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https://www.readbyqxmd.com/read/28731509/keeping-safe-continuous-glucose-monitoring-cgm-in-persons-with-type-1-diabetes-and-impaired-awareness-of-hypoglycaemia-a-qualitative-study
#1
A F Vloemans, C A J van Beers, M de Wit, W Cleijne, S M Rondags, P H Geelhoed-Duijvestijn, M H H Kramer, E H Serné, F J Snoek
AIM: To further our understanding of individual use and experience of continuous glucose monitoring (CGM) in adults with Type 1 diabetes and impaired awareness of hypoglycaemia, we conducted a qualitative study supplementary to a randomized controlled trial, using semi-structured interviews. METHODS: Twenty-three participants of the IN CONTROL trial were interviewed within 4 weeks after the last study visit. The interview centred around experiences of CGM, taking into account the person's expectations prior to the trial...
July 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28728915/continuous-glucose-monitoring-adds-information-beyond-hba1c-in-well-controlled-diabetes-patients-with-early-cardiovascular-autonomic-neuropathy
#2
Jesper Fleischer, Esben Laugesen, Simon Lebech Cichosz, Pernille Hoeyem, Thomas Fremming Dejgaard, Per Loegstrup Poulsen, Lise Tarnow, Troels Krarup Hansen
AIMS: Hyperglycemia as evaluated by HbA1c is a risk factor for the development of cardiovascular autonomic neuropathy (CAN). The aim of the present study was to investigate whether continuous glucose monitoring (CGM) may add information beyond HbA1c in patients with type 2 diabetes and CAN. METHODS: 81 patients with type 2 diabetes (43 men, mean age 58±11year, HbA1c 6.6±0.5%). Patients were tested for CAN using cardiovascular reflex tests (response to standing, deep breathing and Valsalva maneuver) and underwent CGM for three days...
June 30, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28728559/effect-of-insulin-therapy-and-dietary-adjustments-on-safety-and-performance-during-simulated-soccer-tests-in-people-with-type-1-diabetes-study-protocol-for-a-randomized-controlled-trial
#3
Javier Calvo-Marín, Gabriel Torrealba-Acosta, Matthew Campbell, Jesse Gaboury, Ajmol Ali, Chih Hao Chen-Ku
BACKGROUND: Despite the reduction in glycemic derangement in patients with type 1 diabetes mellitus (T1D) through dietary and therapeutic adjustments implemented before, during and after continuous exercise, evidence for its effectiveness with intermittent forms of exercise, such as soccer, is still lacking. METHODS/DESIGN: We designed a study protocol for a randomized, crossover, double-blinded, controlled trial, for the evaluation of the effect that a strategy of dietary and therapeutic modifications may have on safety and performance of persons with T1D in soccer training sessions and cognitive testing...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28726154/use-of-continuous-glucose-monitoring-in-youth-onset-type-2-diabetes
#4
REVIEW
Christine L Chan
PURPOSE OF REVIEW: Continuous glucose monitoring (CGM) technology has long been accepted as a tool for managing glycemia in type 1 diabetes (T1D) and is receiving increased attention as a tool for monitoring glucose patterns in patients with other forms of diabetes, in particular type 2 diabetes (T2D). Recent studies in adults with T2D have shown benefits of CGM in the investigation of glycemic variability, as well as utility as a tool for improving glycemic control. The literature on CGM use in youth-onset T2D, however, is sparse...
September 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28725273/a-randomized-controlled-trial-comparing-the-effects-of-dapagliflozin-and-dpp-4-inhibitors-on-glucose-variability-and-metabolic-parameters-in-patients-with-type-2-diabetes-mellitus-on-insulin
#5
Hiroshi Nomoto, Hideaki Miyoshi, Hajime Sugawara, Kota Ono, Shingo Yanagiya, Mayuko Oita, Akinobu Nakamura, Tatsuya Atsumi
BACKGROUND: Dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose co-transporter 2 (SGLT2) inhibitors improve hyperglycemia, and the usefulness of co-administration of DPP-4 inhibitors and insulin therapy has been well established. However, it has been still uncertain whether combination therapy of SGLT2 inhibitors and insulin is superior to that of DPP-4 inhibitors and the latter. Therefore, we investigated the superiority of dapagliflozin on glucose fluctuation compared with DPP-4 inhibitors in patients with type 2 diabetes mellitus (T2DM) on insulin using a continuous glucose monitoring (CGM) system...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#6
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
#7
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/28707484/autoregressive-modeling-of-drift-and-random-error-to-characterize-a-continuous-intravascular-glucose-monitoring-sensor
#8
Tony Zhou, Jennifer L Dickson, J Geoffrey Chase
BACKGROUND: Continuous glucose monitoring (CGM) devices have been effective in managing diabetes and offer potential benefits for use in the intensive care unit (ICU). Use of CGM devices in the ICU has been limited, primarily due to the higher point accuracy errors over currently used traditional intermittent blood glucose (BG) measures. General models of CGM errors, including drift and random errors, are lacking, but would enable better design of protocols to utilize these devices. This article presents an autoregressive (AR) based modeling method that separately characterizes the drift and random noise of the GlySure CGM sensor (GlySure Limited, Oxfordshire, UK)...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28683829/%C3%AE-glucosidase-inhibitor-miglitol-attenuates-glucose-fluctuation-heart-rate-variability-and-sympathetic-activity-in-patients-with-type-2-diabetes-and-acute-coronary-syndrome-a-multicenter-randomized-controlled-macs-study
#9
Michio Shimabukuro, Atsushi Tanaka, Masataka Sata, Kazuoki Dai, Yoshisato Shibata, Yohei Inoue, Hiroki Ikenaga, Shinji Kishimoto, Kozue Ogasawara, Akira Takashima, Toshiyuki Niki, Osamu Arasaki, Koichi Oshiro, Yutaka Mori, Masaharu Ishihara, Koichi Node
BACKGROUND: Little is known about clinical associations between glucose fluctuations including hypoglycemia, heart rate variability (HRV), and the activity of the sympathetic nervous system (SNS) in patients with acute phase of acute coronary syndrome (ACS). This pilot study aimed to evaluate the short-term effects of glucose fluctuations on HRV and SNS activity in type 2 diabetes mellitus (T2DM) patients with recent ACS. We also examined the effect of suppressing glucose fluctuations with miglitol on these variables...
July 6, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28683068/prediction-of-nocturnal-hypoglycemia-unawareness-by-fasting-glucose-levels-or-post-breakfast-glucose-fluctuations-in-patients-with-type-1-diabetes-receiving-insulin-degludec-a-pilot-study
#10
Hiroshi Takahashi, Rimei Nishimura, Yoshiko Onda, Kiyotaka Ando, Daisuke Tsujino, Kazunori Utsunomiya
OBJECTIVE: To evaluate whether nocturnal asymptomatic hypoglycemia (NAH) can be predicted by fasting glucose levels or post-breakfast glucose fluctuations in patients with type 1 diabetes (T1D) receiving insulin degludec. METHODS: Patients with T1D receiving insulin degludec underwent at-home CGM assessments. Indices for glycemic variability before and after breakfast included fasting glucose levels and the range of post-breakfast glucose elevation. For comparison, the patients were classified into those with NAH and those without...
2017: PloS One
https://www.readbyqxmd.com/read/28679886/the-artificial-pancreas-reducing-safety-risk-via-intra-peritoneal-insulin-delivery
#11
Richard W Jones, Francesco Gianni, Georgios Despotou, Konstantinos Katzis
The Artificial Pancreas is a medical device, currently in development, that aims to provide automatic regulation of blood glucose (BG) levels in ambulatory type 1 diabetes mellitus sufferers. The most popular approach utilises subcutaneous (SC) continuous glucose monitoring (CGM) combined with SC insulin injection controlled by a Model Predictive Control (MPC) algorithm. From a safety risk perspective problematic elements include the performance robustness of the CGM and the need for a pre-meal insulin bolus to provide satisfactory post prandial BG regulation...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28678303/a-comparison-of-discovered-regularities-in-blood-glucose-readings-across-two-data-collection-approaches-used-with-a-type-1-diabetic-youth
#12
Victor Lee, Travis Thurston, Chris Thurston
BACKGROUND: Type 1 diabetes requires frequent testing and monitoring of blood glucose levels in order to determine appropriate type and dosage of insulin administration. This can lead to thousands of individual measurements over the course of a lifetime of a single individual, of which very few are retained as part of a permanent record. The third author, aged 9, and his family have maintained several years of written records since his diagnosis with Type 1 diabetes at age 20 months, and have also recently begun to obtain automated records from a continuous glucose monitor...
July 5, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28672044/life-cycle-energy-efficiency-and-environmental-impact-assessment-of-bioethanol-production-from-sweet-potato-based-on-different-production-modes
#13
Jun Zhang, Chunrong Jia, Yi Wu, Xunfeng Xia, Beidou Xi, Lijun Wang, Youlong Zhai
The bioethanol is playing an increasingly important role in renewable energy in China. Based on the theory of circular economy, integration of different resources by polygeneration is one of the solutions to improve energy efficiency and to reduce environmental impact. In this study, three modes of bioethanol production were selected to evaluate the life cycle energy efficiency and environmental impact of sweet potato-based bioethanol. The results showed that, the net energy ratio was greater than 1 and the value of net energy gain was positive in the three production modes, in which the maximum value appeared in the circular economy mode (CEM)...
2017: PloS One
https://www.readbyqxmd.com/read/28667580/assessing-the-therapeutic-utility-of-professional-continuous-glucose-monitoring-in-type-2-diabetes-across-various-therapies-a-retrospective-evaluation
#14
Jothydev Kesavadev, Robert Vigersky, John Shin, Pradeep Babu Sadasivan Pillai, Arun Shankar, Geethu Sanal, Gopika Krishnan, Sunitha Jothydev
BACKGROUND: There have been few large studies that have analyzed the effect of professional (masked) continuous glucose monitoring (P-CGM) on glycemic control in patients with type 2 diabetes (T2DM) who were on a broad spectrum of baseline therapies. METHODS: We performed a retrospective, blinded evaluation of glycemic control in 296 T2DM adults for 6 months following a 6- to 7-day study of their glycemic profile using masked P-CGM. At baseline, 91% of the patients were on some form of insulin treatment with oral hypoglycemic agents (OHA), while 7% were on one or more OHAs without insulin, and the remaining 2% were on GLP-1RAs...
June 30, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28666360/overnight-closed-loop-control-improves-glycemic-control-in-a-multicenter-study-of-adults-with-type-1-diabetes
#15
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/28656649/multi-gradient-echo-myelin-water-fraction-imaging-comparison-to-the-multi-echo-spin-echo-technique
#16
Eva Alonso-Ortiz, Ives R Levesque, G Bruce Pike
PURPOSE: Myelin water fraction (MWF) mapping based on multi-gradient recalled-echo (MGRE) imaging has been proposed as an alternative to the conventional multi-echo-spin-echo (MESE) approach. In this work, we performed a comparative study of MESE and MGRE-derived MWFs in the same subject group. METHODS: MESE and MGRE data were acquired in 12 healthy volunteers at 3T. T2* decay curves were corrected for the effects of field inhomogeneities and multicomponent analysis of T2  and T2* signals was performed using non-negative least-squares fitting...
June 27, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28654305/commentary-regarding-shapiro-nonadjunctive-use-of-continuous-glucose-monitors-for-insulin-dosing
#17
David Price
The FDA recently expanded the approved use of Dexcom's G5 Mobile continuous glucose monitoring (CGM) system to allow for diabetes treatment decisions. This decision is expected to reduce the burden of SMBG testing and increase the adoption and persistent use of CGM. The safety of nonadjunctive CGM use was questioned because of sporadic large discrepancies between CGM and SMBG values. These data were viewed in the context of complaints found in the FDA MAUDE database and social media postings. This commentary provides additional perspective on the inferences that can be drawn from these reports and the risk of nonadjunctive use of CGM data...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28647947/continuous-glucose-monitoring-in-pediatrics-the-gap-between-potential-benefits-and-the-reality-of-utility
#18
Regina L Taddeo, Joanne T Moser, Pantea P Minnock
Continuous Glucose Monitoring (CGM) is rapidly becoming a standard of care in the management of Type 1 diabetes (T1D). Today's devices are nearly as accurate as home glucose meters. They provide glucose data every 5 minutes, alert to high and low blood glucose levels, and allow for remote monitoring of a user's glucose data and patterns. Use of CGM has many benefits including support for tighter glycemic control without increasing the risk for hypoglycemia. There is however emerging evidence of some negative aspects associated with using CGM, which may result in decreased utilization of the device as well as a decline in quality of life, especially in the pediatric population...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28646412/efficacy-of-additional-canagliflozin-administration-to-type-2-diabetes-patients-receiving-insulin-therapy-examination-of-diurnal-glycemic-patterns-using-continuous-glucose-monitoring-cgm
#19
Mihoko Matsumura, Yuki Nakatani, Seiichi Tanka, Chie Aoki, Masaaki Sagara, Kazunori Yanagi, Kunihiro Suzuki, Yoshimasa Aso
INTRODUCTION: The efficacy of administering a sodium-glucose cotransporter 2 inhibitor during insulin therapy has not been established. In this study, we examined its effects based on diurnal glycemic patterns using continuous glucose monitoring (CGM). METHODS: The subjects were 15 patients who had received insulin therapy for 1 year or more. A CGM device was attached to all subjects for 1 week. The administration of canagliflozin at 100 mg was started 4 days after attachment...
June 23, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28633537/extensive-assessment-of-blood-glucose-monitoring-during-postprandial-period-and-its-impact-on-closed-loop-performance
#20
Lyvia Biagi, Arthur Hirata Bertachi, Ignacio Conget, Carmen Quirós, Marga Giménez, F Javier Ampudia-Blasco, Paolo Rossetti, Jorge Bondia, Josep Vehí
BACKGROUND: Closed-loop (CL) systems aims to outperform usual treatments in blood glucose control and continuous glucose monitors (CGM) are a key component in such systems. Meals represents one of the main disturbances in blood glucose control, and postprandial period (PP) is a challenging situation for both CL system and CGM accuracy. METHODS: We performed an extensive analysis of sensor's performance by numerical accuracy and precision during PP, as well as its influence in blood glucose control under CL therapy...
June 1, 2017: Journal of Diabetes Science and Technology
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