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Journal of Diabetes Science and Technology

Mattia Zanon, Martin Mueller, Pavel Zakharov, Mark S Talary, Marc Donath, Werner A Stahel, Andreas Caduff
BACKGROUND: Extensive past work showed that noninvasive continuous glucose monitoring with a wearable multisensor device worn on the upper arm provides useful information about glucose trends to improve diabetes therapy in controlled and semicontrolled conditions. METHOD: To test previous findings also in uncontrolled conditions, a long term at home study has been organized to collect multisensor and reference glucose data in a population of 20 type 1 diabetes subjects...
November 1, 2017: Journal of Diabetes Science and Technology
Cas Weykamp, Carla Siebelder
HbA1c is a key parameter in diabetes management. For years the test has been used exclusively for monitoring of long-term diabetic control. However, due to improvement of the performance, HbA1c is considered more and more for diagnosis and screening. With this new application, quality demands further increase. A task force of the International Federation of Clinical Chemistry and Laboratory Medicine developed a model to set and evaluate quality targets for HbA1c. The model is based on the concept of total error and takes into account the major sources of analytical errors in the medical laboratory: bias and imprecision...
November 1, 2017: Journal of Diabetes Science and Technology
Paul Jesús Tejada-Llacsa, Stalin Yance-Contreras, Leidy Machuca-Felipa, Carlos A Cordova-Cassia
No abstract text is available yet for this article.
November 1, 2017: Journal of Diabetes Science and Technology
Piotr Ladyzynski
In this issue of Journal of Diabetes Science and Technology Yap and coauthors report on the design and present results from a reliability study of the application called FootSnap that is intended for standardization of the distance and the orientation of the camera relative to the diabetic foot that is photographed. To produce standardized photographs FootSnap uses a straightforward, yet original and useful method. However, other systems have been reported and clinically tested earlier, in which the same parameters of foot images might be standardized and which are free of some limitations of FootSnap...
November 1, 2017: Journal of Diabetes Science and Technology
Tony Zhou, Jennifer L Dickson, Geoffrey M Shaw, J Geoffrey Chase
BACKGROUND: Continuous glucose monitoring (CGM) technology has become more prevalent in the intensive care unit (ICU), offering potential benefits of increased safety and reduced workload in glycemic control (GC). The drift and higher point accuracy errors of CGM devices over traditional intermittent blood glucose (BG) measures have so far limited their application in the ICU. This study delineates the trade-offs of performance, safety and workload that CGM sensors provide in GC protocols...
November 1, 2017: Journal of Diabetes Science and Technology
Christopher M Kappes, James R Kershner, Tina M Morwick, Sheila M Corrigan
BACKGROUND: This study examines the utility of the first prefilled, rapid-acting insulin pen that can be dialed in half-unit increments. Dose accuracy and injection force were examined through a series of design-verification tests, and usability was established by human factors validation testing. METHODS: Devices were tested for dose accuracy at 3 different doses and temperatures and under free fall, vibration, and cold storage conditioning. Injection force was measured at the maximum dose (30 units)...
October 1, 2017: Journal of Diabetes Science and Technology
Vitaliy Gisin, Anna Chan, John B Welsh
Adhesives used for continuous glucose monitoring (CGM) devices can cause skin irritations, which sometimes lead to abandonment of the therapy. A previous sensor manufacturing process involved two separate adhesives-one applied to the skin-facing surface of the fabric patch, and a second, ethyl cyanoacrylate-based adhesive, which secured the plastic transmitter housing to the superficial side of the patch. Our current process for attaching the transmitter housing to the fabric patch uses heatstaking, wherein the housing is heated and pressed against the patch with a specialized assembly apparatus...
October 1, 2017: Journal of Diabetes Science and Technology
Junxiang Luo, Yongming Qu, Qianyi Zhang, Annette M Chang, Scott J Jacober
BACKGROUND: The association of glucose variability (GV) with other glycemic measures is emerging as a topic of interest. The aim of this analysis is to study the correlation between GV and measures of glycemic control, such as glycated hemoglobin (HbA1c) and daily mean glucose (DMG). METHODS: Data from 5 phase 3 trials were pooled into 3 analysis groups: type 2 diabetes (T2D) treated with basal insulin only, T2D treated with basal-bolus therapy, and type 1 diabetes (T1D)...
October 1, 2017: Journal of Diabetes Science and Technology
Eslam Montaser, José-Luis Díez, Jorge Bondia
BACKGROUND: Linear empirical dynamic models have been widely used for glucose prediction. The extension of the concept of seasonality, characteristic of other domains, is explored here for the improvement of prediction accuracy. METHODS: Twenty time series of 8-hour postprandial periods (PP) for a same 60g-carbohydrate meal were collected from a closed-loop controller validation study. A single concatenated time series was produced representing a collection of data from similar scenarios, resulting in seasonality...
October 1, 2017: Journal of Diabetes Science and Technology
Stamatina Zavitsanou, Joon Bok Lee, Jordan E Pinsker, Mei Mei Church, Francis J Doyle, Eyal Dassau
BACKGROUND: Continuous glucose monitoring (CGM) systems are increasingly becoming essential components in type 1 diabetes mellitus (T1DM) management. Current CGM technology requires frequent calibration to ensure accurate sensor performance. The accuracy of these systems is of great importance since medical decisions are made based on monitored glucose values and trends. METHODS: In this work, we introduce a calibration strategy that is augmented with a weekly updating feature...
October 1, 2017: Journal of Diabetes Science and Technology
Akio Kuroda, Satoshi Taniguchi, Yuko Akehi, Hiroyasu Mori, Motoyuki Tamaki, Reiko Suzuki, Yinhua Otsuka, Munehide Matsuhisa
BACKGROUND: Glucose values of continuous glucose monitoring (CGM) have time delays compared with plasma glucose (PG) values. The artificial pancreas (STG-55, Nikkiso, Japan) (AP), which measures venous blood glucose directly, also has a time delay because of the long tubing lines from sampling vessel to the glucose sensor. We investigate accuracy and time delay of CGM and AP in comparison with PG values during 2-step glucose clamp study. METHODS: Seven patients with type 2 diabetes and 2 healthy volunteers were included in this study...
October 1, 2017: Journal of Diabetes Science and Technology
Stefan Pleus, Ulrike Kamecke, Manuela Link, Cornelia Haug, Guido Freckmann
The flash glucose monitoring system FreeStyle Libre (Abbott Diabetes Care Ltd., Witney, UK) measures interstitial glucose concentrations and continuously stores measurement values every 15 minutes. To obtain a current glucose reading, users have to scan the sensor with the reader. In a clinical trial, 5% of the scanned data showed relative differences of more than ±10% compared with continuously stored data points (median -0.5%). Such differences might impact results of studies using this system. It should be indicated whether scanned or continuously stored data were used for analyses...
October 1, 2017: Journal of Diabetes Science and Technology
Eric Zijlstra, Johannes Jahnke, Annelie Fischer, Christoph Kapitza, Thomas Forst
BACKGROUND: Painful subcutaneous insulin injections may decrease treatment compliance. Improving injection comfort therefore represents a particular area of technological research in which steady progress has been made since the introduction of the insulin pen in 1985. Injection pain can be influenced by many variables, but relatively little is known about their impact. This study investigated the impact of injection volume (range 0-2250 µL), speed (range 0-800 µL/sec), and site (abdomen vs thigh) on pain sensation...
October 1, 2017: Journal of Diabetes Science and Technology
Katharine D Barnard, Jort Kropff, Pratik Choudhary, Sankalpa Neupane, Stephen C Bain, Christoph Kapitza, Thomas Forst, Manuela Link, Colleen Mdingi, J Hans DeVries
BACKGROUND: Real-time continuous glucose monitoring is associated with significant benefits for diabetes management. Implantable sensors could overcome some challenges reportedly associated with device visibility, psychosocial functioning and sensor durability. METHODS: A psychosocial assessment was conducted to determine acceptability and impact of an implantable continuous glucose monitoring (CGM) sensor as part of the PRECISE trial. Questionnaires were administered to participants comprising the Diabetes Distress Scale, the CGM impact scale, and bespoke device satisfaction...
October 1, 2017: Journal of Diabetes Science and Technology
David C Klonoff, David Kerr
No abstract text is available yet for this article.
September 1, 2017: Journal of Diabetes Science and Technology
Enrique Campos-Náñez, Jennifer E Layne, Howard C Zisser
BACKGROUND: The objective of this study was to identify the minimum basal insulin infusion rates and bolus insulin doses that would result in clinically relevant changes in blood glucose levels in the most insulin sensitive subjects with type 1 diabetes. METHODS: The UVA/PADOVA Type 1 Diabetes Simulator in silico population of children, adolescents, and adults was administered a basal insulin infusion rate to maintain blood glucose concentrations at 120 mg/dL (6...
September 1, 2017: Journal of Diabetes Science and Technology
Katherine L Modzelewski, Mary-Catherine Stockman, Devin W Steenkamp
Mobile health (mHealth) is an emerging branch of medicine that utilizes technology to impact health care. With increasing access to smartphones and mobile devices, there has been an increase in both the availability and use of mHealth resources, including the use of text messages, apps, and web portals. In diabetes, there is particular interest as technology has long been a mainstay of management through glucometers, insulin pumps and continuous glucose monitors, which are increasingly interconnected. Although there is high demand for mHealth interventions in diabetes, there is no clear consensus on the best way to monitor these interventions...
September 1, 2017: Journal of Diabetes Science and Technology
Kurt Fortwaengler, Enrique Campos-Náñez, Christopher G Parkin, Marc D Breton
OBJECTIVE: An in silico study of type 1 diabetes (T1DM) patients utilized the UVA-PADOVA Type 1 Diabetes Simulator to assess the effect of patient blood glucose monitoring (BGM) system accuracy on clinical outcomes. We applied these findings to assess the financial impact of BGM system inaccuracy. METHODS: The study included 43 BGM systems previously assessed for accuracy according to ISO 15197:2003 and ISO 15197:2013 criteria. Glycemic responses for the 100 in silico adult T1DM subjects were generated, using each meter...
September 1, 2017: Journal of Diabetes Science and Technology
Tim Heise, Kadriye Kaplan, Hanne L Haahr
BACKGROUND: Insulin degludec (IDeg) has significantly lower day-to-day and within-day variability compared to insulin glargine (IGlar) 100U/mL (U100) and 300U/mL (U300). Here, we report post hoc assessments to confirm the robustness of these observations while accounting for potential experimental confounders. METHODS: Two euglycemic clamp studies in type 1 diabetes patients, comparing IDeg to IGlar-U100 (Study A, parallel design, 54 patients; Study B, crossover, 22 patients) and one study comparing IDeg to IGlar-U300 (Study C, crossover, 57 patients), all dosed at 0...
September 1, 2017: Journal of Diabetes Science and Technology
Chiara Fabris, Leon S Farhy, Stacey M Anderson, Ralf M Nass, Boris P Kovatchev, Marc D Breton
AIMS: In type 1 diabetes (T1D), repeated hypoglycemic episodes may reduce hormonal defenses and increase the risk for severe hypoglycemia. In this work, we investigate the effect of a structured hyper/hypoglycemic metabolic challenge on the postintervention glucose variability in T1D subjects studied at home. METHODS: Thirty T1D subjects using insulin pump were monitored with blood glucose meters (SMBG) during a 1-month observation period. After 2 weeks of monitoring, participants were admitted at the University of Virginia Clinical Research Unit to undergo an 8-hour metabolic challenge...
September 1, 2017: Journal of Diabetes Science and Technology
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