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Diabetes. Insulin pump

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https://www.readbyqxmd.com/read/29049584/association-of-insulin-pump-therapy-vs-insulin-injection-therapy-with-severe-hypoglycemia-ketoacidosis-and-glycemic-control-among-children-adolescents-and-young-adults-with-type-1-diabetes
#1
Beate Karges, Anke Schwandt, Bettina Heidtmann, Olga Kordonouri, Elisabeth Binder, Ulrike Schierloh, Claudia Boettcher, Thomas Kapellen, Joachim Rosenbauer, Reinhard W Holl
Importance: Insulin pump therapy may improve metabolic control in young patients with type 1 diabetes, but the association with short-term diabetes complications is unclear. Objective: To determine whether rates of severe hypoglycemia and diabetic ketoacidosis are lower with insulin pump therapy compared with insulin injection therapy in children, adolescents, and young adults with type 1 diabetes. Design, Setting, and Participants: Population-based cohort study conducted between January 2011 and December 2015 in 446 diabetes centers participating in the Diabetes Prospective Follow-up Initiative in Germany, Austria, and Luxembourg...
October 10, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29030383/12-week-24-7-ambulatory-artificial-pancreas-with-weekly-adaptation-of-insulin-delivery-settings-effect-on-hemoglobin-a1c-and-hypoglycemia
#2
Eyal Dassau, Jordan E Pinsker, Yogish C Kudva, Sue A Brown, Ravi Gondhalekar, Chiara Dalla Man, Steve Patek, Michele Schiavon, Vikash Dadlani, Isuru Dasanayake, Mei Mei Church, Rickey E Carter, Wendy C Bevier, Lauren M Huyett, Jonathan Hughes, Stacey Anderson, Dayu Lv, Elaine Schertz, Emma Emory, Shelly K McCrady-Spitzer, Tyler Jean, Paige K Bradley, Ling Hinshaw, Alejandro J Laguna Sanz, Ananda Basu, Boris Kovatchev, Claudio Cobelli, Francis J Doyle
OBJECTIVE: Artificial pancreas (AP) systems are best positioned for optimal treatment of type 1 diabetes (T1D) and are currently being tested in outpatient clinical trials. Our consortium developed and tested a novel adaptive AP in an outpatient, single-arm, uncontrolled multicenter clinical trial lasting 12 weeks. RESEARCH DESIGN AND METHODS: Thirty adults with T1D completed a continuous glucose monitor (CGM)-augmented 1-week sensor-augmented pump (SAP) period...
October 13, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29026740/diabetes-and-ramadan-a-concise-and-practical-update
#3
REVIEW
Mohamed H Ahmed, Nazik Elmalaika Husain, Wadie M Elmadhoun, Sufian K Noor, Abbas A Khalil, Ahmed O Almobarak
Despite the fact that the month of Ramadan includes 29-30 days and the duration of fasting for each day can last for between 12 and 16 h, it was estimated that a large number of individuals with diabetes do fast during Ramadan. In light of recent advancement of new pharmacological agents, drugs such as vildagliptin, sitagliptin, and liraglutide were found to be safe to use during this month of fasting. These therapeutic agents can also be used in combination with metformin. The use of sulfonylureas, in most of the recent guidelines about diabetes and Ramadan, seems not to gain much support due to the risk of hypoglycemia...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29025203/impact-of-targeted-education-on-managing-warning-and-error-signals-by-children-and-adolescents-with-type-1-diabetes-using-the-accu-chek-combo-insulin-pump-system
#4
Asma Deeb, Nabras Al Qahtani, Amal Al Ali, Mariette Akle
PURPOSE: Insulin pumps are widely used in diabetes. They are equipped with safety alarms to alert users. Pump manuals contain alarm codes and how to troubleshoot them. However, these manuals are lengthy and difficult to use, particularly in emergencies. We aim to assess the impact of targeted education on warnings and errors in improving competency to troubleshoot the alarms. METHODS: Twenty-one patients, with a median age of 13, were recruited over a 5-month period...
September 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28990436/acceptability-of-implantable-continuous-glucose-monitoring-sensor
#5
Katharine D Barnard, Jort Kropff, Pratik Choudhary, Sankalpa Neupane, Stephen C Bain, Christoph Kapitza, Thomas Forst, Manuela Link, Colleen Mdingi, J Hans DeVries
BACKGROUND: Real-time continuous glucose monitoring is associated with significant benefits for diabetes management. Implantable sensors could overcome some challenges reportedly associated with device visibility, psychosocial functioning and sensor durability. METHODS: A psychosocial assessment was conducted to determine acceptability and impact of an implantable continuous glucose monitoring (CGM) sensor as part of the PRECISE trial. Questionnaires were administered to participants comprising the Diabetes Distress Scale, the CGM impact scale, and bespoke device satisfaction...
October 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28989086/reported-gastroparesis-in-adults-with-type-1-diabetes-t1d-from-the-t1d-exchange-clinic-registry
#6
Grazia Aleppo, Peter Calhoun, Nicole C Foster, David M Maahs, Viral N Shah, Kellee M Miller
OBJECTIVE: To better understand the prevalence and impact of gastroparesis in the T1D Exchange clinic registry database. METHODS: The analysis included 7107 adult participants with T1D across 45 sites (median age 46years. and median duration 24years). Linear and logistic regression models were used to assess the association of gastroparesis vs. no gastroparesis (obtained from medical record) with demographic characteristics, glycemic control and diabetes complications...
September 6, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28982341/gastrin-a-potential-predictor-of-response-to-incretin-therapy-in-diabetes-type-2-patients
#7
Ines Bilic-Curcic, Maja Cigrovski Berkovic
BACKGROUND AND OBJECTIVES: Personalized management of diabetes has become an imperative since majority of monotherapy fails within 3 years of its use. Identifying responders from non-responders for a certain type of therapy would reduce a period of unsuccessful treatment and minimize health care costs. Incretin therapies, mainly glucagon-like peptide (GLP)-1 receptor agonists (GLP-1RA) are relatively new glucose-lowering agents which increase insulin and lower glucagon response as well as slow down glucose absorption by acting on gastric emptying...
October 3, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28981324/detailed-analysis-of-insulin-absorption-variability-and-the-tissue-response-to-continuous-subcutaneous-insulin-infusion-catheter-implantation-in-swine
#8
Jasmin R Hauzenberger, Brian R Hipszer, Channy Loeum, Peter A McCue, Mark DeStefano, Marc C Torjman, Mahmut T Kaner, Alek R Dinesen, Inna Chervoneva, Thomas R Pieber, Jeffrey I Joseph
BACKGROUND: Worldwide, ∼1 million people manage their type 1 diabetes with an insulin pump and a continuous subcutaneous insulin infusion (CSII) catheter. Patients routinely insert a new catheter every 2-3 days due to increasing variability of insulin absorption over time. Catheter insertion and maintenance damage capillaries, lymphatics, cells, and connective tissue leading to an acute inflammatory response. METHODS: We compared an investigational CSII catheter (IC) and a commercial CSII catheter (CC) regarding insulin absorption pharmacokinetics (PK) and tissue inflammation...
October 5, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28979168/devices-for-continuous-monitoring-of-glucose-update-in-technology
#9
REVIEW
Ana María Gómez, Diana Cristina Henao Carrillo, Oscar Mauricio Muñoz Velandia
Continuous glucose monitoring (CGM) is a tool that allows constant evaluation of glycemic control, providing data such as the trend and fluctuation of interstitial glucose levels over time. In clinical practice, there are two modalities: the professional or retrospective and the personal or real-time CGM (RT-CGM). The latest-generation sensors are more accurate and sensitive for hypoglycemia, improving adherence to self-monitoring, which has allowed optimizing glycemic control. The development of algorithms that allow the suspension of the infusion of insulin during hypoglycemia gave rise to the integrated therapy or sensor-augmented insulin pump therapy with low glucose suspend, which has proven to be an effective and safe alternative in the treatment of diabetic patients with high risk of hypoglycemia...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28965029/continuous-glucose-monitoring-a-review-of-the-technology-and-clinical-use
#10
REVIEW
David C Klonoff, David Ahn, Andjela Drincic
Continuous glucose monitoring (CGM) is an increasingly adopted technology for insulin-requiring patients that provides insights into glycemic fluctuations. CGM can assist patients in managing their diabetes with lifestyle and medication adjustments. This article provides an overview of the technical and clinical features of CGM based on a review of articles in PubMed on CGM from 1999 through January 31, 2017. A detailed description is presented of three professional (retrospective), three personal (real-time) continuous glucose monitors, and three sensor integrated pumps (consisting of a sensor and pump that communicate with each other to determine an optimal insulin dose and adjust the delivery of insulin) that are currently available in United States...
September 1, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28960449/an-integrative-review-of-the-psychosocial-facilitators-and-challenges-of-continuous-subcutaneous-insulin-infusion-therapy-in-type-1-diabetes
#11
REVIEW
Marlene Payk, Tracy Robinson, Deborah Davis, Marjorie Atchan
AIM: To use systematic methods to explore the psychosocial facilitators and challenges of insulin pump therapy among people with type 1 diabetes. BACKGROUND: Insulin pump therapy is now widely accepted in the management of type 1 diabetes. Given the increasing use of insulin pumps it is timely to review the evidence relating to the psychosocial impacts of this therapy which have not been addressed in previous reviews. DESIGN: An integrative review of the literature (January 2005 - February 2017)...
September 28, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28952379/rethinking-the-endpoints-of-mhealth-intervention-research-in-diabetes-care
#12
Katherine L Modzelewski, Mary-Catherine Stockman, Devin W Steenkamp
Mobile health (mHealth) is an emerging branch of medicine that utilizes technology to impact health care. With increasing access to smartphones and mobile devices, there has been an increase in both the availability and use of mHealth resources, including the use of text messages, apps, and web portals. In diabetes, there is particular interest as technology has long been a mainstay of management through glucometers, insulin pumps and continuous glucose monitors, which are increasingly interconnected. Although there is high demand for mHealth interventions in diabetes, there is no clear consensus on the best way to monitor these interventions...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28950341/increased-arterial-stiffness-in-childhood-onset-diabetes-a-cardiovascular-magnetic-resonance-study
#13
Martin Heier, Knut Haakon Stensæth, Cathrine Brunborg, Ingebjørg Seljeflot, Hanna Dis Margeirsdottir, Kristian F Hanssen, Knut Dahl-Jørgensen
Aims: Arterial stiffness is a strong predictor of cardiovascular events. We aimed to assess the impact of type 1 diabetes (T1D) on arterial stiffness and cardiac function in young adults. Methods and results: Aortic pulse wave velocity (PWV), distensibility, left ventricular (LV) function and LV mass were measured by cardiovascular magnetic resonance imaging (CMR) in 47 T1D patients and 33 healthy controls. All were participants in the Atherosclerosis and Childhood Diabetes study, with baseline values registered 5 years previously...
July 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28943578/suppression-of-extrapancreatic-glucagon-by-octreotide-may-reduce-the-fasting-and-postprandial-glucose-levels-in-a-diabetic-patient-after-total-pancreatectomy-a-case-report
#14
Hideyuki Okuma, Ryotaro Bouchi, Seizaburo Masuda, Takato Takeuchi, Masanori Murakami, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa
A 52-year-old woman was treated with sensor augmented pump therapy after undergoing total pancreatectomy for a nonfunctional pancreatic neuroendocrine tumor (NET). The secretion of both endogenous insulin and pancreatic glucagon were completely depleted. Octreotide long acting repeatable (Oct-LAR) was administered for the treatment of liver metastasis of NET. Both the fasting and postprandial glucagon levels decreased immediately after the administration of Oct-LAR. In a continuous glucose monitoring analysis, episodes of nocturnal hypoglycemia was found to increase and an improvement of postprandial hyperglycemia was observed...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28942668/recent-exposure-to-hypoglycemia-increases-glucose-variability-following-a-hyper-hypoglycemic-metabolic-challenge-in-t1d
#15
Chiara Fabris, Leon S Farhy, Stacey M Anderson, Ralf M Nass, Boris P Kovatchev, Marc D Breton
AIMS: In type 1 diabetes (T1D), repeated hypoglycemic episodes may reduce hormonal defenses and increase the risk for severe hypoglycemia. In this work, we investigate the effect of a structured hyper/hypoglycemic metabolic challenge on the postintervention glucose variability in T1D subjects studied at home. METHODS: Thirty T1D subjects using insulin pump were monitored with blood glucose meters (SMBG) during a 1-month observation period. After 2 weeks of monitoring, participants were admitted at the University of Virginia Clinical Research Unit to undergo an 8-hour metabolic challenge...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28942594/keeping-up-with-the-diabetes-technology-2016-endocrine-society-guidelines-of-insulin-pump-therapy-and-continuous-glucose-monitor-management-of-diabetes
#16
REVIEW
Alfonso Galderisi, Elise Schlissel, Eda Cengiz
PURPOSE OF REVIEW: Decades after the invention of insulin pump, diabetes management has encountered a technology revolution with the introduction of continuous glucose monitoring, sensor-augmented insulin pump therapy and closed-loop/artificial pancreas systems. In this review, we discuss the significance of the 2016 Endocrine Society Guidelines for insulin pump therapy and continuous glucose monitoring and summarize findings from relevant diabetes technology studies that were conducted after the publication of the 2016 Endocrine Society Guidelines...
September 23, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28940551/type-1-diabetes-during-adolescence-international-comparison-between-germany-austria-and-sweden
#17
Lena Hanberger, Ulf Samuelsson, Reinhard W Holl, Elke Fröhlich-Reiterer, Karin Åkesson, Sabine Hofer
OBJECTIVES: By using pediatric diabetes quality registries in Austria, Germany, and Sweden treatment of type 1 diabetes and the outcome of care during the vulnerable adolescence period were compared. METHODS: Data in DPV, broadly used in Austria and Germany, and Swediabkids used in Sweden, from clinical visits in the year 2013 on 14 383 patients aged 11 to 16 years regarding hemoglobin A1c (HbA1c), insulin regimen, body mass index (BMI)-SD score (SDS), blood pressure, hypoglycemia, ketoacidosis, and smoking habits were analyzed...
September 22, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28936576/improvement-of-continuous-subcutaneous-insulin-infusion-on-patients-with-type-2-diabetes-mellitus-by-3-dimensional-speckle-tracking-echocardiography
#18
Hong-Xia Luo, Xiao-Ling Zhou, Hong-Ju Kou, Xian-Wei Ni, Qing Wu, Chun-Peng Zou, Dao-Zhu Wu, Yong-Fang Liu
Three-dimensional speckle tracking echocardiography (3D-STE) was used to evaluate the improvement of continuous subcutaneous insulin infusion on the left ventricular (LV) systolic function of patients with type 2 diabetes mellitu (T2DM). We recruited T2DM patients (38 cases, diabetic group) and healthy volunteers (35 cases, control group) to collect LV full volume imaging. TomTec software was used for calculating LV global longitudinal strain (LVGLS), global circumferential strain (LVGCS), peak twist (LVTW), peak apical rotation (LVPAR), ejection fraction (LVEF), and torsion (LVT)...
September 21, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28924484/diabetic-ketoacidosis-producing-extreme-hyperkalemia-in-a-patient-with-type-1-diabetes-on-hemodialysis
#19
Hodaka Yamada, Shunsuke Funazaki, Masafumi Kakei, Kazuo Hara, San-E Ishikawa
Diabetic ketoacidosis (DKA) is a critical complication of type 1 diabetes associated with water and electrolyte disorders. Here, we report a case of DKA with extreme hyperkalemia (9.0 mEq/L) in a patient with type 1 diabetes on hemodialysis. He had a left frontal cerebral infarction resulting in inability to manage his continuous subcutaneous insulin infusion pump. Electrocardiography showed typical changes of hyperkalemia, including absent P waves, prolonged QRS interval and tented T waves. There was no evidence of total body water deficit...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28924481/euglycemic-diabetic-ketoacidosis-a-diagnostic-and-therapeutic-dilemma
#20
Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
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