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Fumitaka Okajima, Tomoko Nagamine, Yuko Nakamura, Naomi Hattori, Hitoshi Sugihara, Naoya Emoto
The efficacy of the administration of sodium-glucose co-transporter 2 inhibitor (SGLT2I) or the co-administration of SGLT2I and dipeptidyl peptidase-4 inhibitor (DPP-4I) to insulin therapy is not well known. Fifty-eight patients with type 2 diabetes, admitted for glycemic control, were randomized to basal-bolus insulin therapy (BBT) alone or BBT plus 50 mg ipragliflozin and/or 20 mg teneligliptin. Insulin doses were adjusted to maintain normal blood glucose levels. Plasma glucose profiles were estimated by continuous glucose monitoring (CGM) before discharge...
October 20, 2016: Journal of Diabetes Investigation
Kevin R Lewis, Susan McCrone, Pamela Deiriggi, Sachin Bendre
OBJECTIVE: The purpose of this study was to determine the effect of continuous glucose monitoring (CGM) on glycemic control in children, adolescents, and young adults ages 7-21 years with poorly controlled diabetes HbA1c 9.0% or more (74 mmol/mol IFCC). MATERIALS AND METHODS: The primary outcome was improvement in HbA1c. The secondary outcome included self-reported hypoglycemia. This 12-week study used a prospective, one-group, pre- and posttest pre-experimental design with a convenience sample...
October 14, 2016: Journal for Specialists in Pediatric Nursing: JSPN
Viswanathan Mohan, Sunil Jain, Jothydev Kesavadev, Manoj Chawla, Abhay Mutha, Vijay Viswanathan, Banshi Saboo, Rajiv Kovil, Ambrish Mithal, Dharmen Punatar, John Shin
BACKGROUND: Retrospective continuous glucose monitoring (CGM) studies may provide healthcare professionals (HCPs) with better understanding of glycemic patterns in patients with type 2 diabetes (T2D) and thereby support patient education and appropriate therapeutic interventions. METHODS: Adults with T2D and A1C values between 8% and 10% were eligible for this 3-month study. Patients were scheduled for 5 visits that included baseline and a month-2 retrospective CGM study (iPro2, Medtronic) followed by data review and therapy modifications...
April 2016: Journal of the Association of Physicians of India
Mark D DeBoer, Daniel R Cherñavvsky, Katarina Topchyan, Boris P Kovatchev, Gary L Francis, Marc D Breton
OBJECTIVE: To evaluate the safety and performance of using a heart rate (HR) monitor to inform an artificial pancreas (AP) system during exercise among adolescents with type 1 diabetes (T1D). MATERIALS AND METHODS: In a randomized, cross-over trial, adolescents with T1D age 13 - 18 years were enrolled to receive on separate days either the unmodified UVa AP (stdAP) or an AP system connected to a portable HR monitor (AP-HR) that triggered an exercise algorithm for blood glucose (BG) control...
October 13, 2016: Pediatric Diabetes
Nalani Haviland, John Walsh, Ruth Roberts, Timothy S Bailey
Since the early 2000s, continuous glucose monitoring (CGM) technology has advanced to become a standard of care in the treatment of type 1 diabetes. Unfortunately, CGM use is not commonly integrated into practice. This article will review the history, technology, and need for systematic training in CGM. Additionally, it will review recent clinical trial data demonstrating the benefits that CGM offers to all people with type 1 diabetes and the clinicians who care for them.
November 2016: Current Diabetes Reports
Brian J Martin, Martin J MacInnis, Jenna B Gillen, Lauren E Skelly, Martin J Gibala
Green tea extract (GTE) ingestion improves glucose homeostasis in healthy and diabetic humans, but the interactive effect of GTE and exercise is unknown. The present study examined the effect of short-term GTE supplementation on the glycemic response to an oral glucose load at rest and following an acute bout of exercise, as well as substrate oxidation during exercise. Eleven sedentary, overweight men with fasting plasma glucose (FPG) ≥5.6 mmol·L(-1) (age, 34 ± 13 years; body mass index = 32 ± 5 kg·m(-2); FPG = 6...
June 15, 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Tracey J Smith, Marques A Wilson, James P Karl, Krista Austin, Asma Bukhari, Stefan M Pasiakos, Kristie L O'Connor, Harris R Lieberman
: Military personnel and some athlete populations endure short-term energy deficits from reduced energy intake and/or increased energy expenditure (EE) that may degrade physical and cognitive performance due to severe hypoglycemia (<3.1 mmol/L). The extent to which energy deficits alter normoglycemia (3.9-7.8 mmol/L) in healthy individuals is not known since prior studies measured glucose infrequently, not continuously. PURPOSE: To characterize the glycemic response to acute, severe energy deficit compared to fully fed control condition, using continuous glucose monitoring (CGM)...
September 29, 2016: Journal of Applied Physiology
Ivan Zeljković, Hrvoje Pintarić, Mislav Vrsalović, Ivan Kruljac
AIMS: To investigate the effectiveness of cardiogoniometry, a novel, non-invasive method, in diagnosing coronary artery disease (CAD) in women and compare it with exercise-ECG test, by using coronary angiography as a reference method. METHODS: It was a single-centre, case-series study including consecutive female patients with stable angina pectoris undergoing coronary angiography. Exercise-ECG test, done according to the Bruce protocol, and cardiogoniometry were obtained prior to coronary angiography...
September 23, 2016: QJM: Monthly Journal of the Association of Physicians
Robert P Hoffman, Amanda S Dye, Hong Huang, John A Bauer
BACKGROUND: Adolescents with type 1 diabetes (T1D) have increased risk of cardiovascular disease as well as elevations in biomarkers of systemic inflammation, plasma protein oxidation and vascular endothelial injury. It is unclear whether hyperglycemia itself, or variations in blood glucose are predictors of these abnormalities. METHODS: This study was designed to determine the relationship of inflammatory (C-reactive protein, CRP), oxidative (total anti-oxidative capacity, TAOC) and endothelial injury (soluble intracellular adhesion molecule 1, sICAM1) markers to glycemic control measures from 3 days of continuous glucose monitoring (CGM) and to hemoglobin A1c (HbA1c), and HbA1c×duration area under the curve (A1cDur)...
October 1, 2016: Journal of Pediatric Endocrinology & Metabolism: JPEM
Takashi Shimoyama, Kazumi Kimura, Junichi Uemura, Naoki Saji, Kensaku Shibazaki
BACKGROUND: The aim of the present study was to clarify the effect of glucose profiles after stroke, which was assessed by a continuous glucose monitoring (CGM) device. METHODS: Acute ischemic stroke patients within 24 h of onset were prospectively studied. CGM was performed for 72 h after admission. CGM parameters were evaluated as follows: (1) mean glucose level, (2) area under the curve (AUC) for glucose level >140 mg/dl and (3) SD of the glucose level. Infarct volume was measured at admission and 24 and 72 h after admission using diffusion-weighted imaging...
September 20, 2016: European Neurology
Cornelis A J van Beers, J Hans DeVries, Susanne J Kleijer, Mark M Smits, Petronella H Geelhoed-Duijvestijn, Mark H H Kramer, Michaela Diamant, Frank J Snoek, Erik H Serné
BACKGROUND: Patients with type 1 diabetes who have impaired awareness of hypoglycaemia have a three to six times increased risk of severe hypoglycaemia. We aimed to assess whether continuous glucose monitoring (CGM) improves glycaemia and prevents severe hypoglycaemia compared with self-monitoring of blood glucose (SMBG) in this high-risk population. METHODS: We did a randomised, open-label, crossover trial (IN CONTROL) at two medical centres in the Netherlands...
September 14, 2016: Lancet Diabetes & Endocrinology
Eijiro Yamada, Shuichi Okada, Yasuyo Nakajima, Claire C Bastie, Manu Vatish, Yuko Tagaya, Aya Osaki, Yoko Shimoda, Ryo Shibusawa, Tsugumichi Saito, Takashi Okamura, Atsushi Ozawa, Masanobu Yamada
AIMS: Optimum therapy for patients with diabetes depends on both acute and long-term changes in plasma glucose, generally assessed by HbA1c levels. However, the correlation between HbA1c and circulating glucose has not been fully determined. Therefore, we carefully examined this correlation when glucose levels were assessed by continuous glucose monitoring (CGM). METHODS: 51 patients (70 % women, 30% male) were examined; among them were 28 type 1 patients with diabetes and 23 type 2 patients with diabetes...
September 15, 2016: Endocrine Practice
Steven V Edelman
The FDA recently conducted an Advisory Panel meeting to evaluate the safety, efficacy, and benefits of granting a nonadjunctive label claim for the DEXCOM G5 Mobile continuous glucose monitoring (CGM) system. If approved, this claim will allow users to make day-to-day treatment decisions, including insulin dosing directly from the glucose values and rate of changes arrows generated by the CGM device, without the requirement of a confirmatory measurement with a self-monitoring blood glucose (SMBG) meter. Sporadic SMBG testing gives limited data, while CGM gives a value every 5 minutes and has alerts, alarms, trending information and allows caregivers to follow the user in real time 24/7...
September 13, 2016: Journal of Diabetes Science and Technology
Dukhabandhu Naik, Hesarghatta Shyamasynder Asha, Mahesh Doddabelavangala Mruthyunjaya, Rita Gupta Patil L, Thomas Vizhalil Paul, Flory Christina, Mercy Inbakumari, Ruby Jose, Jessie Lionel, Annie Regi, P Visalakshi Jeyaseelan, Nihal Thomas
BACKGROUND AND OBJECTIVE: Hypoglycemia is a major hindrance for optimal glycemic control in women with gestational diabetes mellitus[GDM] on insulin. We objectively estimated masked hypoglycemia [glucose < 2.77mmol/L for ≥30minutes] in pregnant women using a continuous glucose monitoring system[CGMS]. METHODS: Twenty pregnant women with GDM on insulin [cases] and ten age-matched euglycemic pregnant women [controls] between 24-36 weeks of gestation were recruited...
September 14, 2016: Journal of Diabetes
S Galasso, A Facchinetti, B M Bonora, V Mariano, F Boscari, E Cipponeri, A Maran, A Avogaro, G P Fadini, D Bruttomesso
BACKGROUND AND AIMS: Degludec is an ultralong-acting insulin analogue with a flat and reproducible pharmacodynamic profile. As some patients with type 1 diabetes (T1D) fail to achieve 24-h coverage with glargine or detemir despite twice-daily injections, we studied the effect of switching T1D patients from twice-daily glargine or detemir to degludec. METHODS AND RESULTS: In this prospective observational study, T1D patients on twice-daily glargine or detemir were enrolled...
August 6, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Dimitri Boiroux, Tinna Björk Aradóttir, Kirsten Nørgaard, Niels Kjølstad Poulsen, Henrik Madsen, John Bagterp Jørgensen
BACKGROUND: Bolus calculators help patients with type 1 diabetes to mitigate the effect of meals on their blood glucose by administering a large amount of insulin at mealtime. Intraindividual changes in patients physiology and nonlinearity in insulin-glucose dynamics pose a challenge to the accuracy of such calculators. METHOD: We propose a method based on a continuous-discrete unscented Kalman filter to continuously track the postprandial glucose dynamics and the insulin sensitivity...
September 8, 2016: Journal of Diabetes Science and Technology
T C Geppert, A M Meyer, G A Perry, P J Gunn
In the dairy industry, excess dietary CP is consistently correlated with decreased conception rates. However, the source from which excess CP is derived and how it affects reproductive function in beef cattle is largely undefined. The objective of this experiment was to determine the effects of feeding excess metabolizable protein (MP) from feedstuffs differing in rumen degradability on ovulatory follicular dynamics, subsequent corpus luteum (CL) development, steroid hormone production and circulating amino acids (AA) in beef cows...
September 9, 2016: Animal: An International Journal of Animal Bioscience
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]
Ana Maria Gomez, Rafael Alfonso-Cristancho, John Jairo Orozco, Peter Matthew Lynch, Diana Prieto, Rhodri Saunders, Stephane Roze, Juan Esteban Valencia
OBJECTIVE: To assess the long-term clinical and economic impact of integrated pump/CGM technology therapy as compared to multiple daily injections (MDI), for the treatment of type 1 diabetes (T1D) in Colombia. METHODS: The CORE Diabetes Model was used to simulate a hypothetical cohort of patients with T1D. Mean baseline characteristics were taken from a clinical study conducted in Colombia and a healthcare payer perspective was adopted, with a 5% annual discount rate applied to both costs and outcomes...
November 2016: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
Yoshio Nagai, Mariko Murakami, Kana Igarashi, Yuta Nakamura, Hidekazu Tsukiyama, Fumiaki Matsubara, Ami Nishine, Toshihiko Ohshige, Satoshi Ishii, Hiroyuki Kato, Yasushi Tanaka
As life expectancy becomes longer in Japan, there has been an increase of elderly patients with type 2 diabetes who need insulin therapy but cannot perform self-injection due to dementia or other conditions. Therefore, the aim of this study was to investigate the efficacy and safety of thrice-weekly insulin degludec therapy in elderly patients with poorly controlled diabetes. The subjects were 22 hospitalized elderly Japanese patients with type 2 diabetes who had difficulty with self-injection. After becoming stable on once-daily insulin degludec treatment, they were assigned to continue once-daily injection (OD group) or were switched to thrice-weekly injection (TW group) for one week...
September 2, 2016: Endocrine Journal
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