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James R Blum, Elliot J Rayfield
No abstract text is available yet for this article.
March 2018: Endocrine Practice
George Grunberger, Yehuda Handelsman, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, Richard A Haas, Victor L Roberts, Guillermo E Umpierrez
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are 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...
March 2018: Endocrine Practice
Stefanie Kamann, Olivier Aerts, Lutz Heinemann
In the past decade, new diabetes technologies, including continuous glucose monitoring (CGM) systems, support patients with diabetes in their daily struggle with achieving a good glucose control. However, shortly after the first CGM systems appeared on the market, also the first concerns about adverse skin reactions were raised. Most patients claimed to suffer from (sometimes severe) skin irritation, or even allergy, which they related to the (acrylate-based) adhesive part of the device. For a long time the actual substance that caused these skin reactions with, for example, the Flash Glucose Monitoring system (iscCGM; Freestyle® Libre) could not be identified; however, recently Belgian and Swedish dermatologists reported that the majority of their patients that have developed a contact-allergic while using iscCGM react sensitively to a specific acrylate, that is, isobornyl acrylate (IBOA)...
March 1, 2018: Journal of Diabetes Science and Technology
Laura Gaetano, Dieter A Häring, Ernst-Wilhelm Radue, Nicole Mueller-Lenke, Avinash Thakur, Davorka Tomic, Ludwig Kappos, Till Sprenger
OBJECTIVE: To study the effect of fingolimod on deep gray matter (dGM), thalamus, cortical GM (cGM), white matter (WM), and ventricular volume (VV) in patients with relapsing-remitting multiple sclerosis (RRMS). METHODS: Data were pooled from 2 phase III studies. A total of 2,064 of 2,355 (88%) contributed to the analysis: fingolimod 0.5 mg n = 783, fingolimod 1.25 mg n = 799, or placebo n = 773. Percentage change from baseline in dGM and thalamic volumes was evaluated with FMRIB's Integrated Registration & Segmentation Tool; WM, cGM, and VV were evaluated with structural image evaluation using normalization of atrophy cross-sectional version (SIENAX) at months 12 and 24...
March 14, 2018: Neurology
Marion Waite, Clare Martin, Rachel Franklin, David Duce, Rachel Harrison
BACKGROUND: People with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different...
March 15, 2018: JMIR Human Factors
Giada Acciaroli, Martina Vettoretti, Andrea Facchinetti, Giovanni Sparacino
Minimally invasive continuous glucose monitoring (CGM) sensors are wearable medical devices that provide real-time measurement of subcutaneous glucose concentration. This can be of great help in the daily management of diabetes. Most of the commercially available CGM devices have a wire-based sensor, usually placed in the subcutaneous tissue, which measures a "raw" current signal via a glucose-oxidase electrochemical reaction. This electrical signal needs to be translated in real-time to glucose concentration through a calibration process...
March 13, 2018: Biosensors
Laura Affinito Bonabello, Davide Maggi, Samuele Fiorini, Veronica Tozzo, Renzo Cordera
No abstract text is available yet for this article.
March 10, 2018: Acta Diabetologica
Lyvia Biagi, Arthur Bertachi, Carmen Quirós, Marga Giménez, Ignacio Conget, Jorge Bondia, Josep Vehí
Continuous glucose monitoring (CGM) plays an important role in treatment decisions for patients with type 1 diabetes under conventional or closed-loop therapy. Physical activity represents a great challenge for diabetes management as well as for CGM systems. In this work, the accuracy of CGM in the context of exercise is addressed. Six adults performed aerobic and anaerobic exercise sessions and used two Medtronic Paradigm Enlite-2 sensors under closed-loop therapy. CGM readings were compared with plasma glucose during different periods: one hour before exercise, during exercise, and four hours after the end of exercise...
March 9, 2018: Biosensors
Wei Li, Fan Ping, Lingling Xu, Meicen Zhou, Hongmei Li, Yaxiu Dong, Yuxiu Li
INTRODUCTION: We compared the effects of insulin lispro mix 25 (LM25) and insulin lispro mix 50 (LM50) on postprandial glucose excursion in patients with type 2 diabetes mellitus (T2DM). METHODS: In this randomized, open-label, investigator-initiated trial, 81 T2DM patients treated with premixed human insulin 70/30 (PHI70/30) for more than 90 days were randomly divided into two groups and received a crossover protocol of either LM25 or LM50 twice daily for 16 weeks...
March 8, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Daisuke Matsutani, Masaya Sakamoto, Hiroyuki Iuchi, Souichirou Minato, Hirofumi Suzuki, Yosuke Kayama, Norihiko Takeda, Ryuzo Horiuchi, Kazunori Utsunomiya
BACKGROUND: It is presently unclear whether glycemic variability (GV) is associated with baroreflex sensitivity (BRS), which is an early indicator of cardiovascular autonomic neuropathy. The present study is the first to examine the relationships between BRS and GV measured using continuous glucose monitoring (CGM). METHODS: This was a multicenter, prospective, open-label clinical trial. A total of 102 patients with type 2 diabetes were consecutively recruited for this study...
March 7, 2018: Cardiovascular Diabetology
Yakui Li, Zhongchao Li, Hu Liu, Jean Noblet, Ling Liu, Defa Li, Fenglai Wang, Changhua Lai
Objective: The objective of this experiment was to determine the net energy (NE) content of full-fat rice bran (FFRB), corn germ meal (CGM), corn gluten feed (CGF), solvent-extracted peanut meal (PNM) and dehulled sunflower meal (SFM) fed to growing pigs using indirect calorimetry or published prediction equations. Methods: Twelve growing barrows with an average initial BW of 32.4 ± 3.3 kg were allotted to a replicated 3 × 6 Youden square design with 3 successive periods and 6 diets...
March 2, 2018: Asian-Australasian Journal of Animal Sciences
Makoto Ohara, Hiroe Nagaike, Satoshi Goto, Ayako Fukase, Yuki Tanabe, Masako Tomoyasu, Takeshi Yamamoto, Toshiyuki Hayashi, Tomoyasu Fukui, Tsutomu Hirano
AIMS: We aimed to evaluate which parameters of improvement in glucose metabolism reduce oxidative stress for patients with Type 2 diabetes mellitus (T2DM). METHODS: Sixty-seven outpatients with T2DM underwent 72 h of continuous glucose monitoring (CGM) and were measured for oxidative stress before and after a 24-week intervention with the following targets: fasting plasma glucose (FPG), <130 mg/dl; postprandial plasma glucose (PPG), <180 mg/dl; and glycated hemoglobin (HbA1c), <7% (53 mmol/mol)...
March 1, 2018: Diabetes Research and Clinical Practice
Leyla J Aouad, Philip Clayton, Kate R Wyburn, David M Gracey, Steven J Chadban
BACKGROUND: The evolution of glycaemic changes after kidney transplantation has not been described. We prospectively examined glycaemic control and variability over time from transplantation using continuous glucose monitoring(CGM). METHOD: CGM devices were fitted for 3-5 days at time of transplant, month 3 and month 6 posttransplant. Indices of glucose control (mean glucose, percent time in hyperglycemic range and GRADE score) and variability were calculated. An OGTT was performed at month 3...
February 28, 2018: Transplantation
André Rosentreter, Alexandra Lappas, Randolf Alexander Widder, Maged Alnawaiseh, Thomas Stefan Dietlein
BACKGROUND: To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). METHODS: Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva...
February 27, 2018: BMC Ophthalmology
Anna Korsgaard Berg, Birthe Susanne Olsen, Jacob P Thyssen, Claus Zachariae, Anne Birgitte Simonsen, Kasper Pilgaard, Jannet Svensson
BACKGROUND: Dermatological complications in children and adolescents that are related to continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) have not been well-characterized. This study examined the prevalence and characteristics of different types of dermatological complications. METHODS: Online questionnaires regarding dermatological complications related to CSII and/or CGM were returned from a total of 144 children and adolescents, aged 2 to 20 years...
February 26, 2018: Pediatric Diabetes
Anna Wood, David O'Neal, John Furler, Elif I Ekinci
The advent of devices that can track interstitial glucose levels which are closely related to blood glucose levels on a near continuous basis has facilitated better insights into patterns of glycaemia. Continuous glucose monitoring (CGM) therefore allows for more intensive monitoring of blood glucose levels and potentially improved glycaemic control. In the context of the announcement on 1 April 2017 that the Australian Government will fund CGM monitoring for people with type 1 diabetes under the age of 21, this paper provides a review of the evidence for CGM and some of the ongoing challenges...
February 21, 2018: Internal Medicine Journal
J Lawton, M Blackburn, J Allen, F Campbell, D Elleri, L Leelarathna, D Rankin, M Tauschmann, H Thabit, R Hovorka
BACKGROUND: Continuous glucose monitoring (CGM) enables users to view real-time interstitial glucose readings and provides information on the direction and rate of change of blood glucose levels. Users can also access historical data to inform treatment decisions. While the clinical and psychological benefits of CGM are well established, little is known about how individuals use CGM to inform diabetes self-management. We explored participants' experiences of using CGM in order to provide recommendations for supporting individuals to make optimal use of this technology...
February 20, 2018: BMC Endocrine Disorders
Max Bingham
Welcome to Diabetes Spectrum 's first installment of Diabetes is Primary, a round-up of the latest diabetes developments for health care providers. In this issue, we take a look at radical weight loss for diabetes remission, Hong Kong's diabetes risk assessment and management program, personalized A1C targets, and diabetes diagnoses. The American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) panel gives its verdict on continuous glucose monitoring (CGM) devices, and we learn how Medicare will soon pay for a diabetes prevention program...
February 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
Ana M Gómez, Oscar M Muñoz, Alejandro Marin, Maria Camila Fonseca, Martin Rondon, María Alejandra Robledo Gómez, Andrei Sanko, Dilcia Lujan, Maira García-Jaramillo, Fabian Mauricio León Vargas
INTRODUCTION: Recent publications frequently introduce new indexes to measure glycemic variability (GV), quality of glycemic control, or glycemic risk; however, there is a lack of evidence supporting the use of one particular parameter, especially in clinical practice. METHODS: A cohort of type 2 diabetes mellitus (T2DM) patients in ambulatory care were followed using continuous glucose monitoring sensors (CGM). Mean glucose (MG), standard deviation, coefficient of variation (CV), interquartile range, CONGA1, 2, and 4, MAGE, M value, J index, high blood glucose index, and low blood glucose index (LBGI) were estimated...
February 1, 2018: Journal of Diabetes Science and Technology
Savitha Subramanian, Irl B Hirsch
PURPOSE OF REVIEW: Diabetes is the leading cause of kidney disease globally. Diabetic kidney disease (DKD) is a heterogeneous disorder manifested as albuminuria and/or decreasing GFR. Hyperglycemic burden is the major contributor to the development of DKD. In this article, we review the evidence for the contribution of glycemic variability and the pitfalls associated with use of hemoglobin A1c (A1C), the gold standard for assessment of glucose control, in the setting of DKD. RECENT FINDINGS: Glycemic variability, characterized by swings in blood glucose levels, can result in generation of mitochondrial reactive oxygen species, a putative inciting factor for hyperglycemia-induced alterations in intracellular metabolic pathways...
February 15, 2018: Current Diabetes Reports
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