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insulin pump and cgm

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https://www.readbyqxmd.com/read/28627221/management-and-family-burdens-endorsed-by-parents-of-youth-7-years-old-with-type-1-diabetes
#1
Kara 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 549 children was 5...
February 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28617628/pilot-study-of-a-novel-application-for-data-visualization-in-type-1-diabetes
#2
Jenise C Wong, Aaron B Neinstein, Howard Look, Brandon Arbiter, Nora Chokr, Cassie Ross, Saleh Adi
BACKGROUND: A novel software application, Blip, was created to combine and display diabetes data from multiple devices in a uniform, user-friendly manner. The objective of this study was to test the usability of this application by adults and caregivers of children with type 1 diabetes (T1D). METHODS: Patients (n = 35) and caregivers of children with T1D (n = 30) using an insulin pump for >1 year ± CGM were given access to the software for 3 months. Diabetes management practices and the use of diabetes data were assessed at baseline and at study end, and feedback was gathered in a concluding questionnaire...
February 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28616804/hypoglycemic-event-frequency-and-the-effect-of-continuous-glucose-monitoring-in-adults-with-type-1-diabetes-using-multiple-daily-insulin-injections
#3
Tonya Riddlesworth, David Price, Nathan Cohen, Roy W Beck
INTRODUCTION: The benefits of continuous glucose monitoring (CGM) in type 1 diabetes have been established among adults using insulin pumps. The DIAMOND randomized clinical trial examined the effectiveness of using CGM in improving glycemic control in participants using insulin injections. The frequency of hypoglycemic events in this trial has not been previously examined. METHODS: Adults with type 1 diabetes using multiple daily insulin injections (MDI) with A1C values of 7...
June 14, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28591776/efficacy-and-safety-of-mini-dose-glucagon-for-treatment-of-non-severe-hypoglycemia-in-adults-with-type-1-diabetes
#4
Morey W Haymond, Stephanie N DuBose, Michael R Rickels, Howard Wolpert, Viral N Shah, Jennifer L Sherr, Ruth S Weinstock, Shivani Agarwal, Alandra S Verdejo, Martin J Cummins, Brett Newswanger, Roy W Beck
Context: Standard treatment for hypoglycemia is oral carbohydrate, but often results in hyperglycemia and requires extra caloric intake. Objective: To evaluate the use of low-dose glucagon to treat mild hypoglycemia in ambulatory adults with type 1 diabetes (T1D). Design: Randomized crossover trial (two 3-week periods). Setting: Five U.S. diabetes clinics. Patients: Twenty adults with T1D using an insulin pump and continuous glucose monitor (CGM) and experiencing frequent mild hypoglycemia...
June 7, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28585879/continuous-glucose-monitoring-a-review-of-recent-studies-demonstrating-improved-glycemic-outcomes
#5
David Rodbard
Continuous Glucose Monitoring (CGM) has been demonstrated to be clinically valuable, reducing risks of hypoglycemia and hyperglycemia, glycemic variability (GV), and improving patient quality of life for a wide range of patient populations and clinical indications. Use of CGM can help reduce HbA1c and mean glucose. One CGM device, with accuracy (%MARD) of approximately 10%, has recently been approved for self-adjustment of insulin dosages (nonadjuvant use) and approved for reimbursement for therapeutic use in the United States...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28584075/application-of-zone-model-predictive-control-artificial-pancreas-during-extended-use-of-infusion-set-and-sensor-a-randomized-crossover-controlled-home-use-trial
#6
Gregory P Forlenza, Sunil Deshpande, Trang T Ly, Daniel P Howsmon, Faye Cameron, Nihat Baysal, Eric Mauritzen, Tatiana Marcal, Lindsey Towers, B Wayne Bequette, Lauren M Huyett, Jordan E Pinsker, Ravi Gondhalekar, Francis J Doyle, David M Maahs, Bruce A Buckingham, Eyal Dassau
OBJECTIVE: As artificial pancreas (AP) becomes standard of care, consideration of extended use of insulin infusion sets (IIS) and continuous glucose monitors (CGMs) becomes vital. We conducted an outpatient randomized crossover study to test the safety and efficacy of a zone model predictive control (zone-MPC)-based AP system versus sensor augmented pump (SAP) therapy in which IIS and CGM failures were provoked via extended wear to 7 and 21 days, respectively. RESEARCH DESIGN AND METHODS: A smartphone-based AP system was used by 19 adults (median age 23 years [IQR 10], mean 8...
June 5, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28581817/insulin-pump-use-in-young-children-with-type-1-diabetes-sociodemographic-factors-and-parent-reported-barriers
#7
Persis V Commissariat, Claire T Boyle, Kellee M Miller, Manasa G Mantravadi, Daniel J DeSalvo, William V Tamborlane, Michelle A Van Name, Barbara J Anderson, Linda A DiMeglio, Lori M Laffel
BACKGROUND: Managing type 1 diabetes (T1D) in young children presents challenges to families and caregivers. Pump therapy may reduce challenges and benefit glycemic control. However, pump use is not universal; parent-reported reasons for lack of uptake are not well described. METHODS: Parents of children <7, with T1D for ≥1 year, in the T1D Exchange registry completed surveys capturing demographic and clinical characteristics, as well as barriers to pump use...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28533136/effect-of-artificial-pancreas-systems-on-glycaemic-control-in-patients-with-type-1-diabetes-a-systematic-review-and-meta-analysis-of-outpatient-randomised-controlled-trials
#8
Alanna Weisman, Johnny-Wei Bai, Marina Cardinez, Caroline K Kramer, Bruce A Perkins
BACKGROUND: Closed-loop artificial pancreas systems have been in development for several years, including assessment in numerous varied outpatient clinical trials. We aimed to summarise the efficacy and safety of artificial pancreas systems in outpatient settings and explore the clinical and technical factors that can affect their performance. METHODS: We did a systematic review and meta-analysis of randomised controlled trials comparing artificial pancreas systems (insulin only or insulin plus glucagon) with conventional pump therapy (continuous subcutaneous insulin infusion [CSII] with blinded continuous glucose monitoring [CGM] or unblinded sensor-augmented pump [SAP] therapy) in adults and children with type 1 diabetes...
May 19, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28503717/a-review-of-the-current-challenges-associated-with-the-development-of-an-artificial-pancreas-by-a-double-subcutaneous-approach
#9
REVIEW
Sverre Christian Christiansen, Anders Lyngvi Fougner, Øyvind Stavdahl, Konstanze Kölle, Reinold Ellingsen, Sven Magnus Carlsen
INTRODUCTION: Patients with diabetes type 1 (DM1) struggle daily to achieve good glucose control. The last decade has seen a rush of research groups working towards an artificial pancreas (AP) through the application of a double subcutaneous approach, i.e., subcutaneous (SC) continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion. Few have focused on the fundamental limitations of this approach, especially regarding outcome measures beyond time in range. METHODS: Based on insulin physiology, the limitations of CGM, SC insulin absorption, meal challenge, and physical activity in DM1 patients, we discuss the limitations of the double SC approach...
June 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28484424/continuous-subcutaneous-insulin-infusion-in-children-a-pilot-study-validating-a-protocol-to-avoid-hypoglycemia-at-initiation
#10
Despoina Manousaki, Johnny Deladoëy, Louis Geoffroy, Patricia Olivier
BACKGROUND: The occurrence of hypoglycemia and hyperglycemia during the first days after transition to continuous subcutaneous insulin infusion (CSII) in patients with type 1 diabetes has not been systematically studied in children. The aim of this prospective study was to demonstrate that the protocol applied in our diabetes clinic is safe at CSII initiation in children. METHODS: We assessed 22 pediatric patients with type 1 diabetes, using continuous glucose monitoring (CGM) before and after CSII initiation (±3 days)...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28459603/closed-loop-control-of-postprandial-glycemia-using-an-insulin-on-board-limitation-through-continuous-action-on-glucose-target
#11
Paolo Rossetti, Carmen Quirós, Vanessa Moscardó, Anna Comas, Marga Giménez, F Javier Ampudia-Blasco, Fabián León, Eslam Montaser, Ignacio Conget, Jorge Bondia, Josep Vehí
BACKGROUND: Postprandial (PP) control remains a challenge for closed-loop (CL) systems. Few studies with inconsistent results have systematically investigated the PP period. OBJECTIVE: To compare a new CL algorithm with current pump therapy (open loop [OL]) in the PP glucose control in type 1 diabetes (T1D) subjects. METHODS: A crossover randomized study was performed in two centers. Twenty T1D subjects (F/M 13/7, age 40.7 ± 10.4 years, disease duration 22...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28426239/performance-of-an-artificial-pancreas-system-for-young-children-with-type-1-diabetes
#12
Mark D DeBoer, Marc D Breton, Christian Wakeman, Elaine M Schertz, Emma G Emory, Jessica L Robic, Laura L Kollar, Boris P Kovatchev, Daniel R Cherñavvsky
BACKGROUND: Young children 5-8 years old with type 1 diabetes (T1D) exhibit clear needs for improved glycemic control but may be limited in their ability to safely interact with an artificial pancreas system. Our goal was to evaluate the safety and performance of an artificial pancreas (AP) system among young children with T1D. RESEARCH DESIGN AND METHODS: In a randomized, crossover trial, children with T1D age 5-8 years were enrolled to receive on separate study periods (in random order) either the UVa AP using the DiAs Control Platform software with child-resistant lock-out screens (followed as an out-patient admission) or their usual insulin pump+continuous glucose monitor (CGM) care at home...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28296467/comparison-of-insulin-pump-therapy-and-multiple-daily-injections-insulin-regimen-in-patients-with-type-1-diabetes-during-ramadan-fasting
#13
Reem Alamoudi, Maram Alsubaiee, Ali Alqarni, Yousef Saleh, Saleh Aljaser, Abdul Salam, Mohsen Eledrisi
INTRODUCTION: Fasting Ramadan carries a high risk for patients with type 1 diabetes (T1DM). Data on the optimum insulin regimen in these patients are limited. OBJECTIVES: To compare glucose profiles in patients with T1DM who use continuous subcutaneous insulin infusion (CSII) compared with those who use multiple daily injections (MDI) insulin regimen during Ramadan fast. The primary outcome was rates of hypoglycemia. Other outcomes included glycemic control, number of days needed to break fasting, and acute glycemic complications...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28272368/use-of-wearable-sensors-and-biometric-variables-in-an-artificial-pancreas-system
#14
Kamuran Turksoy, Colleen Monforti, Minsun Park, Garett Griffith, Laurie Quinn, Ali Cinar
An artificial pancreas (AP) computes the optimal insulin dose to be infused through an insulin pump in people with Type 1 Diabetes (T1D) based on information received from a continuous glucose monitoring (CGM) sensor. It has been recognized that exercise is a major challenge in the development of an AP system. The use of biometric physiological variables in an AP system may be beneficial for prevention of exercise-induced challenges and better glucose regulation. The goal of the present study is to find a correlation between biometric variables such as heart rate (HR), heat flux (HF), skin temperature (ST), near-body temperature (NBT), galvanic skin response (GSR), and energy expenditure (EE), 2D acceleration-mean of absolute difference (MAD) and changes in glucose concentrations during exercise via partial least squares (PLS) regression and variable importance in projection (VIP) in order to determine which variables would be most useful to include in a future artificial pancreas...
March 7, 2017: Sensors
https://www.readbyqxmd.com/read/28251726/outcomes-of-algorithm-based-modifications-of-insulinotherapy-during-exercise-in-mdi-vs-insulin-pump-treated-children-with-type-1-diabetes-results-from-the-tread-diab-study
#15
S Moniotte, M Owen, T Barrea, A Robert, P A Lysy
OBJECTIVES: To evaluate the evolution of subcutaneous glucose (SG) after a standardized aerobic exercise in children and adolescents treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injection (MDI) regimen before and after adaptation of insulin doses. RESEARCH DESIGN AND METHODS: Eleven CSII- and 13 MDI-treated patients performed 2 30-minute sessions of moderate to vigorous (70% of age-based maximal heart rate) exercise on a treadmill under continuous glucose monitoring (CGM)...
March 2, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28245152/real-world-use-and-self-reported-health-outcomes-of-a-patient-designed-do-it-yourself-mobile-technology-system-for-diabetes-lessons-for-mobile-health
#16
Joyce M Lee, Mark W Newman, Achamyeleh Gebremariam, Preciosa Choi, Dana Lewis, Weston Nordgren, John Costik, James Wedding, Benjamin West, Nancy Benovich Gilby, Christopher Hannemann, Josh Pasek, Ashley Garrity, Emily Hirschfeld
BACKGROUND: The aim of this study is to compare demographic/disease characteristics of users versus nonusers of a do-it-yourself (DIY) mobile technology system for diabetes (Nightscout), to describe its uses and personalization, and to evaluate associated changes in health behaviors and outcomes. METHODS: A cross-sectional, household-level online survey was used. Of 1268 household respondents who were members of the CGM in the Cloud Facebook group, there were 1157 individuals with diabetes who provided information about Nightscout use...
April 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28236571/multicentre-randomized-controlled-trial-with-sensor-augmented-pump-vs-multiple-daily-injections-in-hospitalized-patients-with-type-2-diabetes-in-china-time-to-reach-target-glucose
#17
W Gu, Y Liu, Y Chen, W Deng, X Ran, L Chen, D Zhu, J Yang, J Shin, S W Lee, T L Cordero, Y Mu
AIM: Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM). METHODS: Adults (aged 18-65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period...
February 21, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28221823/evaluation-of-a-predictive-low-glucose-management-system-in-clinic
#18
Bruce A Buckingham, Timothy S Bailey, Mark Christiansen, Satish Garg, Stuart Weinzimer, Bruce Bode, Stacey M Anderson, Ronald Brazg, Trang T Ly, Francine R Kaufman
BACKGROUND: Predictions based on continuous glucose monitoring (CGM) data are the basis for automatic suspension and resumption of insulin delivery by a predictive low-glucose management feature termed "suspend before low," which is part of the Medtronic MiniMed(®) 640G combined insulin pump and CGM system. This study assessed the safety and performance characteristics of the system in an in-clinic setting at eight sites. MATERIALS AND METHODS: In-clinic standardized increases in basal insulin delivery rates were used to induce nocturnal hypoglycemia in subjects (14-75 years) with type 1 diabetes wearing the MiniMed 640G system...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28209654/replace-bg-a-randomized-trial-comparing-continuous-glucose-monitoring-with-and-without-routine-blood-glucose-monitoring-in-adults-with-well-controlled-type-1-diabetes
#19
Grazia Aleppo, Katrina J Ruedy, Tonya D Riddlesworth, Davida F Kruger, Anne L Peters, Irl Hirsch, Richard M Bergenstal, Elena Toschi, Andrew J Ahmann, Viral N Shah, Michael R Rickels, Bruce W Bode, Athena Philis-Tsimikas, Rodica Pop-Busui, Henry Rodriguez, Emily Eyth, Anuj Bhargava, Craig Kollman, Roy W Beck
OBJECTIVE: To determine whether the use of continuous glucose monitoring (CGM) without confirmatory blood glucose monitoring (BGM) measurements is as safe and effective as using CGM adjunctive to BGM in adults with well-controlled type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: A randomized noninferiority clinical trial was conducted at 14 sites in the T1D Exchange Clinic Network. Participants were ≥18 years of age (mean 44 ± 14 years), had T1D for ≥1 year (mean duration 24 ± 12 years), used an insulin pump, and had an HbA1c ≤9...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28118453/effect-of-continuous-glucose-monitoring-on-glycemic-control-in-adults-with-type-1-diabetes-using-insulin-injections-the-diamond-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Roy W Beck, Tonya Riddlesworth, Katrina Ruedy, Andrew Ahmann, Richard Bergenstal, Stacie Haller, Craig Kollman, Davida Kruger, Janet B McGill, William Polonsky, Elena Toschi, Howard Wolpert, David Price
Importance: Previous clinical trials showing the benefit of continuous glucose monitoring (CGM) in the management of type 1 diabetes predominantly have included adults using insulin pumps, even though the majority of adults with type 1 diabetes administer insulin by injection. Objective: To determine the effectiveness of CGM in adults with type 1 diabetes treated with insulin injections. Design, Setting, and Participants: Randomized clinical trial conducted between October 2014 and May 2016 at 24 endocrinology practices in the United States that included 158 adults with type 1 diabetes who were using multiple daily insulin injections and had hemoglobin A1c (HbA1c) levels of 7...
January 24, 2017: JAMA: the Journal of the American Medical Association
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