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Diabetes. Insulin pump

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https://www.readbyqxmd.com/read/29454299/congenital-forms-of-diabetes-the-beta-cell-and-beyond
#1
REVIEW
Lisa R Letourneau, Siri Atma W Greeley
The majority of patients diagnosed with diabetes less than 6 months of age, and many cases diagnosed between 6 and 12 months of age, have a gene mutation that causes permanent or transient hyperglycemia. Recent research advances have allowed for the discovery of new causes of congenital diabetes, including genes involved in pancreatic development (GATA4, NKX2-2, MNX1) and monogenic causes of autoimmune dysregulation (STAT3, LRBA). Ongoing follow-up of patients with KCNJ11 and ABCC8 mutations has supported the safety and efficacy of sulfonylureas, as well as the use of insulin pumps and continuous glucose monitors in infants with insulin-requiring forms of monogenic diabetes...
February 14, 2018: Current Opinion in Genetics & Development
https://www.readbyqxmd.com/read/29446511/long-term-study-of-tubeless-insulin-pump-therapy-compared-to-multiple-daily-injections-in-youth-with-type-1-diabetes-data-from-the-german-austrian-dpv-registry
#2
Thomas Danne, Anke Schwandt, Torben Biester, Bettina Heidtmann, Birgit Rami-Merhar, Holger Haberland, Silvia Müther, Semik Khodaverdi, Thomas Haak, Reinhard W Holl
OBJECTIVE: To examine glycemic control in youth with type 1 diabetes (T1D) who switched from multiple daily injections (MDI) to a tubeless insulin pump (Omnipod ® Insulin Management System, Insulet Corp., Billerica, MA) compared to patients who continued MDI therapy over a 3-year time period. RESEARCH DESIGN AND METHODS: This retrospective analysis of the German/Austrian Diabetes Patienten Verlaufsdokumentation (DPV) registry included data from 263 centers and 2529 patients <20 years (n=660 tubeless insulin pump; n=1869 MDI) who initiated treatment on a tubeless insulin pump as of January 1, 2013 and had 1 year of data pre-switch from MDI and 3 years of data post-switch to a tubeless pump...
February 15, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29433562/the-impact-of-insulin-pump-therapy-to-oxidative-stress-in-patients-with-diabetic-nephropathy
#3
Xing-Guang Zhang, Yan-Qi Zhang, Qian-Peng Cheng, Yi Cao, Jian-Min Sun, Xiao-Feng Lv
BACKGROUND: The oxidative stress resulting from increased production of ROS plays a crucial role in the development of diabetic complications. We aim to explore the relationships between oxidative stress, diabetic nephropathy (DN) and short-term insulin pump intensive therapy (insulin therapy). METHODS: Levels of 8-hydroxy-deoxyguanosine (8-OHdG), 3-nitrotyrosine (3-NT), glutathione (GSH), superoxide dismutase (SOD) and Interleukin-6 (IL-6) were estimated before and after 2 weeks of insulin therapy in normal group (NC) and type 2 diabetic (DM) with normal albuminuria (NA), microalbuminuria (MA) and clinical albuminuria (CA)...
February 12, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29429781/high-prevalence-and-incidence-of-diabetic-peripheral-neuropathy-in-children-and-adolescents-with-type-1-diabetes-mellitus-results-from-a-five-year-prospective-cohort-study
#4
Isabella Walter-Höliner, Daniela Seick Barbarini, Jürg Lütschg, Anya Blassnig-Ezeh, Ulrike Zanier, Christoph H Saely, Burkhard Simma
BACKGROUND: In this prospective cohort study, we investigated the prevalence of diabetic peripheral neuropathy at baseline and after five years of follow-up in children and adolescents with type 1 diabetes mellitus using both measurements of nerve conduction velocity and clinical neurological examination. METHODS: A total of 38 patients who underwent insulin pump or intensive insulin therapy were included. The subjects averaged 12.6 ± 2.4 years of age and their diabetes duration averaged 5...
December 13, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/29429377/strategies-for-implementing-effective-mealtime-insulin-therapy-in-type-2-diabetes
#5
Mark Peyrot, Timothy S Bailey, Belinda P Childs, Gérard Reach
INTRODUCTION: Type 2 diabetes mellitus (T2D) is a growing global epidemic. Due to the progressive nature of the disease, many people with T2D require insulin at some point, most commonly a long-acting (basal) insulin to assist with 24-hour control of glucose levels. OBJECTIVE: This opinion paper provides an overview of considerations for primary care providers (PCPs) in intensifying the treatment regimen when basal insulin therapy is inadequate. RESULTS: Control of mealtime hyperglycemia, in addition to fasting hyperglycemia, has been shown to be crucial in reaching A1c goals of <7...
February 12, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29428572/metabolic-control-and-complications-in-italian-people-with-diabetes-treated-with-continuous-subcutaneous-insulin-infusion
#6
Giuseppe Lepore, Riccardo Bonfanti, Lutgarda Bozzetto, Vincenzo Di Blasi, Angela Girelli, Giorgio Grassi, Dario Iafusco, Luigi Laviola, Ivana Rabbone, Riccardo Schiaffini, Daniela Bruttomesso
BACKGROUND AND AIM: The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). METHODS AND RESULTS: Questionnaires investigating the organisation of diabetes care centres, individuals' clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy...
December 9, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29418050/the-process-of-incorporating-insulin-pumps-into-the-everyday-lives-of-people-with-type-1-diabetes-a-critical-interpretive-synthesis
#7
REVIEW
Claire Reidy, Mike Bracher, Claire Foster, Ivaylo Vassilev, Anne Rogers
BACKGROUND: Insulin pump therapy (IPT) is a technological advancement that has been developed to help people manage Type 1 diabetes (T1D). However, ways of managing diabetes requiring the implementation of health technologies bring new complexities and a need to understand the factors which enable people with T1D to incorporate a novel device. This new comprehension could provide an exemplar for people with long-term conditions to incorporate new technologies more generally. OBJECTIVE: To determine what influences the incorporation, adaptation and use of IPT into the everyday lives of people living with diabetes...
February 8, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29416197/impact-of-insulin-delivery-method-on-hypoglycemia-incidence-in-pediatric-type-1-diabetes-mellitus-patients
#8
Snijezana Hasanbegovic, Emina Obarcanin, Edo Hasanbegovic, Nedim Begic
Introduction: Insulin therapy of pediatric patients with type 1 diabetes mellitus (T1DM) is highly demanding due to their dynamic growth, development and different daily life activities. Goal: To determine the optimal insulin delivery method for the prevention of hypoglycemia recorded by continuous monitoring of glucose in patients with insulin pump and PEN. Material and Methods: The study included patients up to 18 years of age with diagnosed T1DM and treated with insulin pump and by insulin therapy with PEN at the Pediatric Clinic of the Clinical Center in Sarajevo...
December 2017: Medical Archives
https://www.readbyqxmd.com/read/29412837/glucose-lowering-therapies-in-type-2-diabetes-opportunities-and-challenges-for-peptides
#9
REVIEW
Clifford J Bailey
This overview considers the opportunities and challenges that face the use of gluco-regulatory peptides to treat type 2 diabetes. New insulin analogues and formulations are being developed with pharmacokinetic properties to speed-up or prolong transfer from a subcutaneous injection site to the target tissues, or to selectively favour effects on the liver. Alternative routes of insulin administration continue to attract attention, and advances in the integration of glucose monitoring with insulin pump devices are improving miniaturised 'closed loop' artificial pancreas systems...
February 2018: Peptides
https://www.readbyqxmd.com/read/29390915/real-time-detection-of-infusion-site-failures-in-a-closed-loop-artificial-pancreas
#10
Daniel P Howsmon, Nihat Baysal, Bruce A Buckingham, Gregory P Forlenza, Trang T Ly, David M Maahs, Tatiana Marcal, Lindsey Towers, Eric Mauritzen, Sunil Deshpande, Lauren M Huyett, Jordan E Pinsker, Ravi Gondhalekar, Francis J Doyle, Eyal Dassau, Juergen Hahn, B Wayne Bequette
BACKGROUND: As evidence emerges that artificial pancreas systems improve clinical outcomes for patients with type 1 diabetes, the burden of this disease will hopefully begin to be alleviated for many patients and caregivers. However, reliance on automated insulin delivery potentially means patients will be slower to act when devices stop functioning appropriately. One such scenario involves an insulin infusion site failure, where the insulin that is recorded as delivered fails to affect the patient's glucose as expected...
January 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29383544/emerging-technologies-for-the-management-of-type-1-diabetes-in-pregnancy
#11
REVIEW
Jennifer M Yamamoto, Helen R Murphy
PURPOSE OF REVIEW: The purpose of the study is to discuss emerging technologies available in the management of type 1 diabetes in pregnancy. RECENT FINDINGS: The latest evidence suggests that continuous glucose monitoring (CGM) should be offered to all women on intensive insulin therapy in early pregnancy. Studies have additionally demonstrated the ability of CGM to help gain insight into specific glucose profiles as they relate to glycaemic targets and pregnancy outcomes...
January 30, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29364220/studying-the-hypothalamic-insulin-signal-to-peripheral-glucose-intolerance-with-a-continuous-drug-infusion-system-into-the-mouse-brain
#12
Reni Ajoy, Szu-Yi Chou
Insulin regulates systematic metabolism in the hypothalamus and the peripheral insulin response. An inflammatory reaction in peripheral adipose tissues contributes to type 2 diabetes mellitus (T2DM) development and appetite regulation in the hypothalamus. Chemokine CCL5 and C-C chemokine receptor type 5 (CCR5) levels have been suggested to mediate arteriosclerosis and glucose intolerance in type 2 diabetes mellitus (T2DM). In addition, CCL5 plays a neuroendocrine role in the hypothalamus by regulating food intake and body temperature, thus, prompting us to investigate its function in hypothalamic insulin signaling and the regulation of peripheral glucose metabolism...
January 4, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29359575/safety-of-insulin-lispro-and-a-biosimilar-insulin-lispro-when-administered-through-an-insulin-pump
#13
James Thrasher, Howard Surks, Irene Nowotny, Suzanne Pierre, Baerbel Rotthaeuser, Karin Wernicke-Panten, Satish Garg
BACKGROUND: SAR342434 (U100; SAR-Lis; insulin lispro) is a biosimilar/follow-on to insulin lispro (U100; Ly-Lis). Similar pharmacokinetics/pharmacodynamics between the two products has been demonstrated in a hyperinsulinemic euglycemic clamp study. The current study evaluated the safety of SAR-Lis and Ly-Lis when administered by continuous subcutaneous insulin infusion (CSII; insulin pumps). METHODS: This was a randomized, open-label, 2 × 4-week, two-arm crossover study in 27 patients with type 1 diabetes mellitus (NCT02603510)...
January 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29358493/effects-of-preceding-ethanol-intake-on-glucose-response-to-low-dose-glucagon-in-individuals-with-type-1-diabetes-a-randomized-placebo-controlled-crossover-study
#14
Ajenthen Ranjan, Kirsten Nørgaard, Rikke Tetzschner, Isabelle Isa Kristin Steineck, Trine Ryberg Clausen, Jens Juul Holst, Sten Madsbad, Signe Schmidt
OBJECTIVE: This study investigated whether preceding ethanol intake impairs glucose response to low-dose glucagon in individuals with type 1 diabetes. RESEARCH DESIGN AND METHODS: This was a randomized, crossover, placebo-controlled study in 12 insulin pump-treated individuals (median [interquartile range] age, 37 [31-51] years; HbA1c, 57 [51-59] mmol/mol or 7.3% [6.8-7.5]; and BMI, 23.922-25] kg/m2). During two overnight study visits, a 6 p.m. dinner (1 g carbohydrates/kg) was served with diet drink (placebo) or diet drink and ethanol (0...
January 22, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29355438/insulin-sensitivity-index-based-optimization-of-insulin-to-carbohydrate-ratio-in-silico-study-shows-efficacious-protection-against-hypoglycemic-events-caused-by-suboptimal-therapy
#15
Michele Schiavon, Chiara Dalla Man, Claudio Cobelli
BACKGROUND AND AIM: The insulin to carbohydrate ratio (CR) is a parameter used by patients with type 1 diabetes (T1D) to calculate the premeal insulin bolus. Usually, it is estimated by the physician based on patient diary, but modern diabetes technologies, such as subcutaneous glucose sensing (continuous glucose monitoring, CGM) and insulin delivery (continuous subcutaneous insulin infusion, CSII) systems, can provide important information for its optimization. In this study, a method for CR optimization based on CGM and CSII data is presented and its efficacy and robustness tested in several in silico scenarios, with the primary aim of increasing protection against hypoglycemia...
February 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29344829/rapid-acting-and-regular-insulin-are-equal-for-high-fat-protein-meal-in-individuals-with-type-1-diabetes-treated-with-multiple-daily-injections
#16
Karolina Jabłońska, Piotr Molęda, Krzysztof Safranow, Lilianna Majkowska
INTRODUCTION: The fat and protein content can impact late postprandial glycemia; therefore, prolonged insulin boluses for high-fat/-protein meals are recommended for patients with type 1 diabetes on insulin pump therapy. It is not clear how to translate these findings to multiple daily injection (MDI) therapy. We hypothesized that regular insulin with a slower onset and a longer duration of action might be advantageous for such meals. METHODS: Twenty-five patients with well-controlled type 1 diabetes (mean HbA1c 6...
January 17, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29343452/a-cell-penetrating-peptide-conjugated-carboxymethyl-%C3%AE-cyclodextrin-to-improve-intestinal-absorption-of-insulin
#17
Liuqing Yang, Manman Li, Yusheng Sun, Liefeng Zhang
In this study, a cell-penetrating peptide conjugate, R8-carboxymethyl-β-cyclodextrin (R8-CM-β-CD), was synthesized, and then we prepared the supramolecular complex (insulin/R8-CM-β-CD). The physicochemical properties of the complex were characterized. The supramolecular complex could facilitate the uptake of insulin, meanwhile, induce a significantly higher internalization of insulin. Interestingly, the transportation efficiency of insulin/R8-CM-β-CD across the Caco-2 cell monolayer was about 3 times greater than that of insulin/CM-β-CD...
January 14, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29342264/effect-of-continuous-glucose-monitoring-on-glycemic-control-acute-admissions-and-quality-of-life-a-real-world-study
#18
Sara Charleer, Chantal Mathieu, Frank Nobels, Christophe De Block, Regis P Radermecker, Michel P Hermans, Youri Taes, Chris Vercammen, Guy T'Sjoen, Laurent Crenier, Steffen Fieuws, Bart Keymeulen, Pieter Gillard
Context: Randomized controlled trials evaluating real-time continuous glucose monitoring (RT-CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use. Objective: To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism and quality of life (QOL). Design: Prospective, observational, multicenter, cohort study. Participants: Five hundred fifteen adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program...
January 12, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29337383/the-national-pregnancy-in-diabetes-npid-audit-challenges-and-opportunities-for-improving-pregnancy-outcomes
#19
H R Murphy, R Bell, A Dornhorst, R Forde, N Lewis-Barned
Our aim was to review the data from the National Pregnancy in Diabetes (NPID) audit, and to identify the challenges and opportunities for improving pregnancy outcomes in women with diabetes. We reviewed three years of NPID data and relevant diabetes and obstetric literature, and found that there has been little change in pregnancy preparation or outcomes over the past 3 years, with substantial clinic-to clinic variations in care. Women with Type 2 diabetes remain less likely to take 5 mg preconception folic acid (22...
January 16, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29332422/unexpected-management-behaviors-in-adolescents-with-type-1-diabetes-using-sensor-augmented-pump-therapy
#20
Mary Binsu Abraham, Kristine Heels, Jennifer A Nicholas, Carol Cole, Rebecca Gebert, Julie Klimek, Tracey Jopling, Geoffrey Ambler, Fergus Cameron, Elizabeth Davis, Timothy W Jones
BACKGROUND: Continuous glucose monitoring can improve glycemic outcomes in individuals with type 1 diabetes. However, the constant exposure to real-time glucose levels can sometimes lead the individual to make some risky choices to address the glycemic excursions. Hence, the purpose of this study was to explore the aberrant management behaviors of youth with type 1 diabetes on sensor-augmented pump therapy (SAPT). METHODS: Participants in a clinical trial using SAPT on Medtronic MiniMed™ 640G pump who experienced deteriorating glycemic control or unexplained hypoglycemia were identified by the health care professional...
January 1, 2018: Journal of Diabetes Science and Technology
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