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https://www.readbyqxmd.com/read/29191845/revisiting-the-relationships-between-measures-of-glycemic-control-and-hypoglycemia-in-continuous-glucose-monitoring-datasets
#1
Marga Gimenez, Amitai Jeremy Tannen, Monika Reddy, Vanessa Moscardo, Ignacio Conget, Nick Oliver
OBJECTIVE: The Diabetes Control and Complications Trial 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...
November 30, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29157869/adapting-and-validating-a-measure-of-diabetes-specific-self-compassion
#2
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...
October 26, 2017: 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
#3
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
#4
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
#5
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/the-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
#6
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 (ASINDTJ). RESULTS: Fifty-six 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 CGM sensor compared to insulin pumps without CGM 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-a1c-and-hypoglycemia
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28965029/continuous-glucose-monitoring-a-review-of-the-technology-and-clinical-use
#11
REVIEW
David C Klonoff, David Ahn, Andjela Drincic
Continuous glucose monitoring (CGM) is an increasingly adopted technology for insulin-requiring patients that provides insights into glycemic fluctuations. CGM can assist patients in managing their diabetes with lifestyle and medication adjustments. This article provides an overview of the technical and clinical features of CGM based on a review of articles in PubMed on CGM from 1999 through January 31, 2017. A detailed description is presented of three professional (retrospective), three personal (real-time) continuous glucose monitors, and three sensor integrated pumps (consisting of a sensor and pump that communicate with each other to determine an optimal insulin dose and adjust the delivery of insulin) that are currently available in United States...
November 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28923465/continuous-glucose-monitoring-in-pregnant-women-with-type-1-diabetes-conceptt-a-multicentre-international-randomised-controlled-trial
#12
Denice S Feig, Lois E Donovan, Rosa Corcoy, Kellie E Murphy, Stephanie A Amiel, Katharine F Hunt, Elizabeth Asztalos, Jon F R Barrett, J Johanna Sanchez, Alberto de Leiva, Moshe Hod, Lois Jovanovic, Erin Keely, Ruth McManus, Eileen K Hutton, Claire L Meek, Zoe A Stewart, Tim Wysocki, Robert O'Brien, Katrina Ruedy, Craig Kollman, George Tomlinson, Helen R Murphy
BACKGROUND: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes. METHODS: In this multicentre, open-label, randomised controlled trial, we recruited women aged 18-40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy...
September 15, 2017: Lancet
https://www.readbyqxmd.com/read/28880188/a-review-of-safety-and-hazards-associated-with-the-artificial-pancreas
#13
Charrise M Ramkissoon, Brian Aufderheide, B Wayne Bequette, Josep Vehi
The artificial pancreas (AP) is a closed-loop (CL) device with the potential to reduce the complications associated with type 1 diabetes mellitus (T1DM) by maintaining euglycemia in patients. The AP encompasses an algorithm that determines the amount of insulin (and other hormones) to be administered to the patient via a continuous subcutaneous insulin infusion (CSII) pump using information provided by a continuous glucose monitor (CGM) and other sensors. As the AP approaches commercialization special attention must be given to safety within all the individual components, including physiological changes in the patient, as well as, safety issues that can arise when these components are combined into a single system...
September 4, 2017: IEEE Reviews in Biomedical Engineering
https://www.readbyqxmd.com/read/28868899/rate-of-change-of-premeal-glucose-measured-by-continuous-glucose-monitoring-predicts-postmeal-glycemic-excursions-in-patients-with-type-1-diabetes-implications-for-therapy
#14
Amit R Majithia, Alexander B Wiltschko, Hui Zheng, Geoffrey A Walford, David M Nathan
BACKGROUND: Patients with type 1 diabetes routinely utilize a single premeal fingerstick glucose to determine premeal insulin doses. Continuous glucose monitoring (CGM) provides much richer glycemic trend information, including glycemic slope (GS). How to incorporate this information into dosing decisions remains an open question. METHODS: We examined the relationship between premeal GS and postmeal glycemic excursions in 240 individuals with type 1 diabetes receiving CGM augmented insulin pump therapy...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28820504/diabetes-insulin-pumps-after-injections-and-cgm-in-t1dm
#15
John C Pickup
No abstract text is available yet for this article.
October 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28770627/management-and-family-burdens-endorsed-by-parents-of-youth-7-years-old-with-type-1-diabetes
#16
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...
September 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28767276/closed-loop-control-without-meal-announcement-in-type-1-diabetes
#17
Faye M Cameron, Trang T Ly, Bruce A Buckingham, David M Maahs, Gregory P Forlenza, Carol J Levy, David Lam, Paula Clinton, Laurel H Messer, Emily Westfall, Camilla Levister, Yan Yan Xie, Nihat Baysal, Daniel Howsmon, Stephen D Patek, B Wayne Bequette
OBJECTIVE: A fully closed-loop insulin-only system was developed to provide glucose control in patients with type 1 diabetes without requiring announcement of meals or activity. Our goal was to assess initial safety and efficacy of this system. RESEARCH DESIGN AND METHODS: The multiple model probabilistic controller (MMPPC) anticipates meals when the patient is awake. The controller used the subject's basal rates and total daily insulin dose for initialization. The system was tested at two sites on 10 patients in a 30-h inpatient study, followed by 15 subjects at three sites in a 54-h supervised hotel study, where the controller was challenged by exercise and unannounced meals...
September 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28745093/optimal-use-of-diabetes-devices-clinician-perspectives-on-barriers-and-adherence-to-device-use
#18
Molly L Tanenbaum, Rebecca N Adams, Sarah J Hanes, Regan C Barley, Kellee M Miller, Shelagh A Mulvaney, Korey K Hood
BACKGROUND: Insulin pumps and continuous glucose monitors (CGM) can improve glycemic control for individuals with type 1 diabetes (T1D). Device uptake rates continue to show room for improvement, and consistent adherence is needed to achieve better outcomes. Diabetes health care providers have important roles to play in promoting device use and adherence. METHODS: We surveyed 209 clinicians who treat people with type 1 diabetes to examine perceptions of barriers to device uptake, attitudes toward diabetes technology, and resources needed for clinicians to improve device uptake...
May 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#19
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
October 20, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28711468/effect-of-initiating-use-of-an-insulin-pump-in-adults-with-type-1-diabetes-using-multiple-daily-insulin-injections-and-continuous-glucose-monitoring-diamond-a-multicentre-randomised-controlled-trial
#20
Roy W Beck, Tonya D Riddlesworth, Katrina J Ruedy, Craig Kollman, Andrew J Ahmann, Richard M Bergenstal, Anuj Bhargava, Bruce W Bode, Stacie Haller, Davida F Kruger, Janet B McGill, William Polonsky, David Price, Elena Toschi
BACKGROUND: The benefit of initiation of insulin pump therapy (continuous subcutaneous insulin infusion; CSII) in patients with type 1 diabetes using continuous glucose monitoring (CGM) has not been studied. We aimed to assess glycaemic outcomes when switching from multiple daily injections (MDI) to CSII in adults with type 1 diabetes using CGM. METHODS: In this multicentre, randomised controlled trial, 75 adults with type 1 diabetes in the CGM group of the DIAMOND trial were randomly assigned via the study website using a computer-generated sequence to continue MDI or switch to CSII, with continuation of CGM, for 28 weeks...
July 12, 2017: Lancet Diabetes & Endocrinology
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