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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/28192024/insulin-pumps
#2
John C Pickup
No abstract text is available yet for this article.
February 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28173843/staff-experiences-of-closing-out-a-clinical-trial-involving-withdrawal-of-treatment-qualitative-study
#3
Julia Lawton, David White, David Rankin, Jackie Elliott, Carolin Taylor, Cindy Cooper, Simon Heller, Nina Hallowell
BACKGROUND: The ending of a clinical trial may be challenging, particularly if staff are required to withdraw the investigated treatment(s); however, this aspect of trial work is surprisingly under-researched. To address this gap, we explored the experiences of staff involved in closing out a trial that entailed withdrawal of treatment (insulin pumps) from some patients. METHODS: Interviews were conducted with n = 22 staff, recruited from seven trial sites. Data were analysed thematically...
February 7, 2017: Trials
https://www.readbyqxmd.com/read/28164370/impact-of-neighbourhood-level-inequity-on-paediatric-diabetes-care
#4
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
#5
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/28147679/packaged-peristaltic-micropump-for-controlled-drug-delivery-application
#6
K B Vinayakumar, Girish Nadiger, Vikas R Shetty, N S Dinesh, M M Nayak, K Rajanna
Micropump technology has evolved significantly in the last two decades and is finding a variety of applications ranging from μTAS (micro Total Analysis System) to drug delivery. However, the application area of the micropump is limited owing to: simple pumping mechanism, ease of handling, controlled (microliter to milliliter) delivery, continuous delivery, and accuracy in flow rate. Here, the author presents the design, development, characterization, and precision flow controlling of a DC-motor driven peristaltic pump for controlled drug delivery application...
January 2017: Review of Scientific Instruments
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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/28118046/reexamining-the-hypoglycemia-fear-survey-for-parents-of-young-children-in-a-sample-of-children-using-insulin-pumps
#14
Susana R Patton, Amy E Noser, Mark A Clements, Lawrence M Dolan, Scott W Powers
BACKGROUND: We update the psychometric properties of the Hypoglycemia Fear Survey-Parents of Young Children (HFS-PYC), a 26-item measure of parents' hypoglycemia fear for young children using an insulin pump. METHODS: We combined three similar datasets for the analyses. The data analyzed included parents' responses to the HFS-PYC and a demographic form. For a subset of children (n = 91), we also analyzed self-monitoring of blood glucose data. We used confirmatory factor analysis (CFA) to confirm the measure's original factor structure...
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
#15
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
#16
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
#17
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
#18
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
#19
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/28093115/use-of-an-implantable-pump-for-controlled-subcutaneous-insulin-delivery-in-healthy-cats
#20
E Zini, I Padrutt, K Macha, A Riederer, M Pesaresi, T A Lutz, C E Reusch
The aim of this study was to examine the safety and reliability of a research-grade implantable pump for controlled delivery of insulin glargine in cats. For this purpose, a small telemetrically controlled drug delivery pump with a refillable reservoir was implanted into the subcutaneous tissues of the dorsal neck in 10 clinically healthy cats. The reservoir was filled with insulin glargine, and the pump was programmed to deliver four boluses of 0.25 IU/kg, 2-3 weeks apart. As a control, insulin glargine (0...
January 2017: Veterinary Journal
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