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insulin pump and cgm

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]
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
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
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...
May 17, 2016: Canadian Journal of Diabetes
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
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...
May 20, 2016: Journal of Diabetes Science and Technology
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
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
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
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
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
Rob Riemsma, Isaac Corro Ramos, Richard Birnie, Nasuh Büyükkaramikli, Nigel Armstrong, Steve Ryder, Steven Duffy, Gill Worthy, Maiwenn Al, Johan Severens, Jos Kleijnen
BACKGROUND: In recent years, meters for continuous monitoring of interstitial fluid glucose have been introduced to help people with type 1 diabetes mellitus (T1DM) to achieve better control of their disease. OBJECTIVE: The objective of this project was to summarise the evidence on the clinical effectiveness and cost-effectiveness of the MiniMed(®) Paradigm™ Veo system (Medtronic Inc., Northridge, CA, USA) and the Vibe™ (Animas(®) Corporation, West Chester, PA, USA) and G4(®) PLATINUM CGM (continuous glucose monitoring) system (Dexcom Inc...
February 2016: Health Technology Assessment: HTA
Sarit Polsky, Dominique Giordano, Mary K Voelmle, Rachel Garcetti, Satish K Garg
The prevalence of diabetes is increasing globally. Technology to improve care among individuals with diabetes is constantly being developed. Women living with Type 1 Diabetes Mellitus (T1DM) have unique challenges affecting their glucose control relating to menstrual cycles, pregnancy, and menopause. The purpose of this review is to examine the literature related to the use of technology to help women with T1DM manage their diabetes during the reproductive years, pregnancy, and beyond. Continuous subcutaneous insulin infusion (CSII) therapy can provider equivalent or better glucose control when compared with multiple daily injections (MDI), with less hypoglycemia, diabetic ketoacidosis, and weight gain...
May 2016: Postgraduate Medicine
Martin de Bock, Matthew Cooper, Adam Retterath, Jennifer Nicholas, Trang Ly, Timothy Jones, Elizabeth Davis
AIMS: This study reports continuous glucose monitoring (CGM) adherence patterns and contributing factors in patients who were part of a 6-month clinical trial using sensor augmented pump therapy with low glucose insulin suspension. METHODS: CGM data from 38 patients using sensor augmented pump therapy for 6 months were analyzed. CGM adherence was defined by having a working sensor available and determined by the time it was switched on as a proportion of available time for the 6 month study period with allowance for practical CGM use...
May 2016: Journal of Diabetes Science and Technology
Carlo Acerini
Health-care technologies have brought many benefits to the medical profession and to patients. The introduction of the continuous subcutaneous insulin infusion (CSII) pump and continuous glucose monitoring (CGM) devices offers patients with type 1 diabetes (T1D) the opportunity to optimize their blood glucose control and are increasingly being championed as a routine treatment approach for young people. However, the current evidence base does not convincingly support arguments for the generalized application of CSII and CGM into routine clinical practice...
May 2016: Pediatric Diabetes
Steven J Russell, Mallory A Hillard, Courtney Balliro, Kendra L Magyar, Rajendranath Selagamsetty, Manasi Sinha, Kerry Grennan, Debbie Mondesir, Laya Ehklaspour, Hui Zheng, Edward R Damiano, Firas H El-Khatib
BACKGROUND: The safety and efficacy of continuous, multiday, automated glycaemic management has not been tested in outpatient studies of preadolescent children with type 1 diabetes. We aimed to compare the safety and efficacy of a bihormonal bionic pancreas versus conventional insulin pump therapy in this population of patients in an outpatient setting. METHODS: In this randomised, open-label, crossover study, we enrolled preadolescent children (aged 6-11 years) with type 1 diabetes (diagnosed for ≥1 year) who were on insulin pump therapy, from two diabetes camps in the USA...
March 2016: Lancet Diabetes & Endocrinology
Timothy S Bailey, George Grunberger, Bruce W Bode, Yehuda Handelsman, Irl B Hirsch, Lois Jovanovič, Victor Lawrence Roberts, David Rodbard, William V Tamborlane, John Walsh
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there were 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...
February 2016: Endocrine Practice
Ivana Rabbone, Fabrizio Barbetti, Marco Marigliano, Riccardo Bonfanti, Elvira Piccinno, Federica Ortolani, Giovanna Ignaccolo, Claudio Maffeis, Santino Confetto, Franco Cerutti, Angela Zanfardino, Dario Iafusco
AIMS: Neonatal diabetes mellitus (NDM) is defined as hyperglycemia and impaired insulin secretion with onset within 6 months of birth. While rare, NDM presents complex challenges regarding the management of glycemic control. The availability of continuous subcutaneous insulin infusion pumps (CSII) in combination with continuous glucose monitoring systems (CGM) provides an opportunity to monitor glucose levels more closely and deliver insulin more safely. METHODS: We report four cases of young infants with NDM successfully treated with CSII and CGM...
August 2016: Acta Diabetologica
Lutz Heinemann, J Hans DeVries
Continuous glucose monitoring (CGM) systems have been available for more than 15 years by now. However, market uptake is relatively low in most countries; in other words, relatively few patients with diabetes use CGM systems regularly. One major reason for the reluctance of patients to use CGM systems is the costs associated (i.e., in most countries no reimbursement is provided by the health insurance companies). In case reimbursement is in place, like in the United States, only certain patient groups get reimbursement that fulfills strict indications...
February 2016: Diabetes Technology & Therapeutics
David Rodbard
Continuous glucose monitoring (CGM) provides information unattainable by intermittent capillary blood glucose, including instantaneous real-time display of glucose level and rate of change of glucose, alerts and alarms for actual or impending hypo- and hyperglycemia, "24/7" coverage, and the ability to characterize glycemic variability. Progressively more accurate and precise, reasonably unobtrusive, small, comfortable, user-friendly devices connect to the Internet to share information and are sine qua non for a closed-loop artificial pancreas...
February 2016: Diabetes Technology & Therapeutics
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