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insulin pump and cgm

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https://www.readbyqxmd.com/read/28007348/home-use-of-a-bihormonal-bionic-pancreas-versus-insulin-pump-therapy-in-adults-with-type-1-diabetes-a-multicentre-randomised-crossover-trial
#1
Firas H El-Khatib, Courtney Balliro, Mallory A Hillard, Kendra L Magyar, Laya Ekhlaspour, Manasi Sinha, Debbie Mondesir, Aryan Esmaeili, Celia Hartigan, Michael J Thompson, Samir Malkani, J Paul Lock, David M Harlan, Paula Clinton, Eliana Frank, Darrell M Wilson, Daniel DeSalvo, Lisa Norlander, Trang Ly, Bruce A Buckingham, Jamie Diner, Milana Dezube, Laura A Young, April Goley, M Sue Kirkman, John B Buse, Hui Zheng, Rajendranath R Selagamsetty, Edward R Damiano, Steven J Russell
BACKGROUND: The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were living at home and participating in their normal daily routines without restrictions on diet or physical activity. METHODS: We did a random-order crossover study in volunteers at least 18 years old who had type 1 diabetes and lived within a 30 min drive of four sites in the USA...
December 20, 2016: Lancet
https://www.readbyqxmd.com/read/28004007/clinical-efficacy-of-two-different-methods-to-initiate-sensor-augmented-insulin-pumps-a-randomized-controlled-trial
#2
Jesus Moreno-Fernandez, Francisco Javier Gómez, Maria Ángeles Gálvez Moreno, Justo P Castaño
Aim. To analyze clinical effect of a novel approach to initiate sensor-augmented insulin pumps in type 1 diabetes mellitus (T1DM) patients through early real-time continuous glucose monitoring (RT-CGM) initiation. Methods. A 26-week pilot study with T1DM subjects randomized (1 : 1) to start RT-CGM three weeks before continuous subcutaneous insulin infusion (CGM pre-CSII) or adding RT-CGM three weeks after continuous subcutaneous insulin infusion (CGM post-CSII). Results. Twenty-two patients were enrolled with a mean age of 36...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27996321/measures-of-glycemic-variability-in-type-1-diabetes-and-the-effect-of-real-time-continuous-glucose-monitoring
#3
Ahmed H El-Laboudi, Ian F Godsland, Desmond G Johnston, Nick S Oliver
OBJECTIVE: To report the impact of continuous glucose monitoring (CGM) on glycemic variability (GV) indices, factors predictive of change, and to correlate variability with conventional markers of glycemia. METHODS: Data from the JDRF study of CGM in participants with type 1 diabetes were used. Participants were randomized to CGM or self-monitored blood glucose (SMBG). GV indices at baseline, at 26 weeks in both groups, and at 52 weeks in the control group were analyzed...
December 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27983910/active-subjects-with-autoimmune-type-1-diabetes-have-better-metabolic-profiles-than-sedentary-controls
#4
M Adamo, R Codella, F Casiraghi, A Ferrulli, C Macrì, E Bazzigaluppi, I Terruzzi, L Inverardi, C Ricordi, L Luzi
<p>Previous studies in humans with type 1 diabetes (T1D) and in non-obese diabetic mice have investigated the beneficial immunomodulatory potential of aerobic physical activity. Performing high volume of aerobic exercise may favorably regulate autoimmunity in diabetes. We tested whether increased physical activity is a self-sufficient positive factor in T1D subjects.</p><p>During a 3-month observational period, active (6M; 40.5±6.1 years; BMI 24.5±2.1) and sedentary (4M, 3F; 35.9±8.9 years; BMI 25...
20, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27899489/diabetes-device-use-in-adults-with-type-1-diabetes-barriers-to-uptake-and-potential-intervention-targets
#5
Molly L Tanenbaum, Sarah J Hanes, Kellee M Miller, Diana Naranjo, Rachel Bensen, Korey K Hood
OBJECTIVE: Diabetes devices (insulin pumps, continuous glucose monitors [CGMs]) are associated with benefits for glycemic control, yet uptake of these devices continues to be low. Some barriers to device uptake may be modifiable through psychosocial intervention, but little is known about which barriers and which patients to target. RESEARCH DESIGN AND METHODS: We surveyed 1,503 adult T1D Exchange participants (mean age 35.3 [SD 14.8] years, diagnosis duration 20...
November 29, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27880079/relationship-between-gastric-emptying-and-diurnal-glycemic-control-in-type-1-diabetes-mellitus-a-randomized-trial
#6
Gopanandan Parthasarathy, Yogish C Kudva, Phillip A Low, Michael Camilleri, Ananda Basu, Adil E Bharucha
CONTEXT: In type 1 diabetes (T1D), delayed gastric emptying (GE) may predispose to a mismatch between insulin delivery and glucose absorption. Previous studies evaluated, only partly, the relationship between delayed GE and postprandial, but not diurnal, glycemia. OBJECTIVE: To assess the relationship between GE disturbances and glycemic control in T1D and the effects of accelerating GE on glycemic control. Design , Setting and Participants: This was a randomized placebo-controlled trial in 30 patients with T1D on an insulin pump at an academic medical center...
November 23, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27837162/sensor-life-and-overnight-closed-loop-a-randomized-clinical-trial
#7
Martin Tauschmann, Janet M Allen, Malgorzata E Wilinska, Yue Ruan, Hood Thabit, Carlo L Acerini, David B Dunger, Roman Hovorka
BACKGROUND: Closed-loop (CL) systems direct insulin delivery based on continuous glucose monitor (CGM) sensor values. CGM accuracy varies with sensor life, being least accurate on day 1 of sensor insertion. We evaluated the effect of sensor life (enhanced Enlite, Medtronic MiniMed, Northridge, CA) on overnight CL. METHODS: In an open-label, randomized, 2-period, inpatient crossover pilot study, 12 adolescents on insulin pump (age 16.7 ± 1.9 years; HbA1c 66 ± 10 mmol/mol) attended a clinical research facility on 2 overnight occasions...
November 10, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27835037/glycemia-treatment-satisfaction-cognition-and-sleep-quality-in-adults-and-adolescents-with-type-1-diabetes-when-using-a-closed-loop-system-overnight-versus-sensor-augmented-pump-with-low-glucose-suspend-function-a-randomized-crossover-study
#8
Amin Sharifi, Martin I De Bock, Dilshani Jayawardene, Margaret M Loh, Jodie C Horsburgh, Carolyn L Berthold, Nirubasini Paramalingam, Leon A Bach, Peter G Colman, Elizabeth A Davis, Benyamin Grosman, Christel Hendrieckx, Alicia J Jenkins, Kavita Kumareswaran, Natalie Kurtz, Andrew Kyoong, Richard J MacIsaac, Jane Speight, Steven Trawley, Glenn M Ward, Anirban Roy, Timothy W Jones, David N O'Neal
BACKGROUND: We compared glycemia, treatment satisfaction, sleep quality, and cognition using a nighttime Android-based hybrid closed-loop system (Android-HCLS) with sensor-augmented pump with low-glucose suspend function (SAP-LGS) in people with type 1 diabetes. MATERIALS AND METHODS: An open-label, prospective, randomized crossover study of 16 adults (mean [SD] age 42.1 [9.6] years) and 12 adolescents (15.2 [1.6] years) was conducted. All participants completed four consecutive nights at home with Android-HCLS (proportional integral derivative with insulin feedback algorithm; Medtronic) and SAP-LGS...
December 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27807014/continuous-glucose-monitoring-cgm-adherence-in-youth-with-type-1-diabetes-associations-with-biomedical-and-psychosocial-variables
#9
Elisa Giani, Rebecca Snelgrove, Lisa K Volkening, Lori M Laffel
BACKGROUND: Continuous glucose monitoring (CGM) remains underutilized in youth with type 1 diabetes (T1D). There is a need to investigate factors associated with CGM use. METHOD: In 61 T1D youth, CGM use was ascertained by downloads reflecting the 4-week periods preceding 3- and 6-month study visits. Demographic and clinical data were obtained from chart review and interview. Youth and parents completed validated psychosocial surveys at baseline and 6 months. RESULTS: Youth (52% male, 93% Caucasian, 80% pump treated) were 12...
November 1, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27596550/-comparison-of-therapeutic-effects-between-sitagliptin-and-voglibose-both-combined-with-sensor-augmented-insulin-pump-in-newly-diagnosed-type-2-diabetes
#10
C H Shi, L Wang, R Bai, Y B Wang, D Liu, X Y Zhang, H Wang, Y Yang, J L Du
OBJECTIVE: To compare the therapeutic effects between sitagliptin and voglibose both with sensor-augmented insulin pump (SAP) in newly diagnosed type 2 diabetes mellitus (T2DM). METHODS: Fifty-six newly diagnosed hospitalized T2DM patients in Department of Endocrinology of the First Affiliated Hospital of Dalian Medical University, with hemoglobin A1c (HbA1c) value of 9%-11%, were randomized into the sitagliptin (S) group (n=28) and the voglibose (V) group (n=28) by block randomisation...
August 23, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27482825/comparison-of-different-treatment-modalities-for-type-1-diabetes-including-sensor-augmented-insulin-regimens-in-52-weeks-of-follow-up-a-comisair-study
#11
Jan Šoupal, Lenka Petruželková, Milan Flekač, Tomáš Pelcl, Martin Matoulek, Martina Daňková, Jan Škrha, Štěpán Svačina, Martin Prázný
OBJECTIVE: To compare different treatment modalities for patients with type 1 diabetes (T1D) based on real-time continuous glucose monitoring (RT-CGM) or self-monitoring of blood glucose (SMBG) combined with multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII). RESEARCH DESIGN AND METHODS: Sixty-five T1D patients were followed up for a year. Of these, 27 started RT-CGM as part of a sensor-augmented insulin regimen (SAIR); within this SAIR group, 15 subjects started sensor-augmented pump (SAP) therapy and the remaining 12 continued with MDIs (MDIs + RT-CGM)...
September 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27340247/recruitment-into-a-pediatric-continuous-glucose-monitoring-rct-patient-and-recruitment-process-characteristics-associated-with-decision-to-participate
#12
Lisa K Volkening, Kaitlin C Gaffney, Michelle L Katz, Lori M Laffel
BACKGROUND: The purpose was to identify patient/family characteristics and recruitment process characteristics associated with the decision to participate in a 2-year continuous glucose monitoring (CGM) RCT for youth with type 1 diabetes and their families. METHOD: Study staff approached patients who were conditionally eligible according to medical record review or referred by a provider. We categorized families according to participation decision (agree vs decline) and timing of decision (day of approach vs later ["thinkers"])...
June 22, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27212045/techniques-for-exercise-preparation-and-management-in-adults-with-type-1-diabetes
#13
Jordan E Pinsker, Amy Kraus, Danielle Gianferante, Benjamen E Schoenberg, Satbir K Singh, Hallie Ortiz, Eyal Dassau, David Kerr
OBJECTIVES: People with type 1 diabetes are at risk for early- and late-onset hypoglycemia following exercise. Reducing this risk may be possible with strategic modifications in carbohydrate intake and insulin use. We examined the exercise preparations and management techniques used by individuals with type 1 diabetes before and after physical activity and sought to determine whether use of differing diabetes technologies affects these health-related behaviours. METHODS: We studied 502 adults from the Type 1 Diabetes Exchange's online patient community, Glu, who had completed an online survey focused on diabetes self-management and exercise...
December 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27208331/day-and-night-closed-loop-glucose-control-in-patients-with-type-1-diabetes-under-free-living-conditions-results-of-a-single-arm-1-month-experience-compared-with-a-previously-reported-feasibility-study-of-evening-and-night-at-home
#14
Eric Renard, Anne Farret, Jort Kropff, Daniela Bruttomesso, Mirko Messori, Jerome Place, Roberto Visentin, Roberta Calore, Chiara Toffanin, Federico Di Palma, Giordano Lanzola, Paolo Magni, Federico Boscari, Silvia Galasso, Angelo Avogaro, Patrick Keith-Hynes, Boris Kovatchev, Simone Del Favero, Claudio Cobelli, Lalo Magni, J Hans DeVries
OBJECTIVE: After testing of a wearable artificial pancreas (AP) during evening and night (E/N-AP) under free-living conditions in patients with type 1 diabetes (T1D), we investigated AP during day and night (D/N-AP) for 1 month. RESEARCH DESIGN AND METHODS: Twenty adult patients with T1D who completed a previous randomized crossover study comparing 2-month E/N-AP versus 2-month sensor augmented pump (SAP) volunteered for 1-month D/N-AP nonrandomized extension. AP was executed by a model predictive control algorithm run by a modified smartphone wirelessly connected to a continuous glucose monitor (CGM) and insulin pump...
July 2016: Diabetes Care
https://www.readbyqxmd.com/read/27207890/efficacy-of-an-overnight-predictive-low-glucose-suspend-system-in-relation-to-hypoglycemia-risk-factors-in-youth-and-adults-with-type-1-diabetes
#15
Peter M Calhoun, Bruce A Buckingham, David M Maahs, Irene Hramiak, Darrell M Wilson, Tandy Aye, Paula Clinton, Peter Chase, Laurel Messer, Craig Kollman, Roy W Beck, John Lum
BACKGROUND: We developed a system to suspend insulin pump delivery overnight when the glucose trend predicts hypoglycemia. This predictive low-glucose suspend (PLGS) system substantially reduces nocturnal hypoglycemia without an increase in morning ketosis. Evaluation of hypoglycemia risk factors that could potentially influence the efficacy of the system remains critical for understanding possible problems with the system and identifying patients that may have the greatest benefit when using the system...
November 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27194309/greater-diet-quality-is-associated-with-more-optimal-glycemic-control-in-a-longitudinal-study-of-youth-with-type-1-diabetes
#16
Tonja R Nansel, Leah M Lipsky, Aiyi Liu
BACKGROUND: Despite the centrality of nutrition in the management of type 1 diabetes, the association of diet quality and macronutrient distribution with glycemic control is ambiguous. OBJECTIVE: This study examined longitudinally the association of dietary intake with multiple indicators of glycemic control in youth with type 1 diabetes participating in a behavioral nutrition intervention study. DESIGN: Participants in a randomized clinical trial of a behavioral nutrition intervention [n = 136; mean ± SD age: 12...
July 2016: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27022096/influences-on-technology-use-and-efficacy-in-type-1-diabetes
#17
Victoria Franklin
The majority of people with type 1 diabetes have suboptimal glycemic control, increasing their complication risk. Technology to support diabetes self-care has advanced significantly and includes self-monitoring of blood glucose (SMBG), insulin pump therapy (IPT), continuous glucose monitoring (CGM), and sensor-augmented pump therapy (SAPT), which are stepping stones toward the "artificial pancreas" using closed-loop technology. Use of these technologies improves clinical outcomes for patients with the appropriate skills and motivation...
May 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/26969142/is-psychological-stress-a-factor-for-incorporation-into-future-closed-loop-systems
#18
Linda A Gonder-Frederick, Jesse H Grabman, Boris Kovatchev, Sue A Brown, Stephen Patek, Ananda Basu, Jordan E Pinsker, Yogish C Kudva, Christian A Wakeman, Eyal Dassau, Claudio Cobelli, Howard C Zisser, Francis J Doyle
BACKGROUND: The relationship between daily psychological stress and BG fluctuations in type 1 diabetes (T1DM) is unclear. More research is needed to determine if stress-related BG changes should be considered in glucose control algorithms. This study in the usual free-living environment examined relationships among routine daily stressors and BG profile measures generated from CGM readings. METHODS: A total of 33 participants with T1DM on insulin pumps wore a CGM device for 1 week and recorded daily ratings of psychological stress, carbohydrates, and insulin boluses...
May 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/26969141/psychological-reactions-associated-with-continuous-glucose-monitoring-in-youth
#19
Susana R Patton, Mark A Clements
Glucose monitoring is prerequisite to all other diabetes self-care behaviors and helps patients to reduce their risk for diabetes-related complications due to elevated glycemia. Because of the amount of information available and the ability to deliver glucose results in real-time, continuous glucose monitoring (CGM) has the ability to improve on self-monitoring blood glucose. However, epidemiologic data demonstrate slow uptake of CGM by patients, especially among youth. Several new diabetes therapies rely on CGM for feedback on patients' glucose levels to optimize treatment (eg, the low-glucose suspend insulin pump) and there are new technologies currently in development that will also need this information to work (eg, the artificial pancreas)...
May 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/26950530/evaluation-of-the-adherence-to-continuous-glucose-monitoring-in-the-management-of-type-1-diabetes-patients-on-sensor-augmented-pump-therapy-the-senlocor-study
#20
MULTICENTER STUDY
Sylvie Picard, Hélène Hanaire, Sabine Baillot-Rudoni, Elisabeth Gilbert-Bonnemaison, Didier Not, Yves Reznik, Bruno Guerci
BACKGROUND: Continuous glucose monitoring (CGM) and sensor-augmented pump (SAP) therapy improve glucose control provided good adherence. In France, not only diabetologists, nurses, and dieticians but also nurses employed by homecare providers (HCPNs) are together involved in the initiation and/or follow-up of continuous subcutaneous insulin injection (CSII) and SAP training. The SENLOCOR Study is an observational study designed to assess SAP adherence over 6 months (primary objective)...
March 2016: Diabetes Technology & Therapeutics
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