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Insulin Pump Therapy

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https://www.readbyqxmd.com/read/29771162/facilitation-of-intensive-insulin-therapy-in-the-early-primary-school-setting-narratives-of-australian-diabetes-educators
#1
Anne Marks, Nathan J Wilson, Stacy Blythe, Christine Johnston
The number of early primary school (EPS) children (aged 4-8 years) with type 1 diabetes mellitus (T1DM) rises each year. Intensive insulin therapy (IIT) can be challenging for these children, as adult support may not be available in the school setting. Diabetes educators (DEs) working in the health system facilitate school diabetes care, which can be time-consuming given the large numbers of children with diabetes. These factors are potential barriers for IIT use in the EPS setting. To explore the experiences of Australian DEs who facilitate IIT use in the EPS setting, a qualitative, narrative inquiry method was used to conduct semi-structured telephone interviews with Australian DEs (n = 13) between December 2014 and June 2016...
May 17, 2018: Comprehensive Child and Adolescent Nursing
https://www.readbyqxmd.com/read/29753624/a-critical-review-and-analysis-of-ethical-issues-associated-with-the-artificial-pancreas
#2
REVIEW
A Quintal, V Messier, R Rabasa-Lhoret, E Racine
The artificial pancreas combines a hormone infusion pump with a continuous glucose ontinuous glucose monitoring, supported by a dosing algorithm currently installed on the pump. It allows for dynamic infusions of insulin (and possibly other hormones such as glucagon) tailored to patient needs. For patients with type 1 diabetes the artificial pancreas has been shown to prevent more effectively hypoglycaemic events and hyperglycaemia than insulin pump therapy and has the potential to simplify care. However, the potential ethical issues associated with the upcoming integration of the artificial pancreas into clinical practice have not yet been discussed...
April 25, 2018: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29753586/cost-effectiveness-of-sensor-augmented-pump-therapy-in-two-different-patient-populations-with-type-1-diabetes-in-italy
#3
A Nicolucci, M C Rossi, D D'Ostilio, A Delbaere, S de Portu, S Roze
BACKGROUND AND AIMS: Sensor-augmented pump therapy (SAP) combines real time continuous glucose monitoring (CGM) with Continuous Subcutaneous Insulin Infusion (CSII) and provides additional benefits beyond those provided by CSII alone. SAP with automated insulin suspension provides early warning of the onset of hyperglycemia and hypoglycemia and has the functionality to suspend insulin delivery if sensor glucose levels are predicted to fall below a predefined threshold. Aim of this study was to assess the cost-effectiveness of SAP with automated insulin suspension versus CSII alone in type 1 diabetes...
April 5, 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29749032/comparison-between-preprandial-versus-postprandial-insulin-aspart-administration-in-patients-with-type-1-diabetes-benefiting-from-insulin-pump-and-real-time-continuous-glucose-monitoring
#4
Philippe Thuillier, Emmanuel Sonnet, Zarrin Alavi, Nathalie Roudaut, Emmanuel Nowak, Angélina Dion, Véronique Kerlan
BACKGROUND: The objective was to compare glycemic control between pre- and post-prandial bolus administration (15min before (PRE) or immediately after the meal (POST)) in patients with type 1 diabetes using insulin pump and real time continuous glucose monitoring (RT-CGM). METHODS: Between September 2015 and February 2016, a single-centre, open randomized, two-way crossover study of patients on bolus insulin aspart administration was conducted during two 14-days periods and according to two administration regimen schedules(...
May 10, 2018: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/29743068/facilitating-the-implementation-of-clinical-technology-in-healthcare-what-role-does-a-national-agency-play
#5
Gill Harvey, Sue Llewellyn, Greg Maniatopoulos, Alan Boyd, Rob Procter
BACKGROUND: Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. METHODS: The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29733870/prevalence-and-geographical-distribution-of-insulin-pump-therapy-in-the-central-denmark-region-and-its-association-with-metabolic-parameters
#6
Ulla Kampmann, Lene Ring Madsen, Lasse Bjerg, Daniel R Witte, Kjeld Hasselstrøm, Torben Østergård, Kirsten Alstrup, Marianne Kleis Møller, Dorrit Dylmer, Klavs Würgler Hansen
AIMS: Insulin treatment in type 1 diabetes encompasses multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII). Both population-based studies and comparative studies regarding CSII use are sparse. The aim of the current study was to describe the prevalence and distribution of CSII use among adults with type 1 diabetes in the Central Denmark Region and to compare metabolic control in CSII-treated patients to those treated with MDI. METHODS: A database was constructed using the Danish Adult Diabetes Registry in 2014/2015 in combination with an audit of the patients' medical records...
May 4, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29681172/analyzing-the-potential-of-advanced-insulin-dosing-strategies-in-patients-with-type-2-diabetes-results-from-a-hybrid-in-silico-study
#7
Florian Reiterer, Matthias Reiter, Luigi Del Re, Merete Bechmann Christensen, Kirsten Nørgaard
BACKGROUND: The ongoing improvement of continuous glucose monitoring (CGM) sensors and of insulin pumps are paving the way for a fast implementation of artificial pancreas (AP) for type 1 diabetes (T1D) patients. The case for type 2 diabetes (T2D) patients is less obvious since usually some residual beta cell function allows for simpler therapy approaches, and even multiple daily injections (MDI) therapy is not very widespread. However, the number of insulin dependent T2D patients is vastly increasing and therefore a need for understanding chances and challenges of an automated insulin therapy arises...
April 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29650309/open-loop-glucose-control-automatic-iob-based-super-bolus-feature-for-commercial-insulin-pumps
#8
Nicolás Rosales, Hernán De Battista, Josep Vehí, Fabricio Garelli
BACKGROUND AND OBJECTIVE: Although there has been significant progress towards closed-loop type 1 diabetes mellitus (T1DM) treatments, most diabetic patients still treat this metabolic disorder in an open-loop manner, based on insulin pump therapy (basal and bolus insulin infusion). This paper presents a method for automatic insulin bolus shaping based on insulin-on-board (IOB) as an alternative to conventional bolus dosing. METHODS: The methodology presented allows the pump to generate the so-called super-bolus (SB) employing a two-compartment IOB dynamic model...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29619896/insulin-pump-therapy-in-adolescents-with-very-poor-glycemic-control-during-a-12-month-cohort-trial
#9
Martin de Bock, Jaimee Rossborough, Aris Siafarikas, Megan Evans, Helen Clapin, Grant Smith, Timothy Jones, Elizabeth Davis
No abstract text is available yet for this article.
April 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29582531/metabolic-control-of-type-1-diabetes-in-youth-with-autism-spectrum-disorder-a-multicenter-diabetes-patienten-verlaufsdokumentation-analysis-based-on-61-749-patients-up-to-20-years-of-age
#10
J-F Lemay, S Lanzinger, D Pacaud, P L Plener, A Fürst-Burger, T Biester, D Hilgard, E Lilienthal, A Galler, G Berger, R W Holl
BACKGROUND: A paucity of reports in the literature exists concerning the co-existence between autism spectrum disorder (ASD) and type 1 diabetes (T1D). OBJECTIVE: To compare clinical characteristics, diabetes management and metabolic control in youth with T1D and ASD (T1D-ASD) with youth without ASD (T1D-non ASD). METHODS: Using the German/Austrian diabetes patient follow-up registry, this study analyzed aggregated data from the last available year of observation for each patient with T1D, ages 1-20 with consistent data on insulin regimen and glycated hemoglobin (A1C), between January, 2005 and March, 2017...
March 26, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29577536/hypoglycaemia-incidence-and-recovery-during-home-use-of-hybrid-closed-loop-insulin-delivery-in-adults-with-type-1-diabetes
#11
Y Ruan, L Bally, H Thabit, L Leelarathna, S Hartnell, M Tauschmann, M E Wilinska, M L Evans, J K Mader, H Kojzar, S Dellweg, C Benesch, S Arnolds, T R Pieber, R Hovorka
INTRODUCTION: Glucose excursion were assessed prior and post hypoglycaemia to increase understanding of hypoglycaemia incidence and recovery during hybrid closed-loop insulin delivery. METHODS: We retrospectively analysed data from 60 adults with type 1 diabetes who received in crossover randomised design day-and-night hybrid closed-loop insulin delivery and insulin pump therapy, the latter with or without real-time continuous glucose monitoring. Over 4-week study periods, we identified hypoglycaemic episodes defined as sensor glucose < 3...
March 25, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29573166/suboptimal-behaviour-and-knowledge-regarding-overnight-glycaemia-in-adults-with-type-1-diabetes-is-common
#12
Christina R Larsson, Andrzej S Januszewski, Rachel T McGrath, Johnny Ludvigsson, Anthony C Keech, Richard J MacIsaac, Glenn M Ward, David N O'Neal, Gregory R Fulcher, Alicia J Jenkins
BACKGROUND: In people with Type 1 diabetes (T1D) nocturnal hypoglycaemia (NH) can be slept through, and can cause seizures, arrhythmias and death. Hypoglycaemia avoidance can induce hyperglycaemia and ketosis. Patient behaviour impacts clinical outcomes and may be changed by education. AIM: To develop and utilise a survey to evaluate patient self-management of overnight glycaemia in adults with Type 1 Diabetes (T1D). METHODS: Adults with T1D attending two Australian tertiary referral diabetes clinics completed a survey about their diabetes self-management and glycaemic control, including their responses to hypothetical pre-bed blood glucose (BG) levels (4-20mmol/L)...
March 23, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29565722/sensor-augmented-pump-based-customized-mathematical-model-for-type-1-diabetes
#13
Benyamin Grosman, Di Wu, Diana Miller, Louis Lintereur, Anirban Roy, Neha Parikh, Francine R Kaufman
BACKGROUND: Simulations using mathematical models are important for studying, developing, and improving therapies for people with type 1 diabetes. METHODS: The Medtronic CareLink® database was used to create virtual patients with a variety of inter-insulin sensitivities, meal absorption rates, pharmacokinetics, age, and gender. In addition, intra-insulin sensitivities of the virtual patients change over a 24-h cycle. RESULTS: A total of 2087 virtual patients were developed...
March 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29563012/diabetes-in-childhood-and-adolescence
#14
Ralph Ziegler, Andreas Neu
BACKGROUND: The incidence of type 1 diabetes mellitus in childhood and adolescence is steadily rising and now stands at 22.9 new cases per year per 100 000 persons up to age 15. METHODS: This review is based on pertinent publications retrieved by a selective literature search, with special attention to the current German S3 guideline on diabetes in childhood and adolescence. RESULTS: Polydipsia, polyuria, and weight loss are the characteristic presenting symptoms of diabetes mellitus...
March 2, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29559408/review-of-hyperglycaemia-definitions-and-pathophysiology
#15
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
Diabetes mellitus is defined by chronic elevation of blood glucose linked to insulin resistance and/or insulinopaenia. Its diagnosis is based on a fasting blood-glucose level of ≥1.26g/L or, in some countries, a blood glycated haemoglobin (HbA1c) level of >6.5%. Of the several forms of diabetes, type-2 diabetes (T2D) is the most common and is found in patients with other risk factors. In contrast, type-1 diabetes (T1D) is linked to the auto-immune destruction of β-pancreatic cells, leading to insulinopaenia...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29559406/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#16
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29555547/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#17
Cheisson Gaëlle, Jacqueminet Sophie, Cosson Emmanuel, Ichai Carole, Leguerrier Anne-Marie, Nicolescu-Catargi Bogdan, Ouattara Alexandre, Tauveron Igor, Valensi Paul, Benhamou Dan
Perioperative hyperglycaemia (>1.80g/L or 10 mmol/L) increases morbidity (particularly due to infection) and mortality. Hypoglycaemia can be managed in the perioperative period by decreasing blood sugar levels with insulin between 0.90 and 1.80g/l but it may occur more frequently when the goal is strict normoglycaemia. We propose continuous administration of insulin therapy via an electronic syringe (IVES) in type-1 diabetes (T1D) and type-2 diabetes (T2D) patients if required or in cases of stress hyperglycaemia...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29547046/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-2018-position-statement-on-integration-of-insulin-pumps-and-continuous-glucose-monitoring-in-patients-with-diabetes-mellitus
#18
George Grunberger, Yehuda Handelsman, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, Richard A Haas, Victor L Roberts, Guillermo E Umpierrez
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician...
March 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29542348/the-promise-and-perils-of-wearable-physiological-sensors-for-diabetes-management
#19
Frank L Schwartz, Cynthia R Marling, Razvan C Bunescu
Development of truly useful wearable physiologic monitoring devices for use in diabetes management is still in its infancy. From wearable activity monitors such as fitness trackers and smart watches to contact lenses measuring glucose levels in tears, we are just at the threshold of their coming use in medicine. Ultimately, such devices could help to improve the performance of sense-and-respond insulin pumps, illuminate the impact of physical activity on blood glucose levels, and improve patient safety. This is a summary of our experience attempting to use such devices to enhance continuous glucose monitoring-augmented insulin pump therapy...
March 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29537377/effectiveness-of-continuous-subcutaneous-insulin-infusion-pump-therapy-during-five-years-of-treatment-on-metabolic-control-in-children-and-adolescents-with-type-1-diabetes-mellitus
#20
Özlem Korkmaz, Günay Demir, Hafize Çetin, İlkin Mecidov, Yasemin Atik Altınok, Samim Özen, Şükran Darcan, Damla Gökşen
AIM: To compare continuous subcutaneous insulin infusion therapy (CSII) with multiple daily insulin therapy (MDI) on metabolic control in children and adolescents with type 1 diabetes mellitus (T1DM) over the long term. METHOD: 52 T1DM patients treated with CSII and monitored for at least 1 year prior to and at least five years following CSII were included. 38 age and sex-matched MDI controls with a 5-year follow up were recruited. RESULTS: Mean age of the subjects, duration of diabetes and CSII therapy were 17...
February 28, 2018: Journal of Clinical Research in Pediatric Endocrinology
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