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Continuous glucose monitoring

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https://www.readbyqxmd.com/read/28107738/hyperglycemia-and-glycemic-variability-are-associated-with-the-severity-of-sepsis-in-nondiabetic-subjects
#1
Lukana Preechasuk, Nattakarn Suwansaksri, Nantawan Ipichart, Sathit Vannasaeng, Chairat Permpikul, Apiradee Sriwijitkamol
PURPOSE: The purpose was to compare glucose variability (GV) obtained via continuous glucose monitoring between nondiabetic sepsis patients and healthy subjects and to seek associations between GV and sepsis severity in nondiabetic sepsis patients. METHODS: Nondiabetic sepsis inpatients and healthy controls received a 72-hour continuous glucose monitoring (iPro2, Medtronic) postadmission and post-oral glucose tolerance test, respectively. The mean glucose level (MGL) along with GV represented by standard deviation (SD) and the mean amplitude of glycemic excursion (MAGE) were calculated at 24 and 72 hours...
December 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28107204/non-invasive-blood-glucose-detection-system-based-on-conservation-of-energy-method
#2
Yang Zhang, Jian-Ming Zhu, Yong-Bo Liang, Hong-Bo Chen, Shi-Min Yin, Zhen-Cheng Chen
The most common method used for minimizing the occurrence of diabetes complications is frequent glucose testing to adjust the insulin dose. However, using blood glucose (BG) meters presents a risk of infection. It is of great importance to develop non-invasive BG detection techniques. To realize high-accuracy, low-cost and continuous glucose monitoring, we have developed a non-invasive BG detection system using a mixed signal processor 430 (MSP430) microcontroller. This method is based on the combination of the conservation-of-energy method with a sensor integration module, which collects physiological parameters, such as the blood oxygen saturation (SPO2), blood flow velocity and heart rate...
January 20, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28106820/current-and-emerging-technology-for-continuous-glucose-monitoring
#3
REVIEW
Cheng Chen, Xue-Ling Zhao, Zhan-Hong Li, Zhi-Gang Zhu, Shao-Hong Qian, Andrew J Flewitt
Diabetes has become a leading cause of death worldwide. Although there is no cure for diabetes, blood glucose monitoring combined with appropriate medication can enhance treatment efficiency, alleviate the symptoms, as well as diminish the complications. For point-of-care purposes, continuous glucose monitoring (CGM) devices are considered to be the best candidates for diabetes therapy. This review focuses on current growth areas of CGM technologies, specifically focusing on subcutaneous implantable electrochemical glucose sensors...
January 19, 2017: Sensors
https://www.readbyqxmd.com/read/28105519/translating-hba1c-measurements-into-estimated-average-glucose-values-in-pregnant-women-with-diabetes
#4
Graham R Law, Mark S Gilthorpe, Anna L Secher, Rosemary Temple, Rudolf Bilous, Elisabeth R Mathiesen, Helen R Murphy, Eleanor M Scott
AIMS/HYPOTHESIS: This study aimed to examine the relationship between average glucose levels, assessed by continuous glucose monitoring (CGM), and HbA1c levels in pregnant women with diabetes to determine whether calculations of standard estimated average glucose (eAG) levels from HbA1c measurements are applicable to pregnant women with diabetes. METHODS: CGM data from 117 pregnant women (89 women with type 1 diabetes; 28 women with type 2 diabetes) were analysed...
January 19, 2017: Diabetologia
https://www.readbyqxmd.com/read/28101899/recommendations-for-the-use-of-sensor-augmented-pumps-with-predictive-low-glucose-suspend-features-in-children-the-importance-of-education
#5
REVIEW
Andrea E Scaramuzza, Claudia Arnaldi, Valentino Cherubini, Elvira Piccinno, Ivana Rabbone, Sonia Toni, Stefano Tumini, Gilberto Candela, Paola Cipriano, Lucia Ferrito, Lorenzo Lenzi, Davide Tinti, Ohad Cohen, Fortunato Lombardo
Sensor-augmented pumps, which consist of a pump and a continuous glucose monitoring system, offer considerable therapeutic opportunities, despite requiring close attention in the early phase of their use. The aim of this paper is to provide recommendations on the use of a predictive low glucose management (PLGM) system (Minimed 640G™, Medtronic, Northridge, CA, USA) in adolescents with type 1 diabetes either at the start of therapy or during follow-up. Sound clinical recommendations on PLGM are of increasing importance since several recent papers have reported significant clinical improvements in patients with PLGM, especially in adults...
January 19, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28098839/continuous-glucose-monitoring-enables-the-detection-of-losses-in-infusion-set-actuation-lisas
#6
Daniel P Howsmon, Faye Cameron, Nihat Baysal, Trang T Ly, Gregory P Forlenza, David M Maahs, Bruce A Buckingham, Juergen Hahn, B Wayne Bequette
Reliable continuous glucose monitoring (CGM) enables a variety of advanced technology for the treatment of type 1 diabetes. In addition to artificial pancreas algorithms that use CGM to automate continuous subcutaneous insulin infusion (CSII), CGM can also inform fault detection algorithms that alert patients to problems in CGM or CSII. Losses in infusion set actuation (LISAs) can adversely affect clinical outcomes, resulting in hyperglycemia due to impaired insulin delivery. Prolonged hyperglycemia may lead to diabetic ketoacidosis-a serious metabolic complication in type 1 diabetes...
January 15, 2017: Sensors
https://www.readbyqxmd.com/read/28098809/the-clinical-benefits-and-accuracy-of-continuous-glucose-monitoring-systems-in-critically-ill-patients-a-systematic-scoping-review
#7
REVIEW
Sigrid C J van Steen, Saskia Rijkenberg, Jacqueline Limpens, Peter H J van der Voort, Jeroen Hermanides, J Hans DeVries
Continuous Glucose Monitoring (CGM) systems could improve glycemic control in critically ill patients. We aimed to identify the evidence on the clinical benefits and accuracy of CGM systems in these patients. For this, we performed a systematic search in Ovid MEDLINE, from inception to 26 July 2016. Outcomes were efficacy, accuracy, safety, workload and costs. Our search retrieved 356 articles, of which 37 were included. Randomized controlled trials on efficacy were scarce (n = 5) and show methodological limitations...
January 14, 2017: Sensors
https://www.readbyqxmd.com/read/28098426/dapagliflozin-in-patients-with-type-1-diabetes-a-post-hoc-analysis-of-the-effect-of-insulin-dose-adjustments-on-24-hour-continuously-monitored-mean-glucose-and-fasting-beta-hydroxybutyrate-levels-from-a-phase-iia-pilot-study
#8
Robert R Henry, Paresh Dandona, Jeremy Pettus, Sunder Mudaliar, John Xu, Lars Hansen
AIMS: To investigate the effects of total daily insulin dose (TDD) reductions on 24-hour continuously monitored mean glucose and fasting beta-hydroxybutyrate (a marker for diabetic ketosis/ketoacidosis [DKA]) using patient-level data from a 14-day, pilot study of dapagliflozin in type 1 diabetes. MATERIALS AND METHODS: Exploratory correlation analysis was performed post-hoc to determine the relationship between change in TDD and a) 24-hour mean glucose (by continuous glucose monitoring) and b) fasting beta-hydroxybutyrate, in 70 patients with type 1 diabetes receiving insulin and dapagliflozin (1-, 2...
January 18, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28096442/kinetic-modeling-of-incremental-ambulatory-peritoneal-dialysis-exchanges
#9
Steven Guest, John K Leypoldt, Michelle E Cassin, Martin J Schreiber
♦ Background: Incremental peritoneal dialysis (PD), the gradual introduction of dialysate exchanges at less than full-dose therapy, has been infrequently described in clinical reports. One concern with less than full-dose dialysis is whether urea clearance targets are achievable with an incremental regimen. In this report, we used a large database of PD patients, across all membrane transport types, and performed urea kinetic modeling determinations of possible incremental regimens for an individual membrane type...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28088457/preformulation-characterization-stabilization-and-formulation-design-for-the-acrylodan-labeled-glucose-binding-protein-sm4-ac
#10
Neha Sahni, Rajoshi Chaudhuri, John M Hickey, Prakash Manikwar, Ajit D'Souza, Andrew Metters, Sangeeta B Joshi, C Russell Middaugh, David B Volkin
This study describes the physicochemical characterization, stabilization and formulation design of SM4-AC, an acrylodan labeled glucose/galactose binding protein for use in a continuous glucose monitoring device. The physical stability profile of SM4-AC as a function of pH and temperature was monitored using a combination of biophysical techniques and the resulting physical stability profile was visualized using an empirical phase diagram. Forced degradation chemical stability studies (Asn deamidation, Met oxidation) of SM4-AC were performed using a combination of capillary isoelectric focusing (cIEF), peptide mapping and reversed phase high performance liquid chromatography (RP-HPLC)...
January 11, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28071894/noninvasive-monitoring-of-blood-glucose-with-raman-spectroscopy
#11
Rishikesh Pandey, Santosh Kumar Paidi, Tulio A Valdez, Chi Zhang, Nicolas Spegazzini, Ramachandra Rao Dasari, Ishan Barman
The successful development of a noninvasive blood glucose sensor that can operate reliably over sustained periods of time has been a much sought after but elusive goal in diabetes management. Since diabetes has no well-established cure, control of elevated glucose levels is critical for avoiding severe secondary health complications in multiple organs including the retina, kidney and vasculature. While fingerstick testing continues to be the mainstay of blood glucose detection, advances in electrochemical sensing-based minimally invasive approaches have opened the door for alternate methods that would considerably improve the quality of life for people with diabetes...
January 10, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28070056/a-case-of-idiopathic-type-1-diabetes-with-subsequent-recovery-of-endogenous-insulin-secretion-despite-initial-diagnosis-of-fulminant-type-1-diabetes
#12
Keizo Kaneko, Chihiro Satake, Junpei Yamamoto, Hironori Takahashi, Shojiro Sawada, Junta Imai, Tetsuya Yamada, Hideki Katagiri
Fulminant type 1 diabetes is characterized by remarkably rapid and complete β-cell destruction. The established diagnostic criteria include the occurrence of diabetic ketosis soon after the onset of hyperglycemic symptoms, elevated plasma glucose with relatively low HbA1c at the first visit, and extremely low C-peptide. Serum C-peptide levels remain extremely low over a prolonged period. A 26-year-old-man with diabetic ketosis was admitted to our hospital. His relatively low HbA1c (7.6 %), despite marked hyperglycemia (593 mg/dL) with marked ketosis, indicated abrupt onset...
January 6, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28055230/improved-postprandial-glycemic-control-with-faster-acting-insulin-aspart-in-patients-with-type-1-diabetes-using-continuous-subcutaneous-insulin-infusion
#13
Bruce W Bode, Joseph A Johnson, Liselotte Hyveled, Søren C Tamer, Marek Demissie
BACKGROUND: Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp. METHODS: This double-blind, randomized, crossover active-controlled trial compared 2-h postprandial plasma glucose (PPG) response, following 2 weeks of CSII with faster aspart or IAsp. Primary endpoint: mean change in PPG 2 h after a standardized meal test (ΔPGav,0-2h)...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28042054/design-and-rationale-of-heart-and-lung-failure-pediatric-insulin-titration-trial-half-pint-a-randomized-clinical-trial-of-tight-glycemic-control-in-hyperglycemic-critically-ill-children
#14
Michael Sd Agus, Ellie Hirshberg, Vijay Srinivasan, Edward Vincent Faustino, Peter M Luckett, Martha Aq Curley, Jamin Alexander, Lisa A Asaro, Kerry Coughlin-Wells, Donna Duva, Jaclyn French, Natalie Hasbani, Martha T Sisko, Carmen L Soto-Rivera, Garry Steil, David Wypij, Vinay M Nadkarni
OBJECTIVES: Test whether hyperglycemic critically ill children with cardiovascular and/or respiratory failure experience more ICU-free days when assigned to tight glycemic control with a normoglycemic versus hyperglycemic blood glucose target range. DESIGN: Multi-center randomized clinical trial. SETTING: Pediatric ICUs at 35 academic hospitals. PATIENTS: Children aged 2weeks to 17years receiving inotropic support and/or acute mechanical ventilation, excluding cardiac surgical patients...
December 30, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28039172/toward-defining-the-threshold-between-low-and-high-glucose-variability-in-diabetes
#15
Louis Monnier, Claude Colette, Anne Wojtusciszyn, Sylvie Dejager, Eric Renard, Nicolas Molinari, David R Owens
OBJECTIVE: To define the threshold for excess glucose variability (GV), one of the main features of dysglycemia in diabetes. RESEARCH DESIGN AND METHODS: A total of 376 persons with diabetes investigated at the University Hospital of Montpellier (Montpellier, France) underwent continuous glucose monitoring. Participants with type 2 diabetes were divided into several groups-groups 1, 2a, 2b, and 3 (n = 82, 28, 65, and 79, respectively)-according to treatment: 1) diet and/or insulin sensitizers alone; 2) oral therapy including an insulinotropic agent, dipeptidyl peptidase 4 inhibitors (group 2a), or sulfonylureas (group 2b); or 3) insulin...
December 30, 2016: Diabetes Care
https://www.readbyqxmd.com/read/28032465/diurnal-glucose-exposure-profiles-of-patients-treated-with-lixisenatide-before-breakfast-or-the-main-meal-of-the-day-an-analysis-using-continuous-glucose-monitoring
#16
Richard M Bergenstal, Ellie Strock, Roger Mazze, Margaret A Powers, Arlene M Monk, Sara Richter, Elisabeth Souhami, Bo Ahren
BACKGROUND: In the parent study of this analysis, patients with type 2 diabetes received lixisenatide before breakfast or the main meal of the day. This sub-study was designed to examine the effect of lixisenatide administered before breakfast or the main meal of the day on continuously assessed 24-hour patient glucose profiles. METHODS: A subset of patients from the parent study underwent two 14-day periods of continuous glucose monitoring (CGM) at the start and end of the 24-week study...
December 29, 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28026743/glucose-monitoring-in-individuals-with-diabetes-using-a-long-term-implanted-sensor-telemetry-system-and-model
#17
Joseph Lucisano, Timothy Routh, Joe Lin, David Gough
OBJECTIVE: The use of a fully implanted, first-generation prototype sensor/telemetry system is described for long-term monitoring of subcutaneous tissue glucose in a small cohort of people with diabetes. METHODS: Sensors are based on a membrane containing immobilized glucose oxidase and catalase coupled to electrochemical oxygen detection and telemetry systems, integrated as an implant. The devices remained implanted for up to 180 days, with signals transmitted every 2 minutes to external receivers...
October 19, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28007348/home-use-of-a-bihormonal-bionic-pancreas-versus-insulin-pump-therapy-in-adults-with-type-1-diabetes-a-multicentre-randomised-crossover-trial
#18
Firas H El-Khatib, Courtney Balliro, Mallory A Hillard, Kendra L Magyar, Laya Ekhlaspour, Manasi Sinha, Debbie Mondesir, Aryan Esmaeili, Celia Hartigan, Michael J Thompson, Samir Malkani, J Paul Lock, David M Harlan, Paula Clinton, Eliana Frank, Darrell M Wilson, Daniel DeSalvo, Lisa Norlander, Trang Ly, Bruce A Buckingham, Jamie Diner, Milana Dezube, Laura A Young, April Goley, M Sue Kirkman, John B Buse, Hui Zheng, Rajendranath R Selagamsetty, Edward R Damiano, Steven J Russell
BACKGROUND: The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were living at home and participating in their normal daily routines without restrictions on diet or physical activity. METHODS: We did a random-order crossover study in volunteers at least 18 years old who had type 1 diabetes and lived within a 30 min drive of four sites in the USA...
December 20, 2016: Lancet
https://www.readbyqxmd.com/read/28004007/clinical-efficacy-of-two-different-methods-to-initiate-sensor-augmented-insulin-pumps-a-randomized-controlled-trial
#19
Jesus Moreno-Fernandez, Francisco Javier Gómez, Maria Ángeles Gálvez Moreno, Justo P Castaño
Aim. To analyze clinical effect of a novel approach to initiate sensor-augmented insulin pumps in type 1 diabetes mellitus (T1DM) patients through early real-time continuous glucose monitoring (RT-CGM) initiation. Methods. A 26-week pilot study with T1DM subjects randomized (1 : 1) to start RT-CGM three weeks before continuous subcutaneous insulin infusion (CGM pre-CSII) or adding RT-CGM three weeks after continuous subcutaneous insulin infusion (CGM post-CSII). Results. Twenty-two patients were enrolled with a mean age of 36...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27999822/glucose-200%C3%A2-mg-dl-during-continuous-glucose-monitoring-identifies-adult-patients-at-risk-for-development-of-cystic-fibrosis-related-diabetes
#20
J L Taylor-Cousar, J S Janssen, A Wilson, C G St Clair, K M Pickard, M C Jones, S J Brayshaw, C S Chacon, C M Barboa, M K Sontag, F J Accurso, D P Nichols, M T Saavedra, J A Nick
Rationale. Cystic fibrosis related diabetes (CFRD) is the most common comorbidity in patients with CF. In spite of increased screening, diagnosis, and treatment of CFRD, the mortality rate in patients with CFRD still far exceeds the mortality rate in those without CFRD. Guidelines suggest that screening for CFRD be performed annually using the 2-hour 75-gram oral glucose tolerance test (OGTT). Adherence to recommended screening has been poor, with only approximately one-quarter of adults with CF undergoing OGTT in 2014...
2016: Journal of Diabetes Research
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