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Diabetes. Insulin pump

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https://www.readbyqxmd.com/read/29224132/treatment-of-mild-to-moderate-hypoglycemia-in-patients-with-type-1-diabetes-treated-with-insulin-pump-therapy-are-current-recommendations-effective
#1
Véronique Gingras, Katherine Desjardins, Mohamed Raef Smaoui, Valérie Savard, Virginie Messier, Ahmad Haidar, Laurent Legault, Rémi Rabasa-Lhoret
AIMS: Mild-to-moderate hypoglycemia (blood glucose < 4.0 mmol/L) is recommended to be treated with 15 g of carbohydrates and to repeat the treatment if hypoglycemia persists after 15 min. This recommendation was established before intensive insulin therapy and based on studies using insulin with different pharmacokinetic profiles from actual insulin analogs showing that 15 g of glucose increases blood glucose by ~ 1.5 mmol/L in 15 min. We aimed to explore the effect of current recommended treatment of mild-to-moderate hypoglycemia in type 1 diabetes (T1D) participants and factors associated with treatment effectiveness...
December 9, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/29215660/-prioritization-of-non-recommended-clinical-activities-in-primary-care
#2
L García Mochon, A Olry de Labry Lima, C Bermudez-Tamayo
OBJECTIVE: To prioritize non-recommended clinical activities in Primary Care (PC), from "Do not do" recommendations listed by the Sociedad Española de Medicina de Familia y Comunitaria (Semfyc), according to expert consensus (physicians, nurses and pharmacists). METHODS: The consensus for the prioritization of non-recommended practices in PC was performed through an online procedure. We used as a base the list of "do not-do" recommendations of the SEMFYC. We asked the experts to prioritize practices that should be de-adopted in PC, based on four prioritization criteria: frequency of occurrence, cost of the activity, ease of disposal and damage caused, which were scored from one to five, according to their recommendation...
December 7, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29215299/complex-assessment-of-metabolic-effectiveness-of-insulin-pump-therapy-in-patients-with-type-2-diabetes-beyond-hba1c-reduction
#3
Rudolf Chlup, Sarah Runzis, Javier Castaneda, Scott W Lee, Xuan Nguyen, Ohad Cohen
BACKGROUND: This prospective single-center study recruited insulin-resistant continuous subcutaneous insulin infusion (CSII) therapy-naive patients with type 2 diabetes (T2D) using insulin analog-based multiple daily injections (MDI) therapy and metformin. METHODS: A total of 23 individuals with T2D (70% male), aged a mean ± standard deviation 57.2 ± 8.03 years, with body mass index of 36.2 ± 7.02 kg/m2, diabetes duration of 13.3 ± 4.64 years, and HbA1c of 10...
December 7, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29212599/depressive-symptoms-at-critical-times-in-youth-with-type-1-diabetes-following-type-1-diabetes-diagnosis-and-insulin-pump-initiation
#4
Dayna E McGill, Lisa K Volkening, David M Pober, Andrew B Muir, Deborah L Young-Hyman, Lori M Laffel
PURPOSE: Depressive symptoms occur at various times during the life cycle in persons with type 1 diabetes. We investigated depressive symptoms prospectively in youth with new-onset type 1 diabetes and in those beginning pump therapy. METHODS: Youth with type 1 diabetes (N = 96), ages 10-17 years, completed the Children's Depression Inventory (CDI) at baseline and at 1, 6, and 12 months after diabetes onset or pump start; scores ≥13 indicated clinical elevation...
December 4, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29212333/-quo-vadis-diabetes-technology
#5
George Grunberger
Management of patients with diabetes mellitus who require intensive insulin therapy has changed dramatically. From urine and then whole blood glucose monitoring patients can now wear personal continuous glucose monitors; from using multiple insulin injections they can now deliver subcutaneous insulin continuously using ever-more sophisticated insulin pumps. With the current integration of continuous glucose monitoring and insulin pumps a new era is arriving when "smart" insulin pumps can automate insulin delivery to assure more stable glycemic control while minimizing episodes of hypoglycemia...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29212332/quo-vadis-diabetes-technology
#6
George Grunberger
Management of patients with diabetes mellitus who require intensive insulin therapy has changed dramatically. From urine and then whole blood glucose monitoring patients can now wear personal continuous glucose monitors; from using multiple insulin injections they can now deliver subcutaneous insulin continuously using ever-more sophisticated insulin pumps. With the current integration of continuous glucose monitoring and insulin pumps a new era is arriving when "smart" insulin pumps can automate insulin delivery to assure more stable glycemic control while minimizing episodes of hypoglycemia...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29211738/metformin-inhibits-the-development-and-promotes-the-resensitization-of-treatment-resistant-breast-cancer
#7
Gerald Davies, Liubov Lobanova, Wojciech Dawicki, Gary Groot, John R Gordon, Matthew Bowen, Troy Harkness, Terra Arnason
Multiple drug resistant (MDR) malignancy remains a predictable and often terminal event in cancer therapy, and affects individuals with many cancer types, regardless of the stage at which they were originally diagnosed or the interval from last treatment. Protein biomarkers of MDR are not globally used for clinical decision-making, but include the overexpression of drug-efflux pumps (ABC transporter family) such as MDR-1 and BCRP, as well as HIF1α, a stress responsive transcription factor found elevated within many MDR tumors...
2017: PloS One
https://www.readbyqxmd.com/read/29204367/protein-and-fat-meal-content-increase-insulin-requirement-in-children-with-type-1-diabetes-role-of-duration-of-diabetes
#8
M van der Hoogt, J C van Dyk, R C Dolman, M Pieters
Background and objective: Hyperglycaemia remains a challenge in type 1 diabetes since current regimes used to determine meal insulin requirements prove to be ineffective. This is particularly problematic for meals containing high amounts of protein and fat. We aimed to determine the post-prandial glycaemic response and total insulin need for mixed meals, using sensor-augmented insulin pumps in children with type 1 diabetes. Methods: Twenty-two children with type 1 diabetes, aged 4-17 years on insulin pump therapy completed this home-based, cross-over, randomised controlled trial...
December 2017: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29193795/lower-mean-blood-glucose-during-short-term-intensive-insulin-therapy-is-associated-with-long-term-glycemic-remission-in-patients-with-newly-diagnosed-type-2-diabetes-evidence-based-recommendations-for-standardization
#9
Liehua Liu, Juan Liu, Lijuan Xu, Weijian Ke, Xuesi Wan, Hai Li, Xiaoying He, Liangjiao Wang, Xiaopei Cao, Haipeng Xiao, Yanbing Li
AIMS/INTRODUCTION: Optimal glycemic targets during short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes were not standardized. This study is performed to determine the optimal glycemic targets during the therapy by analyzing the impacts of glucose levels on therapeutic outcomes. MATERIALS AND METHODS: Nighty-five subjects with newly diagnosed type 2 diabetes were enrolled. Short-term intensive insulin therapy was carried out using insulin pump to achieve and maintain glycemic targets (FBG< 6...
November 30, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29191845/revisiting-the-relationships-between-measures-of-glycemic-control-and-hypoglycemia-in-continuous-glucose-monitoring-datasets
#10
Marga Gimenez, Amitai Jeremy Tannen, Monika Reddy, Vanessa Moscardo, Ignacio Conget, Nick Oliver
OBJECTIVE: The Diabetes Control and Complications Trial identified an inverse relationship between HbA1c and severe hypoglycemia. We investigated the relationship between hypoglycemia and HbA1c in a large type 1 diabetes cohort on multiple daily injection or insulin pump therapy using blinded continuous glucose monitoring (CGM) data. The impact of real-time CGM on these relationships and how these relationships differ with biochemical definitions of hypoglycemia have also been assessed...
November 30, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29191844/reduction-in-hypoglycemia-with-the-predictive-low-glucose-management-system-a-long-term-randomized-controlled-trial-in-adolescents-with-type-1-diabetes
#11
Mary B Abraham, Jennifer A Nicholas, Grant J Smith, Janice M Fairchild, Bruce R King, Geoffrey R Ambler, Fergus J Cameron, Elizabeth A Davis, Timothy W Jones
OBJECTIVE: Short-term studies with automated systems that suspend basal insulin when hypoglycemia is predicted have shown a reduction in hypoglycemia; however, efficacy and safety have not been established in long-term trials. RESEARCH DESIGN AND METHODS: We conducted a 6-month, multicenter, randomized controlled trial in children and adolescents with type 1 diabetes using the Medtronic MiniMed 640G pump with Suspend before low (predictive low-glucose management [PLGM]) compared with sensor-augmented pump therapy (SAPT) alone...
November 30, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29168078/the-effect-of-hypergastrinemia-following-sleeve-gastrectomy-and-pantoprazole-on-type-2-diabetes-mellitus-and-beta-cell-mass-in-goto-kakizaki-rats
#12
E Grong, C Nord, I B Arbo, M Eriksson, B E Kulseng, U Ahlgren, R Mårvik
PURPOSE: Metabolic surgery alters the secretion of gastrointestinal hormones that influence glycemic control. Elevated gastrin has been suggested to benefit patients with type 2 diabetes and has been reported following sleeve gastrectomy in rats. The present study compares the effect of hypergastrinemia following sleeve gastrectomy with proton-pump inhibitor therapy on glycemic control and beta-cell mass in lean, diabetic animals. METHODS: Thirty-three diabetic Goto-Kakizaki rats were randomized into pantoprazole + sham operation (GK-PPI), sleeve gastrectomy (GK-SG) and vehicle + sham operation (GK-V)...
November 22, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29157869/adapting-and-validating-a-measure-of-diabetes-specific-self-compassion
#13
M L Tanenbaum, R N Adams, J S Gonzalez, S J Hanes, K K Hood
AIMS: Self-compassion (SC), or treating oneself with kindness when dealing with personal challenges, has not been rigorously examined in people with T1D. SC has been shown to buffer against negative emotions and to be linked to improved health outcomes, but diabetes-specific SC has not been studied. This study aimed to adapt the Self-Compassion Scale and validate it for a diabetes-specific population. METHODS: We developed and validated a diabetes-specific version of the Self-Compassion Scale (Neff, 2003) in a sample of adults with T1D (N=542; 65% female; 97% non-Hispanic White; M age 41, SD=15...
October 26, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29157581/sleep-in-children-with-type-1-diabetes-and-their-parents-in-the-t1d-exchange
#14
Sarah S Jaser, Nicole C Foster, Bryce A Nelson, Julie M Kittelsrud, Linda A DiMeglio, Maryanne Quinn, Steven M Willi, Jill H Simmons
OBJECTIVES: Sleep has physiological and behavioral impacts on diabetes outcomes, yet little is known about the impact of sleep disturbances in children with type 1 diabetes. The current study sought to characterize sleep in children with type 1 diabetes and in their parents and to examine the associations between child sleep, glycemic control and adherence, parent sleep and well-being, parental fear of hypoglycemia, and nocturnal caregiving behavior. METHODS: Surveys were emailed to parents of 2- to 12-year-old participants in the Type 1 Diabetes (T1D) Exchange clinic registry...
November 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29138541/the-effect-of-peer-support-in-adults-with-insulin-pump-treated-type-1-diabetes-a-pilot-study-of-a-flexible-and-participatory-intervention
#15
Lene Eide Joensen, Merete Meldgaard Andersen, Sabrina Jensen, Kirsten Nørgaard, Ingrid Willaing
Aim: The aim of this study was to explore the effects of a flexible and participatory peer support intervention in a clinical setting for adults with type 1 diabetes treated with an insulin pump, focusing on enhancing diabetes-specific social capital. The key questions were as follows: 1) what effects are appropriate to expect, according to participants? and 2) to what extent did these effects occur? Methods: Two peer support intervention programs were conducted in a diabetes specialist clinic (N=30)...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29120503/route-to-improving-type-1-diabetes-mellitus-glycaemic-outcomes-real-world-evidence-taken-from-the-national-diabetes-audit
#16
A H Heald, M Livingston, A Fryer, G Y C Moreno, N Malipatil, R Gadsby, W Ollier, M Lunt, M Stedman, R J Young
AIM: To use general practice-level data for England, available through the National Diabetes Audit, and primary care prescribing data to identify prescription treatment factors associated with variations in achieved glucose control (HbA1c ). METHODS: General practice-level National Diabetes Audit data on Type 1 diabetes, including details of population characteristics, services, proportion of people achieving target glycaemic control [HbA1c ≤58 mmol/mol (7.5%)] and proportion of people at high glycaemic risk [HbA1c >86 mmol/ml (10%)], were linked to 2013-2016 primary care diabetes prescribing data on insulin types and blood glucose monitoring for all people with diabetes...
November 9, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29118059/diabetes-care-disparities-in-long-standing-type-1-diabetes-in-canada-and-the-united-states-a-cross-sectional-comparison
#17
Alanna Weisman, Leif E Lovblom, Hillary A Keenan, Liane J Tinsley, Stephanie D'Eon, Genevieve Boulet, Mohammed A Farooqi, Julie A Lovshin, Andrej Orszag, Yuliya Lytvyn, Michael H Brent, Narinder Paul, Vera Bril, David Z Cherney, Bruce A Perkins
OBJECTIVE: To assess national differences in diabetes care and quality of life (QOL) between individuals with long-standing type 1 diabetes (≥50 years) in Canada and the U.S. RESEARCH DESIGN AND METHODS: Cross-sectional data from identical surveys administered in the Canadian Study of Longevity in Diabetes and the Joslin Medalist Study, collected in 2013-2016 and 2005-2011, respectively, were compared. Laboratory values and ophthalmic examination were completed by clinical care physicians for Canadians and the Joslin Clinic for Americans...
November 8, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29117449/route-to-improving-type-1-diabetes-mellitus-glycaemic-outcomes-real-world-evidence-taken-from-the-national-diabetes-audit
#18
P J Hammond
The National Diabetes Audit (NDA) has helped to highlight the disparity in glycaemic outcomes between those with Type 1 and those with Type 2 diabetes. Whilst ~70% of those with Type 2 diabetes achieve an HbA1c concentration <58 mmol/mol (7.5%), only 30% of those with Type 1 diabetes do so. Heald et al. [1] have used the data from the NDA to determine whether improved uptake of technology, particularly insulin pump therapy, might improve glycaemic outcomes. This article is protected by copyright. All rights reserved...
November 8, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29107758/exploring-correlates-of-diabetes-related-stress-among-adults-with-type-1-diabetes-in-the-t1d-exchange-clinic-registry
#19
Matthew Tyler Boden, Sasha Gala
AIMS: To explore relations between diabetes-related stress and multiple sociodemographic, diabetes health, other health, and treatment-related variables among a large, diverse sample of adults with Type 1 Diabetes (T1D). METHODS: The sample consisted of 10,821 adults (over 18 years old) enrolled in the T1D Exchange Clinic Registry. The T1D Exchange clinic network consists of 67 diabetes clinical centers throughout the United States selected to broadly represent pediatric and adult patients with T1D...
October 28, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29092790/self-rated-health-among-american-adolescents-with-type-1-diabetes-in-the-t1d-exchange-clinic-registry
#20
Nada A Abualula, Margaret F Rodan, Renee A Milligan, Kathryn H Jacobsen
BACKGROUND: The goal of this study was to examine the self-rated health (SRH) of adolescents with type 1 diabetes (T1D). METHODS: A logistic regression analysis of baseline data from adolescents in the United States included in the T1D Exchange Clinic Registry in 2010-2012 was conducted. Participants were 13-18years old at the time of enrollment in the registry and had been diagnosed with T1D at least one year before enrollment (n=5799). RESULTS: Half (49...
September 23, 2017: Journal of Diabetes and its Complications
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