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Journal of Diabetes Science and Technology

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https://www.readbyqxmd.com/read/28429611/consensus-statement-on-inpatient-use-of-continuous-glucose-monitoring
#1
Amisha Wallia, Guillermo E Umpierrez, Robert J Rushakoff, David C Klonoff, Daniel J Rubin, Sherita Hill Golden, Curtiss B Cook, Bithika Thompson
In June 2016, Diabetes Technology Society convened a panel of US experts in inpatient diabetes management to discuss the current and potential role of continuous glucose monitoring (CGM) in the hospital. This discussion combined with a literature review was a follow-up to a meeting, which took place in May 2015. The panel reviewed evidence on use of CGM in 3 potential inpatient scenarios: (1) the intensive care unit (ICU), (2) non-ICU, and (3) transitioning outpatient CGM use into the hospital setting. Panel members agreed that data from limited studies and theoretical considerations suggested that use of CGM in the hospital had the potential to improve patient clinical outcomes, and in particular reduction of hypoglycemia...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28420260/the-safety-of-nonadjunctive-use-of-continuous-glucose-monitors-for-insulin-dosing-still-not-resolved
#2
Alan R Shapiro
No abstract text is available yet for this article.
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28420259/seasonality-of-insulin-use-in-german-outpatients-with-diabetes-a-retrospective-analysis
#3
Karel Kostev, Sarah Gläser, Louis Jacob
BACKGROUND: Seasonality in insulin sensitivity has been the focus of controversial literature in the past decades. The aim of this study was to analyze seasonality of insulin use in patients with diabetes who were followed in German general practices. METHODS: This study included patients affected by type 1 (T1DM) or type 2 diabetes mellitus (T2DM) who received intensified conventional insulin therapy over a period of at least 12 months between 2013 and 2015. The main outcome was the median insulin dose per day (calculated daily insulin doses, CDDs) between June and August (summer) and between December and February (winter)...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28420258/lace-up-for-healthy-feet-the-impact-of-shoe-closure-on-plantar-stress-response
#4
Hadi Rahemi, David G Armstrong, Ana Enriquez, Joshua Owl, Talal K Talal, Bijan Najafi
OBJECTIVE: This study examined the impact of shoe closure on plantar thermal stress response (TSR), which is known to be a surrogate of shear stress and skin perfusion. It is aimed to explore potential impact of shoe closure on increasing risk factors associated with plantar ulcers in people with diabetic peripheral neuropathy (DPN). METHODS: Fifteen eligible subjects were enrolled. The left foot was used as a reference and fitted to a self-adjusted and habitual lace-tightening method by each subject...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28420257/gestational-diabetes-management-using-smart-mobile-telemedicine
#5
Mercedes Rigla, Iñaki Martínez-Sarriegui, Gema García-Sáez, Belén Pons, Maria Elena Hernando
Gestational diabetes (GDM) burden has been increasing progressively over the past years. Knowing that intrauterine exposure to maternal diabetes confers high risk for macrosomia as well as for future type 2 diabetes and obesity of the offspring, health care organizations try to provide effective control in spite of the limited resources. Artificial-intelligence-augmented telemedicine has been proposed as a helpful tool to facilitate an efficient widespread medical assistance to GDM. The aim of the study we present was to test the feasibility and acceptance of a mobile decision-support system for GDM, developed in the seventh framework program MobiGuide Project, which includes computer-interpretable clinical practice guidelines, access to data from the electronic health record as well as from glucose, blood pressure, and activity sensors...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28406040/seven-year-surveillance-of-the-clinical-performance-of-a-blood-glucose-test-strip-product
#6
Steven Setford, Mike Grady, Stuart Phillips, Lesley Miller, Stephen Mackintosh, Hilary Cameron, Krisna Corrigall
BACKGROUND: A key approach in enabling people with diabetes to better manage their condition is through self-monitoring of blood glucose (SMBG). Any functional SMBG system should demonstrate clinical accuracy across a broad glucose range and be insensitive to hematocrit. Furthermore, it should be incumbent on the manufacturer to demonstrate that their product continues to meet clinical accuracy claims during product lifetime. METHODS: Test strips from a globally distributed SMBG product were sampled from randomly selected production batches as part of the manufacturer's routine product evaluation process...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28406039/a-methodology-to-compare-insulin-dosing-recommendations-in-real-life-settings
#7
Danielle Groat, Maria A Grando, Bithika Thompson, Pedro Neto, Hiral Soni, Mary E Boyle, Marilyn Bailey, Curtiss B Cook
BACKGROUND: We propose a methodology to analyze complex real-life glucose data in insulin pump users. METHODS: Patients with type 1 diabetes (T1D) on insulin pumps were recruited from an academic endocrinology practice. Glucose data, insulin bolus (IB) amounts, and self-reported alcohol consumption and exercise events were collected for 30 days. Rules were developed to retrospectively compare IB recommendations from the insulin pump bolus calculator (IPBC) against recommendations from a proposed decision aid (PDA) and for assessing the PDA's recommendation for exercise and alcohol...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28406035/diagnostic-accuracy-of-random-ecg-in-primary-care-for-early-asymptomatic-cardiac-autonomic-neuropathy
#8
Herbert F Jelinek, Marc T P Adam, Robert Krones, David J Cornforth
AIMS: Cardiac autonomic reflex tests (CARTs) are time consuming and require patient cooperation for detecting cardiac autonomic neuropathy (CAN). Heart rate variability (HRV) analysis requires less patient cooperation and is quicker to complete. However the reliability of HRV results as a clinical tool, with respect to length of recording and accuracy of diagnosis is inconclusive. The current study investigated the reproducibility associated with varying length of recording for early CAN (eCAN) assessment...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28406034/analysis-of-a-new-optimized-percutaneous-access-system-for-cipii
#9
Eric Renard
While only used initially in cases with resistance to subcutaneous insulin therapy, intraperitoneal insulin therapy provides an overall more stable glucose control than subcutaneous insulin therapy thanks to its pharmacokinetics as pointed by Garcia-Verdugo et al from the experience of implantable insulin pumps. The expansion of these devices has been limited by underdelivery issues and high cost. The availability of a new percutaneous access to intraperitoneal route could allow a similar glucose control with less constraints of follow-up and expected lower cost...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28376647/real-time-continuous-glucose-monitoring-facilitates-feelings-of-safety-in-older-adults-with-type-1-diabetes-a-qualitative-study
#10
Michelle L Litchman, Nancy A Allen
BACKGROUND: Older adults with long-standing type 1 diabetes (T1D) have a higher risk for hypoglycemia and hypoglycemia unawareness. Hypoglycemia can be dangerous, even fatal. Real-time continuous glucose monitoring (RT-CGM) effectively supports diabetes management and well-being in adult and pediatric populations. Little is known about older adults and RT-CGM use. The purpose of this study was to identify why RT-CGM was important for diabetes management in individuals with T1D 65 years of age...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28376646/why-the-diabetes-technology-society-surveillance-protocol-for-glucose-meters-needs-to-be-revised
#11
Jan S Krouwer
The Diabetes Technology Society surveillance protocol provides a seal of approval for a glucose meter if a sufficient number of a candidate glucose meter's results meet ISO 15197:2013 limits. The protocol provides clear details about how to conduct this study and analyze the data but has two flaws. There is no specification about the size of glucose meter errors that are outside of ISO limits. A meter that has a result in the E zone of a glucose meter error grid could receive the DTS seal of approval. In addition, the protocol uses the ISO standard, which could be considered a "state of the art" standard instead of an error grid, which is a clinical standard...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28367636/closing-the-loop-in-adults-children-and-adolescents-with-suboptimally-controlled-type-1-diabetes-under-free-living-conditions-a-psychosocial-substudy
#12
Katharine D Barnard, Timothy Wysocki, Vanessa Ully, Julia K Mader, Thomas R Pieber, Hood Thabit, Martin Tauschmann, Lalantha Leelarathna, Sara Hartnell, Carlo L Acerini, Malgorzata E Wilinska, Sibylle Dellweg, Carsten Benesch, Sabine Arnolds, Manuel Holzer, Harald Kojzar, Fiona Campbell, James Yong, Jennifer Pichierri, Peter Hindmarsh, Lutz Heinemann, Mark L Evans, Roman Hovorka
OBJECTIVE: The objective was to explore psychosocial experiences of closed loop technology for adults, children, and adolescents with type 1 diabetes and their parents taking part in two multicenter, free-living, randomized crossover home studies. METHODS: Participants using insulin pump therapy were randomized to either 12 weeks of automated closed-loop glucose control, then 12 weeks of sensor augmented insulin pump therapy (open loop), or vice versa. Closed loop was used for 24 hours by adults and overnight only by children and adolescents...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28367635/a-single-center-long-term-continuous-subcutaneous-insulin-infusion-csii-experience-higher-fractional-use-is-associated-with-less-diabetes-complications
#13
Claudio Tubili, Ugo Di Folco, Maria Rosaria Nardone, Aldo Clementi
No abstract text is available yet for this article.
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28355924/insulin-pump-occlusions
#14
David C Klonoff, Guido Freckmann, Lutz Heinemann
No abstract text is available yet for this article.
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28349710/endovascular-devices-and-revascularization-techniques-for-limb-threatening-ischemia-in-individuals-with-diabetes
#15
Jayer Chung
Diabetes mellitus (DM) is a rapidly worsening global epidemic over the last thirty-five years. The increased prevalence of DM has changed the phenotypic expression of atherosclerotic limb threatening ischemia (LTI), resulting in an increase in lesions in the tibial vessels. These patients are also afflicted with peripheral neuropathy, foot deformities, and medial calcification of the vasculature. In response to the evolving phenotype of atherosclerosis, newer minimally invasive tools and techniques have been developed to improve the blood supply in LTI...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28349709/meeting-report
#16
Barry H Ginsberg, David C Klonoff, Vincent P Crabtree
On July 6 and 7, 2016 the Fourth Artificial Pancreas Workshop: Testing and Adoption of Current and Emerging Technologies was held on the National Institutes of Health (NIH) Campus at the Lister Hill Auditorium. The meeting was sponsored by a group of governmental organizations and NGOs, listed in Appendix A. This was a very timely meeting as the artificial pancreas appears to be growing from academic studies to commercial projects. The first artificial pancreas may be marketed within 12 months and a few may be approved within 24 months...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28349708/use-of-sitagliptin-with-closed-loop-technology-to-decrease-postprandial-blood-glucose-in-type-1-diabetes
#17
Lisa J Underland, Jeniece Trast Ilkowitz, Ranjitha Katikaneni, Amy Dowd, Rubina A Heptulla
BACKGROUND: Postprandial hyperglycemia poses a challenge to closed-loop systems. Dipeptidyl peptidase-4 (DPP-4) inhibitors, like sitagliptin, reduce postprandial glucose concentrations in patients with type 2 diabetes. The objective of this study was to assess sitagliptin's role in type 1 diabetes (T1DM) as an adjunct therapy in reducing postprandial blood glucose with an insulin-only closed-loop system. METHODS: This was a randomized, double-blinded, placebo controlled, crossover design trial...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28332406/continuous-glucose-monitor-interference-with-commonly-prescribed-medications
#18
Ananda Basu, Michael Q Slama, Wayne T Nicholson, Loralie Langman, Thomas Peyser, Rickey Carter, Rita Basu
BACKGROUND: Reliability of continuous glucose monitors (CGM) is a prerequisite for therapeutic dosing of insulin without the need for confirmatory blood glucose meter measurements. Interference of CGMs with commonly prescribed substances has not been extensively evaluated. METHODS: We sought to undertake a novel pilot study to determine the susceptibility of FDA-approved CGM systems (Medtronic Guardian Sof-Sensor, Dexcom G4 Platinum) to erroneous readings in the presence of common medications...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28326795/digital-health-care-by-in-silico-glycation-of-hba1-blood-cells
#19
James M Minor, Leslie M Rickey, Richard M Bergenstal
BACKGROUND: Diabetes health care relies on the HbA1c (A1c) assay and associated average glucose (AG) to evaluate and control chronic glycemia. However, the A1c assay is plagued with significant noise, lag time, and specificity issues. Current studies support the significant health care advantage of clinical action based on real-time blood glucose (BG) metrics. We seek to improve diabetes management by directly relating such metrics to AG levels as mediated by recently discovered recurrent endocrine cycles...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28322064/capillary-samples-and-hemolysis
#20
Helen Heenan, Helen Lunt, Huan Chan, Chris M Frampton
No abstract text is available yet for this article.
March 1, 2017: Journal of Diabetes Science and Technology
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