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Diabetes. Insulin pump

Jeniece Trast Ilkowitz, Steven Choi, Michael L Rinke, Kathy Vandervoot, Rubina A Heptulla
BACKGROUND: Diabetes ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM). Reducing DKA admissions in children with T1DM requires a coordinated, comprehensive management plan. We aimed to decrease DKA admissions, 30-day readmissions, and length of stay (LOS) for DKA admissions. METHODS: A multipronged intervention was designed in 2011 to reach all patients: (1) increase insulin pump use and basal-bolus regimen versus sliding scales, (2) transform educational program, (3) increased access to medical providers, and (4) support for patients and families...
October 2016: Quality Management in Health Care
William F Kendall, Emmanuel C Opara
Since the discovery of insulin by Banting and Best in 1921, the prognosis and treatment options for individuals with diabetes have improved. The development of various insulin types, various oral agents, and insulin pumps have improved the available medical options for individuals afflicted with diabetes. The current need for frequent blood glucose monitoring imposed by multiple daily insulin injections, result in significant life-style challenges for in individuals afflicted with Type 1 diabetes (T1D). In contrast the use of surgical interventions, such as whole organ pancreas transplantation (PT) requires less-intensive glucose monitoring while the organ is viable...
2017: Methods in Molecular Biology
Rebecca Johnson
Some people with well-managed insulin-dependent diabetes can dive safely. Those cleared to participate should control tightly the variables that impact blood glucose levels, including activity, timing, food and insulin. Honest self-assessment is critical. A diabetic diver should cancel a dive if seasick, unusually anxious, or following significant high or low blood glucose levels in the preceding 24 hours. The diver should enter the water with a blood glucose level above 8.3 mmol·L⁻¹ and below 14 mmol·L⁻¹ with a stable or rising trend in blood glucose established with glucose tests at 90, 60, and 30 minutes prior to a dive...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Tim Heise, Eric Zijlstra, Leszek Nosek, Tord Rikte, Hanne Haahr
AIMS: Continuous subcutaneous insulin infusion (CSII) is increasingly used in patients with diabetes. Faster-acting insulin aspart (faster aspart) is insulin aspart (IAsp) in a new formulation with a faster time-action profile. We evaluated the pharmacological characteristics of faster aspart versus IAsp> during CSII. MATERIALS AND METHODS: In this randomised, double-blind, crossover trial, 48 men and women aged 18-64 years with type 1 diabetes mellitus (T1DM) received faster aspart and IAsp as a 0...
October 6, 2016: Diabetes, Obesity & Metabolism
Steef Kurstjens, Jeroen De Baaij, Hacene Bouras, René Bindels, Cees J Tack, Joost Hoenderop
Background Hypomagnesemia (plasma magnesium (Mg2+) concentration <0.7 mmol/L) has been described in patients with type 2 diabetes. Polypharmacy is inevitable when treating a complex disease such as type 2 diabetes and could explain disturbances in the plasma Mg2+ concentration. In this study, we aimed to establish the extent of hypomagnesemia in a cohort of type 2 diabetes patients and to identify determinants of plasma Mg2+ levels. Methods Patient data and samples of 395 type 2 diabetes patients were investigated...
October 5, 2016: European Journal of Endocrinology
J Kropff, J DeJong, S Del Favero, J Place, M Messori, B Coestier, A Farret, F Boscari, S Galasso, A Avogaro, D Bruttomesso, C Cobelli, E Renard, L Magni, J H DeVries
AIM: To assess the impact on fear of hypoglycaemia and treatment satisfaction with an artificial pancreas system used for 2 consecutive months, as well as participant acceptance of the artificial pancreas system. METHODS: In a randomized crossover trial participant-related outcomes associated with an evening-and-night artificial pancreas and sensor-augmented pump therapy were compared. Both intervention periods lasted 8 weeks. The artificial pancreas acceptance questionnaire (range 0-90, higher scores better), Hypoglycaemia Fear Survey II (range 0-72, higher scores worse) and Diabetes Treatment Satisfaction Questionnaire (range 0-36, higher scores better) were completed by 32 participants...
October 1, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Ravi Gondhalekar, Eyal Dassau, Francis J Doyle
A novel Model Predictive Control (MPC) law for an Artificial Pancreas (AP) to automatically deliver insulin to people with type 1 diabetes is proposed. The MPC law is an enhancement of the authors' zone-MPC approach that has successfully been trialled in-clinic, and targets the safe outpatient deployment of an AP. The MPC law controls blood-glucose levels to a diurnally time-dependent zone, and enforces diurnal, hard input constraints. The main algorithmic novelty is the use of asymmetric input costs in the MPC problem's objective function...
September 2016: Automatica: the Journal of IFAC, the International Federation of Automatic Control
Linda A Gonder-Frederick, Jaclyn A Shepard, Jesse H Grabman, Lee M Ritterband
Use of technology in diabetes management is rapidly advancing and has the potential to help individuals with diabetes achieve optimal glycemic control. Over the past 40 years, several devices have been developed and refined, including the blood glucose meter, insulin pump, and continuous glucose monitor. When used in tandem, the insulin pump and continuous glucose monitor have prompted the Artificial Pancreas initiative, aimed at developing control system for fully automating glucose monitoring and insulin delivery...
October 2016: American Psychologist
Erin McKergow, Lianne Parkin, David J Barson, Katrina J Sharples, Benjamin J Wheeler
AIMS: Insulin pumps have been publically funded in New Zealand since 2012 for patients who meet certain clinical criteria; however, the patterns of utilization have not been described. We undertook a nationwide study to estimate the annual proportions of patients with type 1 diabetes mellitus who used a pump between 2012 and 2014, overall, and according to sex, age, ethnicity, socioeconomic position, and region. METHODS: We used data from the New Zealand Virtual Diabetes Register and routinely collected national demographic, health, and pharmaceutical dispensing data from the Ministry of Health to identify patients with type 1 diabetes and to calculate the overall, and subgroup, proportions using pumps...
September 20, 2016: Acta Diabetologica
Marzia Cescon, Daniel J DeSalvo, Trang T Ly, David M Maahs, Laurel H Messer, Bruce A Buckingham, Francis J Doyle, Eyal Dassau
BACKGROUND: Insulin infusion set failure resulting in prolonged hyperglycemia or diabetic ketoacidosis can occur with pump therapy in type 1 diabetes. Set failures are frequently characterized by variable and unpredictable patterns of increasing glucose values despite increased insulin infusion. Early detection may minimize the risk of prolonged hyperglycemia, an important consideration for automated insulin delivery and closed-loop applications. METHODS: A novel algorithm designed to alert the patient to the onset of infusion set failure was developed based upon continuous glucose sensor values and insulin delivered from an insulin pump...
September 12, 2016: Journal of Diabetes Science and Technology
Ohad Cohen, William Valentine
BACKGROUND: Continuous subcutaneous insulin infusion (CSII) is used less for type 2 than for type 1 diabetes because of inconsistencies in evidence of effectiveness. We reviewed published guidelines on intensive insulin therapy in type 2 diabetes to assess whether updating of guidance is needed with respect to evidence used and recommendations for CSII in diabetes management. METHODS: A literature review was performed to identify published national and international guidelines on type 2 diabetes management...
September 12, 2016: Journal of Diabetes Science and Technology
M I Maiorino, G Bellastella, F Castaldo, M Petrizzo, D Giugliano, K Esposito
PURPOSE: The aim of this study was to evaluate the prevalence and risk factors associated with female sexual dysfunction (FSD) in young women with type 1 diabetes treated with different intensive insulin regimens. METHODS: Type 1 diabetic women aged 18-35 years were included in this study if they had stable couple relationship and no oral contraceptive use. All women were asked to complete the Female Sexual Function Index (FSFI) and other validated multiple-choice questionnaires assessing sexual-related distress (Female Sexual Distress Scale, FSDS), quality of life (SF-36 Health Survey), physical activity (International Physical Activity Questionnaire), depressive symptoms (Zung Self-Rating Depression Scale, SRDS) and diabetes-related problems (Diabetes Integration Scale ATT-19)...
September 9, 2016: Journal of Endocrinological Investigation
Martin Tauschmann, Janet M Allen, Malgorzata E Wilinska, Hood Thabit, Carlo L Acerini, David B Dunger, Roman Hovorka
OBJECTIVE: This study evaluated the feasibility, safety, and efficacy of day-and-night hybrid closed-loop insulin delivery in adolescents with type 1 diabetes under free-living conditions. RESEARCH DESIGN AND METHODS: In an open-label randomized crossover study,12 suboptimally controlled adolescents on insulin pump therapy (mean ± SD age 14.6 ± 3.1 years; HbA1c 69 ± 8 mmol/mol [8.5 ± 0.7%]; duration of diabetes 7.8 ± 3.5 years) underwent two 21-day periods in which hybrid closed-loop insulin delivery was compared with sensor-augmented insulin pump therapy in random order...
September 9, 2016: Diabetes Care
Lutz Heinemann, Diana Drossel, Guido Freckmann, Bernhard Kulzer
The estimation is that every third to fourth patient with diabetes suffers from some degree of diabetic retinopathy. Medical products for insulin administration (such as insulin pens and pumps) or glucose monitoring not optimized to the needs of these patients' represent a high barrier for optimal diabetes therapy in daily practice. To date, the number of devices suitable for visually impaired and blind patients with diabetes is scarce. This manuscript outlines the specific needs of this patient group with regard to systems for insulin administration, blood glucose measurement, and continuous glucose monitoring...
September 6, 2016: Journal of Diabetes Science and Technology
Guido Freckmann, Stephan Arndt, Albrecht Fießelmann, Gerhard Klausmann, Kristina Pralle, Thomas Künsting, Bettina Petersen
BACKGROUND: Continuous subcutaneous insulin infusion (CSII) therapy is a valuable option especially for people with type 1 diabetes. Although insulin infusion sets (IIS) are essential components of most insulin pump systems, only few studies have been conducted on their performance and safety. In this study 2 IIS with soft cannulas were compared. METHODS: In an open-label, randomized, crossover, multicenter 8-week study 80 type 1 diabetic subjects on CSII (20-74 years, mean 46...
September 6, 2016: Journal of Diabetes Science and Technology
C H Shi, L Wang, R Bai, Y B Wang, D Liu, X Y Zhang, H Wang, Y Yang, J L Du
OBJECTIVE: To compare the therapeutic effects between sitagliptin and voglibose both with sensor-augmented insulin pump (SAP) in newly diagnosed type 2 diabetes mellitus (T2DM). METHODS: Fifty-six newly diagnosed hospitalized T2DM patients in Department of Endocrinology of the First Affiliated Hospital of Dalian Medical University, with hemoglobin A1c (HbA1c) value of 9%-11%, were randomized into the sitagliptin (S) group (n=28) and the voglibose (V) group (n=28) by block randomisation...
August 23, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Maria Adela Grando, Danielle Groat, Hiral Soni, Mary Boyle, Marilyn Bailey, Bithika Thompson, Curtiss B Cook
BACKGROUND: There is a lack of systematic ways to analyze how diabetes patients use their insulin pumps to self-manage blood glucose to compensate for alcohol ingestion and exercise. The objective was to analyze "real-life" insulin dosing decisions occurring in conjunction with alcohol intake and exercise among patients using insulin pumps. METHODS: We recruited adult type 1 diabetes (T1D) patients on insulin pump therapy. Participants were asked to maintain their daily routines, including those related to exercising and consuming alcohol, and keep a 30-day journal on exercise performed and alcohol consumed...
September 5, 2016: Journal of Diabetes Science and Technology
Danielle Groat, Maria Adela Grando, Hiral Soni, Bithika Thompson, Mary Boyle, Marilyn Bailey, Curtiss B Cook
BACKGROUND: Successful diabetes management requires behavioral changes. Little is known about self-management behaviors (SMB) in adults on insulin pump (IP) therapy. OBJECTIVE: Analyze and characterize observed common diabetes SMB in adult participants with type 1 diabetes (T1D) using IPs and to correlate behaviors with glycemic outcomes based on participant's individual glucose targets. MATERIALS AND METHODS: One month of IP data from adults with T1D were downloaded...
September 1, 2016: Journal of Diabetes Science and Technology
P Ross, A R Gray, J Milburn, I M Kumarasamy, F Wu, S Farrand, J Armishaw, E Wiltshire, J Rayns, P Tomlinson, B J Wheeler
AIMS: While there have been many outcome-focussed studies examining insulin pump therapy, only a few have looked at potential adverse events (AEs), with none examining the relationship between AEs and pump/infusion set type, ethnicity or socio-economic status. In addition, current data on the incidence and characteristics of pump-associated AEs are confined to one paediatric centre. We aimed to describe the incidence, characteristics and potential predictors of insulin pump-associated AEs in New Zealand adults and children with T1DM...
September 1, 2016: Acta Diabetologica
Monica T Marin, Michael L Coffey, Joni K Beck, Paul S Dasari, Rebecca Allen, Sowmya Krishnan
No abstract text is available yet for this article.
August 2016: Diabetes Spectrum: a Publication of the American Diabetes Association
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