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https://www.readbyqxmd.com/read/28990436/acceptability-of-implantable-continuous-glucose-monitoring-sensor
#1
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
#2
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
#3
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
#4
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...
September 1, 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
#5
Denice S Feig, Lois E Donovan, Rosa Corcoy, Kellie E Murphy, Stephanie A Amiel, Katharine F Hunt, Elisabeth 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 14, 2017: Lancet
https://www.readbyqxmd.com/read/28880188/a-review-of-safety-and-hazards-associated-with-the-artificial-pancreas
#6
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
#7
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
#8
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
#9
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...
August 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28767276/closed-loop-control-without-meal-announcement-in-type-1-diabetes
#10
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
#11
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
#12
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...
July 18, 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
#13
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
https://www.readbyqxmd.com/read/28666360/overnight-closed-loop-control-improves-glycemic-control-in-a-multicenter-study-of-adults-with-type-1-diabetes
#14
Sue A Brown, Marc D Breton, Stacey M Anderson, Laura Kollar, Patrick Keith-Hynes, Carol J Levy, David W Lam, Camilla Levister, Nihat Baysal, Yogish C Kudva, Ananda Basu, Vikash Dadlani, Ling Hinshaw, Shelly McCrady-Spitzer, Daniela Bruttomesso, Roberto Visentin, Silvia Galasso, Simone Del Favero, Yenny Leal, Federico Boscari, Angelo Avogaro, Claudio Cobelli, Boris P Kovatchev
Context: Closed-loop control (CLC) for the management of T1D is a novel method for optimizing glucose control and strategies for individualized implementation are being developed. Objective: Analyze glycemic control in an Overnight CLC system designed to "reset" the patient to near normal glycemic targets every morning. Design: Randomized cross-over multicenter clinical trial. Participants: 44 subjects with T1D on insulin pump therapy...
June 28, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28627221/retracted-management-and-family-burdens-endorsed-by-parents-of-youth-7-years-old-with-type-1-diabetes
#15
Kara Harrington, Claire T Boyle, Kellee M Miller, Marisa E Hilliard, Barbara J Anderson, Michelle Van Name, Linda A DiMeglio, Lori M Laffel
No abstract text is available yet for this article.
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
#16
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...
July 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
#17
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...
August 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-nonsevere-hypoglycemia-in-adults-with-type-1-diabetes
#18
RANDOMIZED CONTROLLED TRIAL
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 of hypoglycemia is oral carbohydrate, but it often results in hyperglycemia and entails extra caloric intake. Objective: To evaluate 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...
August 1, 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
#19
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
#20
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...
August 2017: Diabetes Care
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