagnosis of patients, often based on information delivered by wearable devices; (3) provide decision support to assist patients in selecting treatment; or (4) deliver timely recommendations for treatment to increase adherence to prescribed therapy. There is a perception that mobile applications can provide meaningful clinical benefits, however, there is only sparse convincing evidence to support this belief at the present time...
August 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28770627/management-and-family-burdens-endorsed-by-parents-of-youth-7-years-old-with-type-1-diabetes
#2
Kara R Harrington, Claire T Boyle, Kellee M Miller, Marisa E Hilliard, Barbara J Anderson, Michelle Van Name, Linda A DiMeglio, Lori M Laffel
BACKGROUND: This study investigated unique burdens experienced by parents of young children with type 1 diabetes in the context of contemporary diabetes management. METHODS: Self-report surveys and medical record information from the T1D Exchange clinic registry were used. Parental burden and family impact scores were tabulated across demographic and clinical characteristics, overall and according to age group (<4, 4-<6, and 6-<7 years). RESULTS: The mean age of the 597 children was 5...
August 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28748706/the-development-of-new-composite-metrics-for-the-comprehensive-analytic-and-visual-assessment-of-hypoglycemia-using-the-hypo-triad
#3
Andreas Thomas, John Shin, Boyi Jiang, Chantal McMahon, Ralf Kolassa, Robert A Vigersky
BACKGROUND: Quantifying hypoglycemia has traditionally been limited to using the frequency of hypoglycemic events during a given time interval using data from blood glucose (BG) testing. However, continuous glucose monitoring (CGM) captures three parameters-a Hypo-Triad-unavailable with BG monitoring that can be used to better characterize hypoglycemia: area under the curve (AUC), time (duration of hypoglycemia), and frequency of daily episodes below a specified threshold. METHODS: We developed two new analytic metrics to enhance the traditional Hypo-Triad of CGM-derived data to more effectively capture the intensity of hypoglycemia (IntHypo) and overall hypoglycemic environment called the "hypoglycemia risk volume" (HypoRV)...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28748705/the-comprehensive-glucose-pentagon-a-glucose-centric-composite-metric-for-assessing-glycemic-control-in-persons-with-diabetes
#4
Robert A Vigersky, John Shin, Boyi Jiang, Thorsten Siegmund, Chantal McMahon, Andreas Thomas
BACKGROUND: Composite metrics have the potential to provide more complete and clinically useful information about glycemic control than traditional individual metrics such as hemoglobin A1C, %/time/area under curve of hypoglycemia and hyperglycemia. METHODS: Using five key metrics that are derived from continuous glucose monitoring, we developed a new, multicomponent composite metric, the Comprehensive Glucose Pentagon (CGP) that demonstrates glycemic control both numerically and visually...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28741369/bolus-advisors-sources-of-error-targets-for-improvement
#5
John Walsh, Ruth Roberts, Timothy S Bailey, Lutz Heinemann
Bolus advisors that are designed to improve the accuracy of individual bolus doses relative to a meal's carb content and the current glucose have not substantially changed since they were introduced 15 years ago despite an obvious need for enhancement and innovation. Although some glycemic benefits have been demonstrated, bolus advisors largely ignore the large amounts of clinical data they gather that could have a significant impact on glucose outcomes. Concerns have also been raised regarding the aggressive nature of largely unpublished or poorly explained bolus advisor algorithms...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28737105/future-of-diabetes-technology
#6
Lutz Heinemann
No abstract text is available yet for this article.
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28728437/does-continuous-diffusion-of-oxygen-improve-diabetic-foot-ulcer-healing
#7
Lawrence A Lavery, Easton C Ryan
The objective of this article is to evaluate the study design, rational and results of Continuous Diffusion of Oxygen Therapy (CDOT) to heal diabetic foot ulcers (DFUs). The study was a double-blinded placebo controlled randomized clinical study to evaluate DFUs over a 12-week period. The primary outcome was the proportion of ulcers that healed and the secondary outcome that was reported was the time to ulcer healing. In the per protocol analysis and in the intent to treat analysis, a higher proportion of DFUs healed in the CDOT group (per protocol 46% vs 22%, P = ...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28728436/now-is-the-time-for-a-security-and-safety-standard-for-consumer-smartphones-controlling-diabetes-devices
#8
David C Klonoff, David Kerr, Dave Kleidermacher
No abstract text is available yet for this article.
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28728435/hyperglycemia-as-a-predictor-for-adverse-outcome-in-icu-patients-with-and-without-diabetes
#9
Simon Lebech Cichosz, Clara Schaarup
The aim of this study was to investigate hyperglycemia as a predictor for mortality and length of intensive care unit (ICU) stay in groups of patients with and without known diabetes. The present study examines data from 200 859 patients included in eICU Collaborative Research Database, a large multicenter critical care database. The results show that hyperglycemia among ICU patients without diabetes is strongly associated with adverse event. In comparison, hyperglycemia is not as strong among patients with diabetes...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28728434/economic-model-predictive-control-of-bihormonal-artificial-pancreas-system-based-on-switching-control-and-dynamic-r-parameter
#10
Fengna Tang, Youqing Wang
BACKGROUND: Blood glucose (BG) regulation is a long-term task for people with diabetes. In recent years, more and more researchers have attempted to achieve automated regulation of BG using automatic control algorithms, called the artificial pancreas (AP) system. In clinical practice, it is equally important to guarantee the treatment effect and reduce the treatment costs. The main motivation of this study is to reduce the cure burden. METHODS: The dynamic R-parameter economic model predictive control (R-EMPC) is chosen to regulate the delivery rates of exogenous hormones (insulin and glucagon)...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28707484/autoregressive-modeling-of-drift-and-random-error-to-characterize-a-continuous-intravascular-glucose-monitoring-sensor
#11
Tony Zhou, Jennifer L Dickson, J Geoffrey Chase
BACKGROUND: Continuous glucose monitoring (CGM) devices have been effective in managing diabetes and offer potential benefits for use in the intensive care unit (ICU). Use of CGM devices in the ICU has been limited, primarily due to the higher point accuracy errors over currently used traditional intermittent blood glucose (BG) measures. General models of CGM errors, including drift and random errors, are lacking, but would enable better design of protocols to utilize these devices. This article presents an autoregressive (AR) based modeling method that separately characterizes the drift and random noise of the GlySure CGM sensor (GlySure Limited, Oxfordshire, UK)...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28697625/effects-of-structured-versus-unstructured-self-monitoring-of-blood-glucose-on-glucose-control-in-patients-with-non-insulin-treated-type-2-diabetes-a-meta-analysis-of-randomized-controlled-trials
#12
Edoardo Mannucci, Alessandro Antenore, Francesco Giorgino, Marina Scavini
BACKGROUND: The use of self-monitoring of blood glucose (SMBG) in patients with non-insulin-treated type 2 diabetes is debated. Meta-analyses of randomized clinical trials (RCTs) suggest a small reduction of HbA1c in patients using SMBG, without considering potential confounders, such as SMBG regimen and use of SMBG data to adjust diabetes medications. METHODS: A meta-analysis was performed including RCTs in patients with non-insulin-treated type 2 diabetes, with an intervention of ≥24 weeks and HbA1c as the primary endpoint, to verify the effect of SMBG (vs no monitoring), structured SMBG (vs unstructured), and of SMBG-driven therapy adjustments...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28677417/evaluating-interventions-and-titrations-using-fasting-blood-glucose
#13
James M Minor, Leslie M Rickey, Richard M Bergenstal
A recent paper reported a computer coded glycation method ("in silico glycation") to monitor daily average glucose (AG) and associated A1c using the fasting readings of each patient. This letter discusses application to a patient.
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28677416/manual-closed-loop-insulin-delivery-using-a-saddle-point-model-predictive-control-algorithm-results-of-a-crossover-randomized-overnight-study
#14
Isabelle Guilhem, Maxime Penet, Anaïs Paillard, Marc Carpentier, Annabelle Esvant, Marie-Anne Lefebvre, Jean-Yves Poirier
BACKGROUND: The purpose was to assess the efficacy of a new closed-loop algorithm (Saddle Point Model Predictive Control, SP-MPC) in achieving nocturnal normoglycemia while reducing the risk of hypoglycemia in patients with type 1 diabetes. METHOD: In this randomized crossover study, 10 adult patients (mean hemoglobin A1c 7.35 ± 1.04%) were assigned to be treated overnight by open loop using sensor-augmented pump therapy (open-loop SAP) or manual closed-loop delivery...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28677415/our-first-825-t2dm-patients-on-14-day-factory-calibrated-glucose-monitoring-system-clinical-utility-and-challenges
#15
Jothydev Kesavadev, Arun Shankar, Ashwin David Ashok, Sheeja Srinivas, Neethu Annie Ajai, Geethu Sanal, Gopika Krishnan, Lakshmy Ramachandran, Sunitha Jothydev
No abstract text is available yet for this article.
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28677414/self-reported-compensation-techniques-for-carbohydrate-exercise-and-alcohol-behaviors-in-patients-with-type-1-diabetes-on-insulin-pump-therapy
#16
Danielle Groat, Hiral Soni, Maria Adela Grando, Bithika Thompson, Curtiss B Cook
Studies have found variability in self-care behaviors in patients with type 1 diabetes, particularly when incorporating exercise and alcohol consumption. The objective of this study was to provide results from a survey to understand (1) insulin pump behaviors, (2) reported self-management behaviors for exercise and alcohol, and (3) perceptions of the effects of exercise and alcohol on blood glucose (BG) control. Fourteen participants from an outpatient endocrinology practice were recruited and administered an electronic survey...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28681638/issues-and-ideas-in-bolus-advisor-research-with-commentary-on-a-methodology-to-compare-insulin-dosing-algorithms-in-real-life-settings
#17
John Walsh
The accompanying article by Groat et al in this issue presents a methodology to compare glucose outcomes from insulin bolus dose recommendations observed retrospectively from a novel iDecide bolus calculator with glucose outcomes from the prospective bolus recommendations provided by a current insulin pump. The methodology in this article evaluates a bolus calculator algorithm and also evaluates calculations for two additional lifestyle behaviors, exercise and alcohol intake, that are modifiable risk factors associated with diabetes...
June 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28681637/persistence-with-oral-antihyperglycemic-drugs-in-type-2-diabetes-mellitus-patients-with-dementia-in-germany
#18
Louis Jacob, Leonie Adam-Schnepf, Karel Kostev
BACKGROUND: The aim of this study was to analyze the persistence with oral antihyperglycemic drugs in type 2 diabetes mellitus (T2DM) patients with dementia in Germany. METHODS: This study included adults with T2DM who were treated with oral antihyperglycemic drugs and were diagnosed with dementia in 1262 German general practices between January 2013 and December 2015 (index date). Dementia cases were matched (1:1) to controls without dementia by age, gender, type of practice, type of residence, physician, and initial antihyperglycemic therapy, using a propensity score method...
June 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28660789/glycemic-control-with-early-initiation-of-continuous-glucose-monitoring-system-in-adults-with-recently-diagnosed-type-1a-diabetes
#19
Viral N Shah, Tyler L Gallo, Micaela Marker, Janet K Snell-Bergeon
No abstract text is available yet for this article.
June 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28637358/comparative-simulation-study-of-glucose-control-methods-designed-for-use-in-the-intensive-care-unit-setting-via-a-novel-controller-scoring-metric
#20
Jeremy DeJournett, Leon DeJournett
BACKGROUND: Effective glucose control in the intensive care unit (ICU) setting has the potential to decrease morbidity and mortality rates and thereby decrease health care expenditures. To evaluate what constitutes effective glucose control, typically several metrics are reported, including time in range, time in mild and severe hypoglycemia, coefficient of variation, and others. To date, there is no one metric that combines all of these individual metrics to give a number indicative of overall performance...
June 1, 2017: Journal of Diabetes Science and Technology
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