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Insulin algorithm

Harshal Deshmukh, Maria Papageorgiou, Eric S Kilpatrick, Stephen L Atkin, Thozhukat Sathyapalan
OBJECTIVE: The aim of this study was to develop a simple phenotypic algorithm that can capture the underlying clinical and hormonal abnormalities to help in the diagnosis and risk stratification of PCOS. METHODS: The study consisted of 111 women with PCOS fulfilling the Rotterdam diagnostic criteria and 67 women without PCOS. A Firth's penalised logistic regression model was used for independent variable section. Model optimism, discrimination and calibration were assessed using bootstrapping, area under the curve (AUC) and Hosmer-Lemeshow statistics, respectively...
October 19, 2018: Clinical Endocrinology
Youjia Hu, Jian Peng, Fangyong Li, F Susan Wong, Li Wen
Type 1 diabetes (T1D) is a progressive autoimmune disease in which the insulin-producing beta cells are destroyed by auto-reactive T cells. Recent studies suggest that microbiota are closely associated with disease development. We studied gut, oral and vaginal microbiota longitudinally in non-obese diabetic (NOD) mice. We showed that the composition of microbiota is very different at the different mucosal sites and between young and adult mice. Gut microbiota are more diverse than oral or vaginal microbiota and the changes were more evident in the mice before and after onset of diabetes...
October 18, 2018: Scientific Reports
Vasilios Karageorgiou, Theodoros G Papaioannou, Ioannis Bellos, Krystallenia Alexandraki, Nikolaos Tentolouris, Christodoulos Stefanadis, George P Chrousos, Dimitrios Tousoulis
OBJECTIVE: Artificial pancreas is a technology that minimizes user input by bridging continuous glucose monitoring and insulin pump treatment, and has proven safety in the adult population. The purpose of this meta-analysis is to evaluate the efficacy of closed-loop (CL) systems in the glycemic control of non-adult type 1 diabetes patients in both a pairwise and network meta-analysis (NMA) context and investigate various parameters potentially affecting the outcome. METHODS: Literature was systematically searched using the MEDLINE (1966-2018), Scopus (2004-2018), Cochrane Central Register of Controlled Trials (CENTRAL) (1999-2018), Clinicaltrials...
October 12, 2018: Metabolism: Clinical and Experimental
Muhammad Imtiaz Hasan, Wasim Amer, Nabeea Junaid
OBJECTIVE: To ascertain the effectiveness of implementing the American Diabetes Association/European Association for the Study of Diabetes 2009 consensus algorithm in achieving glycaemic control in patients with type 2 diabetes. METHODS: The prospective, observational, open label, product registry was conducted at 38 sites across 7 cities in Pakistan between July 2011 and February 2014. Uncontrolled type 2 diabetes patients were either initiated on or switched to insulin glargine from other basal insulin...
September 2018: JPMA. the Journal of the Pakistan Medical Association
David Endesfelder, Wolfgang Zu Castell, Ezio Bonifacio, Marian Rewers, William A Hagopian, Jin-Xiong She, Åke Lernmark, Jorma Toppari, Kendra Vehik, Alistair J K Williams, Liping Yu, Beena Akolkar, Jeffrey P Krischer, Anette-G Ziegler, Peter Achenbach
Progression to clinical type 1 diabetes varies between children developing beta-cell autoantibodies. Differences in autoantibody patterns could relate to disease progression and etiology. Here we modeled complex longitudinal autoantibody profiles using a novel wavelet-based algorithm. We identified clusters of similar profiles, associated with different types of progression, among 600 children from The Environmental Determinants of Diabetes in the Young birth cohort study who developed persistent autoantibodies against insulin (IAA), GAD (GADA) and/or insulinoma-associated antigen-2 (IA-2A), and were followed prospectively in 3 to 6 months intervals (median follow-up 6...
October 10, 2018: Diabetes
Sue Brown, Dan Raghinaru, Emma Emory, Boris Kovatchev
OBJECTIVE: To pilot test a new closed-loop control technology to validate it for a further large clinical trial. RESEARCH DESIGN AND METHODS: The t:slim X2 insulin pump with Control-IQ Technology (Tandem Diabetes Care) includes a Dexcom G6 sensor and a closed-loop algorithm implemented in the pump that 1 ) automates insulin correction boluses, 2 ) has a dedicated hypoglycemia safety system, and 3 ) gradually intensifies control overnight, aiming for blood glucose levels of approximately 100-120 mg/dL every morning...
October 10, 2018: Diabetes Care
Dominic Ehrmann, Bernhard Kulzer, Melanie Schipfer, Bernhard Lippmann-Grob, Thomas Haak, Norbert Hermanns
OBJECTIVE: Continuous subcutaneous insulin infusion (CSII) is the most advanced form of insulin delivery, but it requires structured education to provide users with the necessary knowledge/skills and to support their motivation. Currently, no structured education program designed to provide this training has been evaluated. We developed a CSII-specific, structured education program (Insulin Pump Treatment [INPUT]) and evaluated its impact on glycemic control, behavior, and psychosocial status...
October 10, 2018: Diabetes Care
Shahar Bar Yehuda, Rachel Axlerod, Ori Toker, Nir Zigman, Iris Goren, Vered Mourad, Natan Lederman, Nurit Cohen, Eran Matz, Doron Dushnitzky, Matan Gavish, Nirit Borovsky, Doron Schwarts, Iris Dotan, Dan Turner
Introduction: There are conflicting data on the association between inflammatory bowel diseases (IBD) and autoimmunity disorders. The aim of this study was to explore this association including the effect of medications on this association. Methods: We utilized health administrative data collected by 3 of 4 Israel's Health Maintenance Organizations (HMO) covering 52% of the population of Israel. We explored the prevalence of the following autoimmune disorders: Insulin Dependent Diabetes Mellitus (IDDM), psoriasis, Sjögren syndrome, celiac, systemic lupus erythematosus (SLE), primary sclerosis cholangitis (PSC) and autoimmune thyroiditis, among all IBD patients versus non-IBD controls...
October 9, 2018: Journal of Crohn's & Colitis
Emanuel Raschi, Arianna Mazzotti, Elisabetta Poluzzi, Fabrizio De Ponti, Giulio Marchesini
Pharmacotherapy used to treat type 2 diabetes mellitus (T2DM) is facing a paradigm shift in clinical practice with recent cardiovascular (CV) outcome trials having a substantial impact on drug prescription with treatment having a more tailored approach. In patients with T2DM, the issue of chronic liver disease is multifaceted. However, a clinical evidence is emerging on the beneficial effect of antidiabetic medications on nonalcoholic fatty liver disease (NAFLD). Areas covered: The authors provide a synopsis on the current and upcoming pharmacotherapy for NAFLD, including the challenges with their development, focusing on drugs for T2DM...
October 9, 2018: Expert Opinion on Pharmacotherapy
Michael A Wood, Dorothy I Shulman, Gregory P Forlenza, Bruce W Bode, Orit Pinhas-Hamiel, Bruce A Buckingham, Kevin B Kaiserman, David R Liljenquist, Timothy S Bailey, John Shin, Suiying Huang, Xiaoxiao Chen, Toni L Cordero, Scott W Lee, Francine R Kaufman
BACKGROUND: The Medtronic predictive low-glucose management (PLGM) algorithm automatically stops insulin delivery when sensor glucose (SG) is predicted to reach or fall below a preset low-glucose value within the next 30 min, and resumes delivery after hypoglycemia recovery. The present study evaluated the PLGM algorithm performance of the MiniMed™ 670G system SmartGuard™ "suspend before low" feature in children aged 7-13 years with type 1 diabetes (T1D). METHOD: Participants (N = 105, mean ± standard deviation of 10...
October 6, 2018: Diabetes Technology & Therapeutics
Almut G Winterstein, Nakyung Jeon, Ben Staley, Dandan Xu, Carl Henriksen, Gloria Pflugfelder Lipori
PURPOSE: Hypoglycemia is one of the most concerning adverse drug events in hospitalized patients. Using information from institutional electronic health records, we aimed to develop dynamic predictive models to identify patients at high risk for hypoglycemia during antihyperglycemic therapy. METHODS: The study population consisted of 21,840 patients who received antihyperglycemic medication on any of the first 5 hospital days (the "risk model days") at 2 large hospitals...
October 2, 2018: American Journal of Health-system Pharmacy: AJHP
Johanna K DiStefano
Angiopoietin-like protein 8 (ANGPTL8) is associated with reduced HDL-cholesterol levels and may contribute to the development of dyslipidemia. Factors regulating ANGPTL8 expression remain poorly understood. Here we analyzed the relationship between miRNA-143-3p and ANGPTL8 in liver cells. Using target prediction algorithms, we identified a putative binding site for miR-143-3p in the ANGPTL8 3' untranslated region (3'UTR). Exogenous miR-143-3p interacted with the ANGPTL8 3'UTR to downregulate its expression compared to scrambled sequence control...
September 24, 2018: Gene
Gregory P Forlenza, Laurel H Messer, Cari Berget, R Paul Wadwa, Kimberly A Driscoll
PURPOSE OF REVIEW: Summarize biopsychosocial factors associated with using continuous glucose monitors (CGMs), insulin pumps, and artificial pancreas (AP) systems and provide a "call to the field" about their importance to technology uptake and maintained use. RECENT FINDINGS: Insulin pumps and CGMs are becoming standard of care for individuals with type 1 diabetes (T1D). AP systems combining a CGM, insulin pump, and automated dosing algorithm are available for commercial use...
September 26, 2018: Current Diabetes Reports
Jochen Seufert, Andreas Fritsche, Stefan Pscherer, Helmut Anderten, Anja Borck, Katrin Pegelow, Peter Bramlage, Martin Pfohl
For patients with type 2 diabetes mellitus (T2DM) and inadequate glycaemic control, addition of basal-insulin is recommended, but titration and optimisation of basal insulin therapy in primary care is not well understood. Therefore, we conducted an observational trial in 2,470 T2DM patients upon initiation of insulin-glargine 100U/L (Gla-100) on top of OADs. Physicians were free to choose either a so-called "Davies", "Fritsche" or "individual" titration algorithm. We found that FBG and HbA1c levels were effectively reduced by Gla-100; 65...
September 18, 2018: Diabetes, Obesity & Metabolism
Micah T Long, Douglas B Coursin, Mark J Rice
Type 1 diabetes mellitus is a lifelong condition. It requires intensive patient involvement including frequent glucose measurements and subcutaneous insulin dosing to provide optimal glycemic control to decrease short- and long-term complications of diabetes mellitus without causing hypoglycemia. Variations in insulin pharmacokinetics and responsiveness over time in addition to illness, stress, and a myriad of other factors make ideal glucose control a challenge. Control-to-range and control-to-target artificial pancreas devices (closed-loop artificial pancreas devices [C-APDs]) consist of a continuous glucose monitor, response algorithm, and insulin delivery device that work together to automate much of the glycemic management for an individual while continually adjusting insulin dosing toward a glycemic target...
September 6, 2018: Anesthesia and Analgesia
K L Kalweit, D G Van Zyl, P Rheeder
BACKGROUND: Self-monitoring of blood glucose (SMBG) can inform on the timing of hyperglycaemia, but there is currently no standardised approach to utilising these data to improve glycaemic control in patients with type 2 diabetes. OBJECTIVES: To assess the improvement in glycaemic control when an insulin titration algorithm was used in combination with SMBG in patients with poorly controlled, insulin-treated type 2 diabetes. METHODS: This 6-month prospective study recruited 39 poorly controlled (glycated haemoglobin (HbA1c) ≥8...
July 25, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Ramzi A Ajjan, Michael H Cummings, Peter Jennings, Lalantha Leelarathna, Gerry Rayman, Emma G Wilmot
Continuous glucose monitoring and flash glucose monitoring systems are increasingly used by people with diabetes on multiple daily injections of insulin and continuous subcutaneous insulin infusion. Along with real-time updates on current glucose levels, these technologies also use trend arrows to provide information on the direction and rate of change of glucose. Two systems, the Dexcom G5 and the FreeStyle Libre, have recently been approved for use without the need for adjunct capillary blood glucose, and there is a need for practical guidance for insulin dosing which incorporates rate of change in the insulin dosing algorithm...
September 3, 2018: Diabetes & Vascular Disease Research
Susanne M Cabrera, Samuel Engle, Mary Kaldunski, Shuang Jia, Rhonda Geoffrey, Pippa Simpson, Aniko Szabo, Cate Speake, Carla J Greenbaum, Yi-Guang Chen, Martin J Hessner
AIMS/HYPOTHESIS: The study aimed to determine whether discrete subtypes of type 1 diabetes exist, based on immunoregulatory profiles at clinical onset, as this has significant implications for disease treatment and prevention as well as the design and analysis of clinical trials. METHODS: Using a plasma-based transcriptional bioassay and a gene-ontology-based scoring algorithm, we examined local participants from the Children's Hospital of Wisconsin and conducted an ancillary analysis of TrialNet CTLA4-Ig trial (TN-09) participants...
November 2018: Diabetologia
Wenping Liu, Gangping Zhang, Liling Yu, Binfeng Xu, Haoyu Jin
Artificial pancreas (AP) is an important treatment for patients with Type 1 diabetes (T1D). The control algorithm adopted in an AP system determines its reliability and accuracy. The generalized predictive control (GPC) is a representative adaptive control algorithm and has been widely applied to AP systems. However, we found that the traditional GPC controller does not work well for adolescents with T1D because of their high-fluctuating blood glucose and high insulin resistance. Here, we propose an improved GPC algorithm with an adaptive reference glucose trajectory and an adaptive softening factor...
August 29, 2018: Artificial Organs
Felix Aberer, Julia K Mader, Julia Holzgruber, Christian Trummer, Verena Schwetz, Marlene Pandis, Peter Pferschy, Hildegard Greinix, Norbert J Tripolt, Thomas R Pieber, Armin Zebisch, Heinz Sill, Albert Wölfler, Harald Sourij
Steroid-induced hyperglycemia (SIHG) has shown to independently increase the risk for mortality in patients with acute Graft-versus-host disease (aGvHD) and it is still unclear whether SIHG might be a modifiable risk factor. Therefore a feasibility trial was conducted aiming to evaluate the performance of a standardized decision support system (GlucoTab) for insulin therapy in patients with SIHG. 10 hyperglycemic aGvHD patients were included and treated either with GlucoTab (GT) or standard of care (SOC) during hospitalization...
August 25, 2018: Journal of Diabetes Investigation
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