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Insulin Pump Therapy

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https://www.readbyqxmd.com/read/29327220/patient-perceptions-and-preferences-for-a-mealtime-insulin-delivery-patch
#1
Mark Peyrot, Darlene Dreon, Vivien Zraick, Brett Cross, Meng H Tan
INTRODUCTION: A basal-bolus insulin regimen is needed to achieve glycated hemoglobin A1c (HbA1c) below 7.0% in people with type 1 (T1D) or type 2 (T2D) diabetes who have significant loss of beta-cell function. Nonadherence to therapy is common and negatively affects the ability to reach treatment goals. We examined patient assessment of a new, wearable mealtime insulin-delivery system (patch) relative to their current mealtime insulin-delivery system (syringe, pen, or pump). The patch is designed to deliver only boluses of fast-acting insulin (no basal insulin), mechanically controlled by the patient...
January 11, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29316338/efficacy-of-automatic-bolus-calculator-with-automatic-speech-recognition-in-patients-with-type-1-diabetes-a-randomized-crossover-trial
#2
Piotr Foltynski, Piotr Ladyzynski, Ewa Pankowska, Karolina Mazurczak
BACKGROUND: Patients using an insulin pump as part of their diabetes treatment need to calculate insulin bolus to compensate for a meal. Some patients do not modify their meal boluses according to the changing amount and composition of food products in a meal. The lack of correct meal boluses leads to unstable, and therefore harmful blood glucose levels. The aim of the current study was to test the system supporting bolus determination based on the voice description of a meal. METHODS: The developed bolus calculator consists of the smartphone application and three remote servers for automatic speech recognition, text analysis, and insulin dosage calculation...
January 8, 2018: Journal of Diabetes
https://www.readbyqxmd.com/read/29303370/the-effects-of-subcutaneous-insulin-infusion-versus-multiple-insulin-injections-on-glucose-variability-in-young-adults-with-type-1-diabetes-the-2-year-follow-up-of-the-observational-metro-study
#3
Maria Ida Maiorino, Giuseppe Bellastella, Ofelia Casciano, Paolo Cirillo, Vittorio Simeon, Paolo Chiodini, Michela Petrizzo, Maurizio Gicchino, Ornella Romano, Paola Caruso, Dario Giugliano, Katherine Esposito
BACKGROUND: Type 1 diabetic patients have high instability of daily glucose levels. The aim of this study was to evaluate the long-term effects of continuous subcutaneous insulin infusion (CSII) therapy, compared with multiple daily injections of insulin (MDI), on glucose variability, in young type 1 diabetic patients transitioned to the adult diabetes care. METHODS: Patients aged 18-30 years and considered eligible for insulin pump therapy were included in the study...
January 5, 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29298818/fifteen-minute-consultation-insulin-pumps-for-type-1-diabetes-in-children-and-young-people
#4
Philippa Prentice, Daniela Elleri
There is increasing worldwide use of continuous subcutaneous insulin infusions in paediatric type 1 diabetes (T1D), reflecting recent research outcomes and guidance, as well as families' wishes. Children/young people may present acutely with medical or surgical problems, in addition to issues related to T1D. This review provides general paediatricians with an introduction to pump therapy, highlighting common problems, management issues and when to seek specialist advice.
January 3, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29285796/weight-based-carbohydrate-treatment-of-hypoglycaemia-in-people-with-type-1-diabetes-using-insulin-pump-therapy-a-randomized-crossover-clinical-trial
#5
L McTavish, B Corley, M Weatherall, E Wiltshire, J D Krebs
AIM: To test whether weight-based treatment is more effective than usual care in people with Type 1 diabetes receiving continuous subcutaneous insulin infusion therapy with regard to both hypoglycaemia and avoiding excessive rebound hyperglycaemia. METHODS: Children and adults on continuous subcutaneous insulin infusion were enrolled into a study with a crossover design. Each episode of hypoglycaemia (defined as capillary glucose <4.0 mmol/l) was randomly assigned one of two treatment protocols using glucose tablets: either 0...
December 28, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29277329/human-embryonic-stem-cell-derived-cardiomyocytes-as-an-in-vitro-model-to-study-cardiac-insulin-resistance
#6
Ilvy M E Geraets, Dipanjan Chanda, Florence H J van Tienen, Arthur van den Wijngaard, Rick Kamps, Dietbert Neumann, Yilin Liu, Jan F C Glatz, Joost J F P Luiken, Miranda Nabben
Patients with type 2 diabetes (T2D) and/or insulin resistance (IR) have an increased risk for the development of heart failure (HF). Evidence indicates that this increased risk is linked to an altered cardiac substrate preference of the insulin resistant heart, which shifts from a balanced utilization of glucose and long-chain fatty acids (FAs) towards an almost complete reliance on FAs as main fuel source. This shift leads to a loss of endosomal proton pump activity and increased cardiac fat accumulation, which eventually triggers cardiac dysfunction...
December 20, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29273897/impact-of-flash-glucose-monitoring-on-hypoglycaemia-in-adults-with-type-1-diabetes-managed-with-multiple-daily-injection-therapy-a-pre-specified-subgroup-analysis-of-the-impact-randomised-controlled-trial
#7
Per Oskarsson, Ramiro Antuna, Petronella Geelhoed-Duijvestijn, Jens Krӧger, Raimund Weitgasser, Jan Bolinder
AIMS/HYPOTHESIS: Evidence for the effectiveness of interstitial glucose monitoring in individuals with type 1 diabetes using multiple daily injection (MDI) therapy is limited. In this pre-specified subgroup analysis of the Novel Glucose-Sensing Technology and Hypoglycemia in Type 1 Diabetes: a Multicentre, Non-masked, Randomised Controlled Trial' (IMPACT), we assessed the impact of flash glucose technology on hypoglycaemia compared with capillary glucose monitoring. METHODS: This multicentre, prospective, non-masked, RCT enrolled adults from 23 European diabetes centres...
December 23, 2017: Diabetologia
https://www.readbyqxmd.com/read/29258910/glucose-responsive-insulin-delivery-for-type-1-diabetes-the-artificial-pancreas-story
#8
Lia Bally, Hood Thabit, Roman Hovorka
Insulin replacement therapy is integral to the management of type 1 diabetes, which is characterised by absolute insulin deficiency. Optimal glycaemic control, as assessed by glycated haemoglobin, and avoidance of hyper- and hypoglycaemic excursions have been shown to prevent diabetes-related complications. Insulin pump use has increased considerably over the past decade with beneficial effects on glycaemic control, quality of life and treatment satisfaction. The advent and progress of ambulatory glucose sensor technology has enabled continuous glucose monitoring based on real-time glucose levels to be integrated with insulin therapy...
December 16, 2017: International Journal of Pharmaceutics
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
#9
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/29215299/complex-assessment-of-metabolic-effectiveness-of-insulin-pump-therapy-in-patients-with-type-2-diabetes-beyond-hba1c-reduction
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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/29159870/predictive-hyperglycemia-and-hypoglycemia-minimization-in-home-double-blind-randomized-controlled-evaluation-in-children-and-young-adolescents
#20
Gregory P Forlenza, Dan Raghinaru, Faye Cameron, B Wayne Bequette, H Peter Chase, R Paul Wadwa, David M Maahs, Emily Jost, Trang T Ly, Darrell M Wilson, Lisa Norlander, Laya Ekhlaspour, Hyojin Min, Paula Clinton, Nelly Njeru, John W Lum, Craig Kollman, Roy W Beck, Bruce A Buckingham
OBJECTIVE: The primary objective of this trial was to evaluate the feasibility, safety, and efficacy of a predictive hyperglycemia and hypoglycemia minimization (PHHM) system vs predictive low glucose suspension (PLGS) alone in optimizing overnight glucose control in children 6 to 14 years old. RESEARCH DESIGN AND METHODS: Twenty-eight participants 6 to 14 years old with T1D duration ≥1 year with daily insulin therapy ≥12 months and on insulin pump therapy for ≥6 months were randomized per night into PHHM mode or PLGS-only mode for 42 nights...
November 20, 2017: Pediatric Diabetes
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