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Diabetes. Insulin pump

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https://www.readbyqxmd.com/read/28209654/replace-bg-a-randomized-trial-comparing-continuous-glucose-monitoring-with-and-without-routine-blood-glucose-monitoring-in-well-controlled-adults-with-type-1-diabetes
#1
Grazia Aleppo, Katrina J Ruedy, Tonya D Riddlesworth, Davida F Kruger, Anne L Peters, Irl Hirsch, Richard M Bergenstal, Elena Toschi, Andrew J Ahmann, Viral N Shah, Michael R Rickels, Bruce W Bode, Athena Philis-Tsimikas, Rodica Pop-Busui, Henry Rodriguez, Emily Eyth, Anuj Bhargava, Craig Kollman, Roy W Beck
OBJECTIVE: To determine whether the use of continuous glucose monitoring (CGM) without confirmatory blood glucose monitoring (BGM) measurements is as safe and effective as using CGM adjunctive to BGM in well-controlled adults with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: A randomized noninferiority clinical trial was conducted at 14 sites in the T1D Exchange Clinic Network. Participants were ≥18 years of age (mean 44 ± 14 years), had T1D for ≥1 year (mean duration 24 ± 12 years), used an insulin pump, and had an HbA1c ≤9...
February 16, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28164370/impact-of-neighbourhood-level-inequity-on-paediatric-diabetes-care
#2
A B M Clarke, D Daneman, J R Curtis, F H Mahmud
AIMS: To evaluate the association between neighbourhood-level inequity and glycaemic control in paediatric participants with Type 1 diabetes using the Neighbourhood Equity Index (NEI). METHODS: The NEI was linked to the clinical data of 519 children with diabetes followed at the Hospital for Sick Children (Toronto, Canada). The NEI is a composite measure of inequity developed using the World Health Organization's Urban Health Equity Assessment and Response Tool (HEART), which encompasses 15 weighted indicators evaluating economic, social, environmental and lifestyle factors...
February 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28161977/achieving-effective-glycaemic-control-using-an-insulin-micro-pump
#3
Peter Kelly
For those with type 1 diabetes mellitus (T1DM), a deranged blood glucose level can cause hypo/hyperglycaemic episodes and in the long term contribute to microvascular disease. Such outcomes can effect concordance with insulin management regimens and affect the patient's quality of life. A variety of insulin delivery methods are available, including continuous subcutaneous insulin infusion (CSII) via either a tethered or patch pump. Pumps have the potential to improve delivery, monitoring and adjustment of insulin regimens, thus freeing patient's time and affording more control of their disease...
February 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28145047/influence-of-health-locus-of-control-and-fear-of-hypoglycaemia-on-glycaemic-control-and-treatment-satisfaction-in-people-with-type-1-diabetes-on-insulin-pump-therapy
#4
L Indelicato, V Mariano, S Galasso, F Boscari, E Cipponeri, C Negri, A Frigo, A Avogaro, E Bonora, M Trombetta, D Bruttomesso
AIM: To assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion. METHODS: People with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub-classified as an 'acceptable glucose control' group [HbA1c ≤58 mmol/mol (7.5%)] and a 'suboptimum glucose control' group [HbA1c >58 mmol/mol (7...
February 1, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28143733/fear-of-hypoglycemia-influence-on-glycemic-variability-and-self-management-behavior-in-young-adults-with-type-1-diabetes
#5
Pamela Martyn-Nemeth, Laurie Quinn, Sue Penckofer, Chang Park, Vanessa Hofer, Larisa Burke
PURPOSE: The purpose of this study was to examine how fear of hypoglycemia (FOH) is associated with glycemic variability (GV) and self-management behavior in young adults (aged 18-35) with type 1 diabetes (T1DM). PROCEDURES: Using a prospective repeated-measures design, in 35 young adults, within- and between-person and temporal associations of FOH, specific self-management behaviors, and GV were measured. The data were collected using questionnaires and real-time measures using daily diaries, insulin pump downloads, actigraphy, and continuous glucose monitoring...
January 20, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28135116/an-expert-opinion-on-advanced-insulin-pump-use-in-youth-with-type-1-diabetes
#6
Bruce W Bode, Francine R Kaufman, Nan Vint
Among children and adolescents with type 1 diabetes mellitus, the use of insulin pump therapy has increased since its introduction in the early 1980s. Optimal management of type 1 diabetes mellitus depends on sufficient understanding by patients, their families, and healthcare providers on how to use pump technology. The goal for the use of insulin pump therapy should be to advance proficiency over time from the basics taught at the initiation of pump therapy to utilizing advanced settings to obtain optimal glycemic control...
January 30, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28134397/-review-update-on-magnesium-metabolism
#7
Pasquale Fatuzzo, Luca Zanoli, Viviana Scollo, Grazia Portale, Agostino Gaudio, Alessandra Pani, Antonio Granata
Magnesium is the second intracellular cation and the fourth most abundant mineral in the body. Low levels of magnesium have been associated with insulin resistance and type-2 diabetes mellitus, asthma, osteoporosis and chronic kidney disease (CKD). The use of proton pump inhibitors (PPIs) represents the most common cause of hypomagnesemia. The risk of hypomagnesemia, and consequently worsening of the renal function, is increased when diuretics are added to therapy in subjects treated with PPIs. Interestingly, diuretics and PPIs are two of the most used drugs in subjects with CKD...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28130944/pediatric-insulin-pump-therapy-reflecting-on-the-first-10-years-of-a-universal-funding-program-in-ontario
#8
Rayzel Shulman, Fiona A Miller, Thérèse A Stukel, Denis Daneman, Astrid Guttmann
We evaluated the universal funding program for pediatric insulin pumps in Ontario by examining the dynamics underlying patterns of pump use and adverse events using population-based health administrative data available at the Institute for Clinical Evaluative Sciences (ICES), supplemented by other data. We found that (1) pump use has increased steadily since 2006 with variation across centres and disparity in use by socioeconomic status; (2) pump discontinuation is uncommon; (3) physicians value pump therapy in numerous ways that provide important insights into patterns of uptake; and (4) the safety profile of pump therapy is, in general, very good; however, individuals of lower socioeconomic status are at an increased risk of acute diabetes complications, most frequently diabetic ketoacidosis...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28118453/effect-of-continuous-glucose-monitoring-on-glycemic-control-in-adults-with-type-1-diabetes-using-insulin-injections-the-diamond-randomized-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Roy W Beck, Tonya Riddlesworth, Katrina Ruedy, Andrew Ahmann, Richard Bergenstal, Stacie Haller, Craig Kollman, Davida Kruger, Janet B McGill, William Polonsky, Elena Toschi, Howard Wolpert, David Price
Importance: Previous clinical trials showing the benefit of continuous glucose monitoring (CGM) in the management of type 1 diabetes predominantly have included adults using insulin pumps, even though the majority of adults with type 1 diabetes administer insulin by injection. Objective: To determine the effectiveness of CGM in adults with type 1 diabetes treated with insulin injections. Design, Setting, and Participants: Randomized clinical trial conducted between October 2014 and May 2016 at 24 endocrinology practices in the United States that included 158 adults with type 1 diabetes who were using multiple daily insulin injections and had hemoglobin A1c (HbA1c) levels of 7...
24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28118050/administration-of-biosimilar-insulin-analogs-role-of-devices
#10
Lutz Heinemann, Ingo Fritz, Hootan Khatami, Steven V Edelman
With the expiration of patent protection for several originator insulin analog molecules, the availability of insulin analog copies is set to increase. Many regulatory authorities have developed, and continue to refine, guidelines for the approval of biosimilar insulin analogs. Aspects such as the structure, pharmacokinetics and pharmacodynamics, efficacy, safety, and immunogenicity of biosimilar insulin analogs are extensively addressed in these guidelines, but how the biosimilar insulin analog is administered to people with diabetes is not usually a topic...
February 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28117542/the-additional-dose-of-insulin-for-high-protein-mixed-meal-provides-better-glycemic-control-in-children-with-type-1-diabetes-on-insulin-pumps-randomized-cross-over-study
#11
Katarzyna Piechowiak, Katarzyna Dżygało, Agnieszka Szypowska
BACKGROUND: Delivery of insulin for high-protein low-fat meals with carbohydrates on the basis of carbohydrates leads to higher late postprandial glycemia. Studies with mixed meals demonstrated lower blood glucose level after dual wave bolus. The objective of our study was to assess the impact of additional dose of insulin in dual wave bolus for high-protein mixed meal on the postprandial glycemia. MATERIALS AND METHODS: We performed a randomized, double-blind, two-way cross-over study, including 58 children with type 1 diabetes, aged 14...
January 24, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28100606/predictive-hyperglycemia-and-hypoglycemia-minimization-in-home-evaluation-of-safety-feasibility-and-efficacy-in-overnight-glucose-control-in-type-1-diabetes
#12
Tamara Spaic, Marsha Driscoll, Dan Raghinaru, Bruce A Buckingham, Darrell M Wilson, Paula Clinton, H Peter Chase, David M Maahs, Gregory P Forlenza, Emily Jost, Irene Hramiak, Terri Paul, B Wayne Bequette, Faye Cameron, Roy W Beck, Craig Kollman, John W Lum, Trang T Ly
OBJECTIVE: The objective of this study was to determine the safety, feasibility, and efficacy of a predictive hyperglycemia and hypoglycemia minimization (PHHM) system compared with predictive low-glucose insulin suspension (PLGS) alone in overnight glucose control. RESEARCH DESIGN AND METHODS: A 42-night trial was conducted in 30 individuals with type 1 diabetes in the age range 15-45 years. Participants were randomly assigned each night to either PHHM or PLGS and were blinded to the assignment...
January 18, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28099035/-let-the-algorithm-do-the-work-reduction-of-hypoglycemia-using-sensor-augmented-pump-therapy-with-predictive-insulin-suspension-smartguard-in-pediatric-type-1-diabetes-patients
#13
Torben Biester, Olga Kordonouri, Martin Holder, Kerstin Remus, Dorothee Kieninger-Baum, Tanja Wadien, Thomas Danne
BACKGROUND: A sensor-augmented insulin pump (SAP) using the MiniMed(®) 640G system with SmartGuard™ technology allows an automatic stop of insulin delivery based on prediction of low glucose levels. Since pediatric patients are particularly prone to hypoglycemia, this device may offer additional protection beyond conventional sensor-augmented therapy. METHODS: This prospective, pediatric multicenter user evaluation assessed 6 weeks of SAP with SmartGuard (threshold setting for hypoglycemia: 70 mg/dL) compared to a preceding period of 2 weeks with SAP only...
January 18, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28094472/outpatient-60-hour%C3%A2-day-and-night%C3%A2-glucose-control-with-dual-hormone%C3%A2-artificial-pancreas-single-hormone-artificial-pancreas-%C3%A2-or-sensor-augmented-pump-therapy-in-adults-with%C3%A2-type-1-diabetes-an-open-label-%C3%A2-randomised-crossover-controlled-trial
#14
Ahmad Haidar, Virginie Messier, Laurent Legault, Martin Ladouceur, Rémi Rabasa-Lhoret
AIMS: To assess whether the dual-hormone (insulin and glucagon) artificial pancreas reduces hypoglycemia compared to the single-hormone (insulin alone) artificial pancreas in outpatient settings during the day and night. MATERIAL AND METHODS: In a randomized, three-way, crossover trial, we compared the dual-hormone artificial pancreas, the single-hormone artificial pancreas, and sensor-augmented pump therapy (control) in 23 adults with type 1 diabetes. Each intervention was applied from 08 h00 Day 1 to 20 h00 Day 3 (60 hours) in outpatient free-living conditions...
January 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28094136/day-and-night-glycaemic-control-with-closed-loop-insulin-delivery-versus-conventional-insulin-pump-therapy-in-free-living-adults-with-well-controlled-type-1-diabetes-an-open-label-randomised-crossover-study
#15
Lia Bally, Hood Thabit, Harald Kojzar, Julia K Mader, Jehona Qerimi-Hyseni, Sara Hartnell, Martin Tauschmann, Janet M Allen, Malgorzata E Wilinska, Thomas R Pieber, Mark L Evans, Roman Hovorka
BACKGROUND: Tight control of blood glucose concentration in people with type 1 diabetes predisposes to hypoglycaemia. We aimed to investigate whether day-and-night hybrid closed-loop insulin delivery can improve glucose control while alleviating the risk of hypoglycaemia in adults with HbA1c below 7·5% (58 mmol/mol). METHODS: In this open-label, randomised, crossover study, we recruited adults (aged ≥18 years) with type 1 diabetes and HbA1c below 7·5% from Addenbrooke's Hospital (Cambridge, UK) and Medical University of Graz (Graz, Austria)...
January 13, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28052468/young-people-with-type-1-diabetes-mellitus-attitudes-perceptions-and-experiences-of-diabetes-management-and-continuous-subcutaneous-insulin-infusion-therapy
#16
Lin Perry, Steven James, Katharine Steinbeck, Janet Dunbabin, Julia Lowe
RATIONALE, AIMS, AND OBJECTIVES: Continuous subcutaneous insulin infusion (CSII; insulin pump) use is increasing. However, there is little information about how this technology is used compared with other insulin delivery methods (ie, injections) by young people with type 1 diabetes mellitus in Australia. This study explored young people's attitudes, perceptions, and experiences with diabetes management comparing those using with those not using CSII, and proportions likely to transition to adult services requiring initiation and/or support for CSII use...
January 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28033258/impact-of-disease-management-programs-on-metabolic-control-in-patients-with-type-1-diabetes-mellitus-a-cohort-study-in-shantou-china
#17
Kun Lin, Xiaoping Yang, Yixi Wu, Shuru Chen, Guoshu Yin, Jianjun Zhan, Chujia Lin, Wencan Xu, Yongsong Chen, Dan Lin, Peiwen Xie, Yishan Fang, Qiuqiang Lin, Shaoda Lin
The aim of this study is to evaluate the effect of diabetes disease management program (DMP) on glycemic control in type 1 diabetes mellitus (T1DM) patients in Shantou China.A sample of 240 participants recruited from 3C study Shantou subgroup was followed up in DMP for 3 years. The DMP provided self-management education, individualized therapy plan, diabetes complications screening, and laboratory examination periodical according to clinical practice guidelines. Primary outcomes were changes in hemoglobin A1C (HbA1c)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28018888/health-care-for-children-with-diabetes-mellitus-from-low-income-families-in-ontario-and-california-a-population-based-cohort-study
#18
Sunitha V Kaiser, Vandana Sundaram, Eyal Cohen, Rayzel Shulman, Jun Guan, Lee Sanders, Astrid Guttmann
BACKGROUND: Children with diabetes mellitus in low-income families have poor outcomes, but little is known as to how this relates to healthcare system structure. Our objective was to gain insight into how best to structure health systems to serve these children by describing their health care use in 2 health system models: a Canadian model, with an organized diabetes care network that includes generalists, and an American model, with targeted support services for children from low-income families...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28011458/insulin-and-glucose-alter-death-associated-protein-kinase-3-dapk3-dna-methylation-in-human-skeletal-muscle
#19
Jonathan M Mudry, David G Lassiter, Carolina Nylén, Sonia García-Calzón, Erik Näslund, Anna Krook, Juleen R Zierath
DNA methylation is altered by environmental factors. We hypothesized DNA methylation is altered in skeletal muscle in response to either insulin or glucose exposure. We performed a genome-wide DNA methylation analysis in muscle from healthy men before and after insulin exposure. DNA methylation of selected genes was determined in muscle from healthy and type 2 diabetic men before and after a glucose tolerance test. Insulin altered DNA methylation in the 3'UTR of the calcium pump ATP2A3 gene. Insulin increased DNA methylation in the gene body of DAPK3, a gene involved in cell proliferation, apoptosis and autophagy...
December 23, 2016: Diabetes
https://www.readbyqxmd.com/read/28008584/changes-in-quality-of-diabetes-care-and-morbidity-over-20-years-in-people-with-type-1-diabetes-and-long-diabetes-duration-the-jevin-trial
#20
T Heller, K Reise, J Roth, T Lehmann, R Schiel, S Lorkowski, U A Müller, N Müller
Background: The JEVIN trial started as a cross-sectional study in 1989/90 in Jena, a city of the former German Democratic Republic. At that time, the centralized diabetes care system was broken down and restarted 10 years later; structured treatment and teaching programs were implemented, blood glucose self-monitoring, insulin pump-systems and analogue insulin were introduced. We surveyed people with type-1-diabetes of the baseline JEVIN trial in a 20-year follow-up. Methods: 131 patients with type-1-diabetes were analyzed in 1989/90...
December 22, 2016: Experimental and Clinical Endocrinology & Diabetes
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