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https://www.readbyqxmd.com/read/29661916/sustained-reduction-in-severe-hypoglycemia-in-adults-with-type-1-diabetes-complicated-by-impaired-awareness-of-hypoglycemia-2-year-follow-up-in-the-hypocompass-randomized-clinical-trial
#1
Stuart A Little, Jane Speight, Lalantha Leelarathna, Emma Walkinshaw, Horng Kai Tan, Anita Bowes, Alexandra Lubina-Solomon, Thomas J Chadwick, Deborah D Stocken, Catherine Brennand, Sally M Marshall, Ruth Wood, David Kerr, Daniel Flanagan, Simon R Heller, Mark L Evans, James A M Shaw
OBJECTIVE: Severe hypoglycemia is a feared complication of type 1 diabetes; yet, few trials have targeted prevention using optimized self-management (educational, therapeutic, and technological support). We aimed to investigate whether improved awareness and reduced severe hypoglycemia, achieved during an intensive randomized clinical trial (RCT), were sustained after return to routine care. RESEARCH DESIGN AND METHODS: Ninety-six adults with type 1 diabetes (29 ± 12 years' duration) and impaired awareness of hypoglycemia at five U...
April 16, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29547046/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-2018-position-statement-on-integration-of-insulin-pumps-and-continuous-glucose-monitoring-in-patients-with-diabetes-mellitus
#2
George Grunberger, Yehuda Handelsman, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, Richard A Haas, Victor L Roberts, Guillermo E Umpierrez
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician...
March 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29535079/human-factors-and-data-logging-processes-with-the-use-of-advanced-technology-for-adults-with-type-1-diabetes-systematic-integrative-review
#3
REVIEW
Marion Waite, Clare Martin, Rachel Franklin, David Duce, Rachel Harrison
BACKGROUND: People with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different...
March 15, 2018: JMIR Human Factors
https://www.readbyqxmd.com/read/29484783/high-frequencies-of-dermatological-complications-in-children-using-insulin-pumps-or-sensors
#4
Anna Korsgaard Berg, Birthe Susanne Olsen, Jacob P Thyssen, Claus Zachariae, Anne Birgitte Simonsen, Kasper Pilgaard, Jannet Svensson
BACKGROUND: Dermatological complications in children and adolescents that are related to continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) have not been well-characterized. This study examined the prevalence and characteristics of different types of dermatological complications. METHODS: Online questionnaires regarding dermatological complications related to CSII and/or CGM were returned from a total of 144 children and adolescents, aged 2 to 20 years...
February 26, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29416197/impact-of-insulin-delivery-method-on-hypoglycemia-incidence-in-pediatric-type-1-diabetes-mellitus-patients
#5
Snijezana Hasanbegovic, Emina Obarcanin, Edo Hasanbegovic, Nedim Begic
Introduction: Insulin therapy of pediatric patients with type 1 diabetes mellitus (T1DM) is highly demanding due to their dynamic growth, development and different daily life activities. Goal: To determine the optimal insulin delivery method for the prevention of hypoglycemia recorded by continuous monitoring of glucose in patients with insulin pump and PEN. Material and Methods: The study included patients up to 18 years of age with diagnosed T1DM and treated with insulin pump and by insulin therapy with PEN at the Pediatric Clinic of the Clinical Center in Sarajevo...
December 2017: Medical Archives
https://www.readbyqxmd.com/read/29383544/emerging-technologies-for-the-management-of-type-1-diabetes-in-pregnancy
#6
REVIEW
Jennifer M Yamamoto, Helen R Murphy
PURPOSE OF REVIEW: The purpose of the study is to discuss emerging technologies available in the management of type 1 diabetes in pregnancy. RECENT FINDINGS: The latest evidence suggests that continuous glucose monitoring (CGM) should be offered to all women on intensive insulin therapy in early pregnancy. Studies have additionally demonstrated the ability of CGM to help gain insight into specific glucose profiles as they relate to glycaemic targets and pregnancy outcomes...
January 30, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29355438/insulin-sensitivity-index-based-optimization-of-insulin-to-carbohydrate-ratio-in-silico-study-shows-efficacious-protection-against-hypoglycemic-events-caused-by-suboptimal-therapy
#7
Michele Schiavon, Chiara Dalla Man, Claudio Cobelli
BACKGROUND AND AIM: The insulin to carbohydrate ratio (CR) is a parameter used by patients with type 1 diabetes (T1D) to calculate the premeal insulin bolus. Usually, it is estimated by the physician based on patient diary, but modern diabetes technologies, such as subcutaneous glucose sensing (continuous glucose monitoring, CGM) and insulin delivery (continuous subcutaneous insulin infusion, CSII) systems, can provide important information for its optimization. In this study, a method for CR optimization based on CGM and CSII data is presented and its efficacy and robustness tested in several in silico scenarios, with the primary aim of increasing protection against hypoglycemia...
February 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29342264/effect-of-continuous-glucose-monitoring-on-glycemic-control-acute-admissions-and-quality-of-life-a-real-world-study
#8
Sara Charleer, Chantal Mathieu, Frank Nobels, Christophe De Block, Regis P Radermecker, Michel P Hermans, Youri Taes, Chris Vercammen, Guy T'Sjoen, Laurent Crenier, Steffen Fieuws, Bart Keymeulen, Pieter Gillard
Context: Randomized controlled trials evaluating real-time continuous glucose monitoring (RT-CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use. Objective: To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism and quality of life (QOL). Design: Prospective, observational, multicenter, cohort study. Participants: Five hundred fifteen adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program...
January 12, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29273897/impact-of-flash-glucose-monitoring-on-hypoglycaemia-in-adults-with-type-1-diabetes-managed-with-multiple-daily-injection-therapy-a-pre-specified-subgroup-analysis-of-the-impact-randomised-controlled-trial
#9
Per Oskarsson, Ramiro Antuna, Petronella Geelhoed-Duijvestijn, Jens Krӧger, Raimund Weitgasser, Jan Bolinder
AIMS/HYPOTHESIS: Evidence for the effectiveness of interstitial glucose monitoring in individuals with type 1 diabetes using multiple daily injection (MDI) therapy is limited. In this pre-specified subgroup analysis of the Novel Glucose-Sensing Technology and Hypoglycemia in Type 1 Diabetes: a Multicentre, Non-masked, Randomised Controlled Trial' (IMPACT), we assessed the impact of flash glucose technology on hypoglycaemia compared with capillary glucose monitoring. METHODS: This multicentre, prospective, non-masked, RCT enrolled adults from 23 European diabetes centres...
March 2018: Diabetologia
https://www.readbyqxmd.com/read/29247547/psychosocial-impacts-of-hybrid-closed-loop-systems-in-the-management-of-diabetes-a-review
#10
REVIEW
C Farrington
There is a pressing need for new treatment regimens that enable improved glycaemic control and reduced diabetes self-management burdens. Closed-loop, or artificial pancreas, systems represent one of the most promising avenues in this regard. Closed-loop systems connect wearable continuous glucose monitor (CGM) sensors to smartphone- or tablet-mounted algorithms that process and model CGM data to deliver precise and frequently updated doses of fast-acting insulin (and glucagon in dual-hormone systems) to users via wearable pumps...
April 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29191845/revisiting-the-relationships-between-measures-of-glycemic-control-and-hypoglycemia-in-continuous-glucose-monitoring-data-sets
#11
Marga Gimenez, Amitai Jeremy Tannen, Monika Reddy, Vanessa Moscardo, Ignacio Conget, Nick Oliver
OBJECTIVE: The Diabetes Control and Complications Trial (DCCT) identified an inverse relationship between HbA1c and severe hypoglycemia. We investigated the relationship between hypoglycemia and HbA1c in a large type 1 diabetes cohort on multiple daily injection or insulin pump therapy using blinded continuous glucose monitoring (CGM) data. The impact of real-time CGM on these relationships and how these relationships differ with biochemical definitions of hypoglycemia have also been assessed...
February 2018: Diabetes Care
https://www.readbyqxmd.com/read/29157869/adapting-and-validating-a-measure-of-diabetes-specific-self-compassion
#12
M L Tanenbaum, R N Adams, J S Gonzalez, S J Hanes, K K Hood
AIMS: Self-compassion (SC), or treating oneself with kindness when dealing with personal challenges, has not been rigorously examined in people with T1D. SC has been shown to buffer against negative emotions and to be linked to improved health outcomes, but diabetes-specific SC has not been studied. This study aimed to adapt the Self-Compassion Scale and validate it for a diabetes-specific population. METHODS: We developed and validated a diabetes-specific version of the Self-Compassion Scale (Neff, 2003) in a sample of adults with T1D (N=542; 65% female; 97% non-Hispanic White; M age 41, SD=15...
February 2018: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29157581/sleep-in-children-with-type-1-diabetes-and-their-parents-in-the-t1d-exchange
#13
Sarah S Jaser, Nicole C Foster, Bryce A Nelson, Julie M Kittelsrud, Linda A DiMeglio, Maryanne Quinn, Steven M Willi, Jill H Simmons
OBJECTIVES: Sleep has physiological and behavioral impacts on diabetes outcomes, yet little is known about the impact of sleep disturbances in children with type 1 diabetes. The current study sought to characterize sleep in children with type 1 diabetes and in their parents and to examine the associations between child sleep, glycemic control and adherence, parent sleep and well-being, parental fear of hypoglycemia, and nocturnal caregiving behavior. METHODS: Surveys were emailed to parents of 2- to 12-year-old participants in the Type 1 Diabetes (T1D) Exchange clinic registry...
November 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29107758/exploring-correlates-of-diabetes-related-stress-among-adults-with-type-1-diabetes-in-the-t1d-exchange-clinic-registry
#14
Matthew Tyler Boden, Sasha Gala
AIMS: To explore relations between diabetes-related stress and multiple sociodemographic, diabetes health, other health, and treatment-related variables among a large, diverse sample of adults with Type 1 Diabetes (T1D). METHODS: The sample consisted of 10,821 adults (over 18 years old) enrolled in the T1D Exchange Clinic Registry. The T1D Exchange clinic network consists of 67 diabetes clinical centers throughout the United States selected to broadly represent pediatric and adult patients with T1D...
October 28, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29060152/personalization-of-a-compartmental-physiological-model-for-an-artificial-pancreas-through-integration-of-patient-s-state-estimation
#15
P Jallon, S Lachal, C Franco, G Charpentier, E Huneker, M Doron, Sylvia Franc, Pierre-Yves Benhamou, Sophie Borot, Bruno Guerci, He le Ne Hanaire, Nathalie Jeandidier, Alfred Penfornis, Eric Renard, Yves Reznik, Pauline Schaepelynck, Chantal Simon
Artificial Pancreas (AP) are developed for patients with Type 1 diabetes. This medical device system consists in the association of a subcutaneous continuous glucose monitor (CGM) providing a proxy of the patient's glycaemia and a control algorithm offering the real-time modification of the insulin delivery with an automatic command of the subcutaneous insulin pump. The most complex algorithms are based on a compartmental model of the glucoregulatory system of the patient coupled to an approach of MPC (Model-Predictive-Control) for the command...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29055098/safety-of-the-batteries-and-power-units-used-in-insulin-pumps-a-pilot-cross-sectional-study-by-the-association-for-the-study-of-innovative-diabetes-treatment-in-japan
#16
Takashi Murata, Shinsuke Nirengi, Naoki Sakane, Akio Kuroda, Yushi Hirota, Munehide Matsuhisa, Mitsuyoshi Namba, Tetsuro Kobayashi
AIMS/INTRODUCTION: We investigated the safety of the batteries and power units used in insulin pumps in Japan. MATERIALS AND METHODS: A self-administered questionnaire was sent to the 201 members of the Association for Innovative Diabetes Treatment in Japan. RESULTS: A total of 56 members responded, and among the 1,499 active devices, 66 had episodes of trouble related to the batteries and power units. The ratio of reported troubles to the number of insulin pumps was significantly higher in insulin pumps with a continuous glucose monitoring sensor compared with insulin pumps without a continuous glucose monitoring sensor (odds ratio 2...
October 21, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29030383/twelve-week-24-7-ambulatory-artificial-pancreas-with-weekly-adaptation-of-insulin-delivery-settings-effect-on-hemoglobin-a-1c-and-hypoglycemia
#17
MULTICENTER STUDY
Eyal Dassau, Jordan E Pinsker, Yogish C Kudva, Sue A Brown, Ravi Gondhalekar, Chiara Dalla Man, Steve Patek, Michele Schiavon, Vikash Dadlani, Isuru Dasanayake, Mei Mei Church, Rickey E Carter, Wendy C Bevier, Lauren M Huyett, Jonathan Hughes, Stacey Anderson, Dayu Lv, Elaine Schertz, Emma Emory, Shelly K McCrady-Spitzer, Tyler Jean, Paige K Bradley, Ling Hinshaw, Alejandro J Laguna Sanz, Ananda Basu, Boris Kovatchev, Claudio Cobelli, Francis J Doyle
OBJECTIVE: Artificial pancreas (AP) systems are best positioned for optimal treatment of type 1 diabetes (T1D) and are currently being tested in outpatient clinical trials. Our consortium developed and tested a novel adaptive AP in an outpatient, single-arm, uncontrolled multicenter clinical trial lasting 12 weeks. RESEARCH DESIGN AND METHODS: Thirty adults with T1D completed a continuous glucose monitor (CGM)-augmented 1-week sensor-augmented pump (SAP) period...
December 2017: Diabetes Care
https://www.readbyqxmd.com/read/28990436/acceptability-of-implantable-continuous-glucose-monitoring-sensor
#18
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
https://www.readbyqxmd.com/read/28989086/reported-gastroparesis-in-adults-with-type-1-diabetes-t1d-from-the-t1d-exchange-clinic-registry
#19
Grazia Aleppo, Peter Calhoun, Nicole C Foster, David M Maahs, Viral N Shah, Kellee M Miller
OBJECTIVE: To better understand the prevalence and impact of gastroparesis in the T1D Exchange clinic registry database. METHODS: The analysis included 7107 adult participants with T1D across 45 sites (median age 46years. and median duration 24years). Linear and logistic regression models were used to assess the association of gastroparesis vs. no gastroparesis (obtained from medical record) with demographic characteristics, glycemic control and diabetes complications...
September 6, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28979168/devices-for-continuous-monitoring-of-glucose-update-in-technology
#20
REVIEW
Ana María Gómez, Diana Cristina Henao Carrillo, Oscar Mauricio Muñoz Velandia
Continuous glucose monitoring (CGM) is a tool that allows constant evaluation of glycemic control, providing data such as the trend and fluctuation of interstitial glucose levels over time. In clinical practice, there are two modalities: the professional or retrospective and the personal or real-time CGM (RT-CGM). The latest-generation sensors are more accurate and sensitive for hypoglycemia, improving adherence to self-monitoring, which has allowed optimizing glycemic control. The development of algorithms that allow the suspension of the infusion of insulin during hypoglycemia gave rise to the integrated therapy or sensor-augmented insulin pump therapy with low glucose suspend, which has proven to be an effective and safe alternative in the treatment of diabetic patients with high risk of hypoglycemia...
2017: Medical Devices: Evidence and Research
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