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Insulin Pump Therapy

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https://www.readbyqxmd.com/read/27911116/finding-the-right-route-for-insulin-delivery-an-overview-of-implantable-pump-therapy
#1
Lia Bally, Hood Thabit, Roman Hovorka
Implantable pump therapy adopting the intraperitoneal route of insulin delivery has been available for the past three decades. The key rationale for implantable pump therapy is the restoration of the portal-peripheral insulin gradient of the normal physiology. Uptake in clinical practice is limited to specialized centers and selected patient populations. Areas covered: Implantable pump therapy is discussed, including technical aspects, rationale for its use, and glycemic and non-glycemic effects. Target populations, summaries of clinical studies and issues related to implantable pump therapy are highlighted...
December 2, 2016: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/27909691/6q24-transient-neonatal-diabetes-how-to-manage-while-waiting-for-genetic-results
#2
Julie Fudvoye, Khaldoun Farhat, Virginie De Halleux, Corina Ramona Nicolescu
Diabetes, rare in the neonatal period, should be evoked in every newborn presenting with unexplained intrauterine and early postnatal growth retardation. This case report illustrates the clinical course and therapeutic approach of a newborn diagnosed with transient diabetes. The baby was born at 37 weeks of gestation with a severe intrauterine growth restriction. Except a mild macroglossia and signs of growth restriction, physical examination was normal. On the fifth day of life, hyperglycemia (180 mg/dl) was noted, and the next day, the diagnosis of diabetes was confirmed (high blood sugar, glucosuria, undetectable levels of insulin and C-peptide)...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27896954/effect-of-carbohydrate-counting-using-bolus-calculators-on-glycemic-control-in-type-1-diabetes-patients-during-continuous-subcutaneous-insulin-infusion
#3
Eijiro Yamada, Shuichi Okada, Yasuyo Nakajima, Claire C Bastie, Yuko Tagaya, Aya Osaki, Yoko Shimoda, Ryo Shibusawa, Tsugumichi Saito, Atsushi Ozawa, Masanobu Yamada
This study examined the long-term efficacy of insulin pump therapy for type 1 diabetes patients when performed using carbohydrate counting with bolus calculators for one year. Twenty-two type 1 diabetes patients who had just started continuous subcutaneous insulin infusion were examined and divided into 2 groups: one that was educated about carbohydrate counting using bolus calculators (n=14) and another that did not use bolus calculators (n=8). After one year, the hemoglobin A1c levels of the patient group that used bolus calculators decreased persistently and significantly (P=0...
November 29, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27893687/spontaneous-and-transient-predinner-hyperglycemia-in-some-patients-with-diabetes-dusk-phenomenon
#4
Wei Li, Si-Na Du, Min-Jia Shi, Zhan-Zhan Sun
Blood glucose fluctuations have higher risk than absolute blood glucose level in diabetic chronic complications. At present, "dawn phenomenon" is well known by clinicians, but "dusk phenomenon" has not been recognized. This study explored the objective existence of "dusk phenomenon" (spontaneous and transient predinner hyperglycemia) and its clinical significance.The data of 54 patients with diabetes, who received routine insulin pump therapy between December 2010 and October 2012 in our hospital, were retrospectively analyzed...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27885706/insulin-pump-failures-in-italian-children-with-type%C3%A2-1-diabetes-retrospective-1-year-cohort-study
#5
I Rabbone, N Minuto, R Bonfanti, M Marigliano, F Cerutti, V Cherubini, G d'Annunzio, A Frongia, D Iafusco, G Ignaccolo, F Lombardo, R Schiaffini, S Toni, S Tumini, S Zucchini, A Pistorio, A E Scaramuzza
AIMS: Insulin pump failure and/or malfunction requiring replacement have not been thoroughly investigated. This study evaluated pump replacement in children and adolescents with Type 1 diabetes using insulin pump therapy. METHODS: Data were collected for all participants younger than 19 years, starting insulin pump therapy before 31 December 2013. For each child, age, disease duration, date of insulin pump therapy initiation, insulin pump model, failure/malfunction/replacement yes/no and reason were considered for the year 2013...
November 25, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/27872168/accurate-carbohydrate-counting-is-an-important-determinant-of-postprandial-glycemia-in-children-and-adolescents-with-type-1-diabetes-on-insulin-pump-therapy
#6
Asma Deeb, Ahlam Al Hajeri, Iman Alhmoudi, Nico Nagelkerke
BACKGROUND: Carbohydrate (CHO) counting is a key nutritional intervention utilized in the management of diabetes to optimize postprandial glycemia. The aim of the study was to examine the impact of accuracy of CHO counting on the postprandial glucose in children and adolescents with type 1 diabetes on insulin pump therapy. METHODS: Children/adolescents with type 1 diabetes who were on insulin pump therapy for a minimum of 6 months are enrolled in the study. Patients were instructed to record details of meals consumed, estimated CHO count per meal, and 2-hour postprandial glucose readings over 3-5 days...
November 20, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27860498/clinical-outcomes-after-1-year-of-augmented-insulin-pump-therapy-in-patients-with-diabetes-in-a-specialized-diabetes-center-in-medell%C3%A3-n-colombia
#7
Alex Ramirez-Rincon, Jaime Hincapie-García, Claudia Monsalve Arango, Natalia Aristizabal, Estefany Castillo, Gloria Hincapie, Eliana Zapata, Diana Paola Cuesta, Maria Delgado, Veronica Abad, Jose Luis Torres, Andres Palacio, José Fernando Botero
BACKGROUND: Type 1 diabetes can be difficult to control. Augmented pump therapy (CSII-rtCGM) has become an important tool for controlling blood glucose and decreasing hypoglycemia. METHODS: Describe the results 1 year after starting CSII-rtCGM in patients with diabetes in Medellín, Colombia. This is an observational, retrospective study. Patients with type 1 and type 2 diabetes started on CSII-rtCGM between January 2008 and June 2015 were included. Qualitative variables were analyzed as absolute or relative frequencies...
November 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27835049/insulin-pump-failures-has-there-been-an-improvement-update-of-a-prospective-observational-study
#8
Agathe Guenego, Guillaume Bouzillé, Stéphanie Breitel, Annabelle Esvant, Jean-Yves Poirier, Fabrice Bonnet, Isabelle Guilhem
BACKGROUND: Insulin pump failures had been assessed in our center by a prospective observational study from 2001 to 2007. The aim of this study was to update our data since 2008 and to determine whether there exist specific risk factors for insulin pump failures. METHODS: All insulin pump defects were prospectively collected between 2008 and 2013 in a monocentric cohort of 350 new pumps. Clinical consequences were recorded. Brand and model of pumps and type of defects and patients' characteristics (gender, type of diabetes, age at diabetes diagnosis, age at first pump, pump treatment duration, number of previous pumps, and number of previous pump failures) were tested for possible association with insulin pump failure...
November 11, 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27824066/a-novel-insulin-glucose-model-after-a-mixed-meal-test-in-patients-with-type-1-diabetes-on-insulin-pump-therapy
#9
Luca Marchetti, Federico Reali, Marco Dauriz, Corinna Brangani, Linda Boselli, Giulia Ceradini, Enzo Bonora, Riccardo C Bonadonna, Corrado Priami
Current closed-loop insulin delivery methods stem from sophisticated models of the glucose-insulin (G/I) system, mostly based on complex studies employing glucose tracer technology. We tested the performance of a new minimal model (GLUKINSLOOP 2.0) of the G/I system to characterize the glucose and insulin dynamics during multiple mixed meal tests (MMT) of different sizes in patients with type 1 diabetes (T1D) on insulin pump therapy (continuous subcutaneous insulin infusion, CSII). The GLUKINSLOOP 2.0 identified the G/I system, provided a close fit of the G/I time-courses and showed acceptable reproducibility of the G/I system parameters in repeated studies of identical and double-sized MMTs...
November 8, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27777901/excess-weight-gain-during-insulin-pump-therapy-is-associated-with-higher-basal-insulin-doses
#10
Claudia Boucher-Berry, Elaine A Parton, Ramin Alemzadeh
BACKGROUND: While higher total daily dose (TDD) of insulin has been associated with excess weight gain on insulin pump therapy, the role of higher total basal dose (TBD) of insulin on weight gain has not been studied. We evaluated the impact of higher TBD on weight gain in relationship to glycosylated hemoglobin (HbA1c), hypoglycemic episodes, and change in body mass index (BMI) z score in a group of pediatric patients with type 1 diabetes mellitus (T1DM). METHODS: One-year data from 91 (54 Female/37 Male) patients (2...
2016: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/27770589/factors-affecting-the-benefit-of-insulin-dose-intensification-in-people-with-type-2-diabetes-an-analysis-from-the-opt2mise-randomized-trial
#11
I Schütz-Fuhrmann, J Castañeda, Y Reznik, R Aronson, I Conget, S Liabat, S Runzis, S de Portu, O Cohen
The recent OpT2mise randomized trial compared the efficacy of insulin pump therapy and multiple daily injections (MDI) in people with Type 2 diabetes and HbA1c levels that remained ≥64 mmol/mol (8.0%) despite insulin dose optimization [1,2]. During the initial 6-month randomized phase of the study, pump therapy was shown to produce a significant improvement in glycaemic control and a 20% reduction in total daily insulin dose, compared with MDI therapy [1], and these benefits were sustained during the subsequent 6-month extension phase during which all participants received pump therapy [2]...
October 22, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/27764721/type-1-diabetes-in-older-adults-comparing-treatments-and-chronic-complications-in-the-united-states-t1d-exchange-and-the-german-austrian-dpv-registries
#12
Ruth S Weinstock, Ingrid Schütz-Fuhrmann, Crystal G Connor, Julia M Hermann, David M Maahs, Morten Schütt, Shivani Agarwal, Sabine E Hofer, Roy W Beck, Reinhard W Holl
AIMS: Compare characteristics, therapies and clinical outcomes in older adults with type 1 diabetes in the United States T1D Exchange (T1DX) and German/Austrian Diabetes Patienten Verlaufsdokumentation (DPV) registries. METHODS: Cross-sectional study of adults ≥60years old with type 1 diabetes seen in 2011-2012 in the T1DX (n=1283) and DPV (n=2014) registries. Wilcoxon rank-sum test was used for continuous variables and chi-square test for categorical variables...
October 4, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27696520/psychological-outcomes-of-evening-and-night-closed-loop-insulin-delivery-under-free-living-conditions-in-people-with-type-1-diabetes-a-2-month-randomized-crossover-trial
#13
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
https://www.readbyqxmd.com/read/27693206/randomized-evidence-for-reduction-of-perioperative-mortality-an-updated-consensus-process
#14
Giovanni Landoni, Antonio Pisano, Vladimir Lomivorotov, Gabriele Alvaro, Ludhmila Hajjar, Gianluca Paternoster, Caetano Nigro Neto, Nicola Latronico, Evgeny Fominskiy, Laura Pasin, Gabriele Finco, Rosetta Lobreglio, Maria Luisa Azzolini, Giuseppe Buscaglia, Alberto Castella, Marco Comis, Adele Conte, Massimiliano Conte, Francesco Corradi, Erika Dal Checco, Giovanni De Vuono, Marco Ganzaroli, Eugenio Garofalo, Gordana Gazivoda, Rosalba Lembo, Daniele Marianello, Martina Baiardo Redaelli, Fabrizio Monaco, Valentina Tarzia, Marta Mucchetti, Alessandro Belletti, Paolo Mura, Mario Musu, Giovanni Pala, Massimiliano Paltenghi, Vadim Pasyuga, Desiderio Piras, Claudio Riefolo, Agostino Roasio, Laura Ruggeri, Francesco Santini, Andrea Székely, Luigi Verniero, Antonella Vezzani, Alberto Zangrillo, Rinaldo Bellomo
OBJECTIVE: Of the 230 million patients undergoing major surgical procedures every year, more than 1 million will die within 30 days. Thus, any nonsurgical interventions that help reduce perioperative mortality might save thousands of lives. The authors have updated a previous consensus process to identify all the nonsurgical interventions, supported by randomized evidence, that may help reduce perioperative mortality. DESIGN AND SETTING: A web-based international consensus conference...
August 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27621142/early-detection-of-infusion-set-failure-during-insulin-pump-therapy-in-type-1-diabetes
#15
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...
November 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27621141/do-we-need-updated-guidelines-on-the-use-of-insulin-pump-therapy-in-type-2-diabetes-a-review-of-national-and-international-practice-guidelines
#16
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...
November 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27613610/sexual-function-in-young-women-with-type-1-diabetes-the-metro-study
#17
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
https://www.readbyqxmd.com/read/27612500/home-use-of-day-and-night-hybrid-closed-loop-insulin-delivery-in-suboptimally-controlled-adolescents-with-type-1-diabetes-a-3-week-free-living-randomized-crossover-trial
#18
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
https://www.readbyqxmd.com/read/27605593/usability-of-medical-devices-for-patients-with-diabetes-who-are-visually-impaired-or-blind
#19
REVIEW
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...
November 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27605591/randomized-cross-over-study-comparing-two-infusion-sets-for-csii-in-daily-life
#20
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
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