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Insulin Pump Therapy

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https://www.readbyqxmd.com/read/29117449/route-to-improving-type-1-diabetes-mellitus-glycaemic-outcomes-real-world-evidence-taken-from-the-national-diabetes-audit
#1
P J Hammond
The National Diabetes Audit (NDA) has helped to highlight the disparity in glycaemic outcomes between those with Type 1 and those with Type 2 diabetes. Whilst ~70% of those with Type 2 diabetes achieve an HbA1c concentration <58 mmol/mol (7.5%), only 30% of those with Type 1 diabetes do so. Heald et al. [1] have used the data from the NDA to determine whether improved uptake of technology, particularly insulin pump therapy, might improve glycaemic outcomes. This article is protected by copyright. All rights reserved...
November 8, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29080577/a-primer-on-insulin-pump-therapy-for-health-care-providers
#2
REVIEW
Deborah L McCrea
An estimated 1 million people use an insulin pump to manage their diabetes. Few medical professionals understand or feel comfortable caring for people who use an insulin pump. This article will help the medical professional understand the reasons why the insulin pump helps the user to achieve better glycemic control, have more flexibility, and enjoy a better quality of life. Additionally, this article discusses the advantages, disadvantages, candidate selection, contraindications, basic functions, and troubleshooting of the insulin pump...
December 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/29066463/angiotensin-1-7-stimulates-brown-adipose-tissue-and-reduces-diet-induced-obesity
#3
Hidechika Morimoto, Jun Mori, Hisakazu Nakajima, Yasuhiro Kawabe, Yusuke Tsuma, Shota Fukuhara, Kazuki Kodo, Kazuya Ikoma, Satoaki Matoba, Gavin Y Oudit, Hajime Hosoi
The renin-angiotensin system is a key regulator of metabolism with beneficial effects of the angiotensin 1-7 peptide. We hypothesized that the anti-obesity effect of Ang 1-7 is related to the stimulation of brown adipose tissue (BAT). We administered Ang 1-7 (0.54 mg・kg(-1)・d(-1)) for 28 days via implanted micro-osmotic pumps to mice with high-fat diet (HFD) induced obesity. Ang 1-7 treatment reduced body weight, upregulated thermogenesis and ameliorated impaired glucose homeostasis without affecting food consumption...
October 24, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29049584/association-of-insulin-pump-therapy-vs-insulin-injection-therapy-with-severe-hypoglycemia-ketoacidosis-and-glycemic-control-among-children-adolescents-and-young-adults-with-type-1-diabetes
#4
COMPARATIVE STUDY
Beate Karges, Anke Schwandt, Bettina Heidtmann, Olga Kordonouri, Elisabeth Binder, Ulrike Schierloh, Claudia Boettcher, Thomas Kapellen, Joachim Rosenbauer, Reinhard W Holl
Importance: Insulin pump therapy may improve metabolic control in young patients with type 1 diabetes, but the association with short-term diabetes complications is unclear. Objective: To determine whether rates of severe hypoglycemia and diabetic ketoacidosis are lower with insulin pump therapy compared with insulin injection therapy in children, adolescents, and young adults with type 1 diabetes. Design, Setting, and Participants: Population-based cohort study conducted between January 2011 and December 2015 in 446 diabetes centers participating in the Diabetes Prospective Follow-up Initiative in Germany, Austria, and Luxembourg...
October 10, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28990436/acceptability-of-implantable-continuous-glucose-monitoring-sensor
#5
Katharine D Barnard, Jort Kropff, Pratik Choudhary, Sankalpa Neupane, Stephen C Bain, Christoph Kapitza, Thomas Forst, Manuela Link, Colleen Mdingi, J Hans DeVries
BACKGROUND: Real-time continuous glucose monitoring is associated with significant benefits for diabetes management. Implantable sensors could overcome some challenges reportedly associated with device visibility, psychosocial functioning and sensor durability. METHODS: A psychosocial assessment was conducted to determine acceptability and impact of an implantable continuous glucose monitoring (CGM) sensor as part of the PRECISE trial. Questionnaires were administered to participants comprising the Diabetes Distress Scale, the CGM impact scale, and bespoke device satisfaction...
October 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28989086/reported-gastroparesis-in-adults-with-type-1-diabetes-t1d-from-the-t1d-exchange-clinic-registry
#6
Grazia Aleppo, Peter Calhoun, Nicole C Foster, David M Maahs, Viral N Shah, Kellee M Miller
OBJECTIVE: To better understand the prevalence and impact of gastroparesis in the T1D Exchange clinic registry database. METHODS: The analysis included 7107 adult participants with T1D across 45 sites (median age 46years. and median duration 24years). Linear and logistic regression models were used to assess the association of gastroparesis vs. no gastroparesis (obtained from medical record) with demographic characteristics, glycemic control and diabetes complications...
September 6, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28982341/gastrin-a-potential-predictor-of-response-to-incretin-therapy-in-diabetes-type-2-patients
#7
Ines Bilic-Curcic, Maja Cigrovski Berkovic
BACKGROUND AND OBJECTIVES: Personalized management of diabetes has become an imperative since majority of monotherapy fails within 3 years of its use. Identifying responders from non-responders for a certain type of therapy would reduce a period of unsuccessful treatment and minimize health care costs. Incretin therapies, mainly glucagon-like peptide (GLP)-1 receptor agonists (GLP-1RA) are relatively new glucose-lowering agents which increase insulin and lower glucagon response as well as slow down glucose absorption by acting on gastric emptying...
October 3, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28979168/devices-for-continuous-monitoring-of-glucose-update-in-technology
#8
REVIEW
Ana María Gómez, Diana Cristina Henao Carrillo, Oscar Mauricio Muñoz Velandia
Continuous glucose monitoring (CGM) is a tool that allows constant evaluation of glycemic control, providing data such as the trend and fluctuation of interstitial glucose levels over time. In clinical practice, there are two modalities: the professional or retrospective and the personal or real-time CGM (RT-CGM). The latest-generation sensors are more accurate and sensitive for hypoglycemia, improving adherence to self-monitoring, which has allowed optimizing glycemic control. The development of algorithms that allow the suspension of the infusion of insulin during hypoglycemia gave rise to the integrated therapy or sensor-augmented insulin pump therapy with low glucose suspend, which has proven to be an effective and safe alternative in the treatment of diabetic patients with high risk of hypoglycemia...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28960449/an-integrative-review-of-the-psychosocial-facilitators-and-challenges-of-continuous-subcutaneous-insulin-infusion-therapy-in-type-1-diabetes
#9
REVIEW
Marlene Payk, Tracy Robinson, Deborah Davis, Marjorie Atchan
AIM: To use systematic methods to explore the psychosocial facilitators and challenges of insulin pump therapy among people with type 1 diabetes. BACKGROUND: Insulin pump therapy is now widely accepted in the management of type 1 diabetes. Given the increasing use of insulin pumps it is timely to review the evidence relating to the psychosocial impacts of this therapy which have not been addressed in previous reviews. DESIGN: An integrative review of the literature (January 2005 - February 2017)...
September 28, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28943578/suppression-of-extrapancreatic-glucagon-by-octreotide-may-reduce-the-fasting-and-postprandial-glucose-levels-in-a-diabetic-patient-after-total-pancreatectomy-a-case-report
#10
Hideyuki Okuma, Ryotaro Bouchi, Seizaburo Masuda, Takato Takeuchi, Masanori Murakami, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa
A 52-year-old woman was treated with sensor augmented pump therapy after undergoing total pancreatectomy for a nonfunctional pancreatic neuroendocrine tumor (NET). The secretion of both endogenous insulin and pancreatic glucagon were completely depleted. Octreotide long acting repeatable (Oct-LAR) was administered for the treatment of liver metastasis of NET. Both the fasting and postprandial glucagon levels decreased immediately after the administration of Oct-LAR. In a continuous glucose monitoring analysis, episodes of nocturnal hypoglycemia was found to increase and an improvement of postprandial hyperglycemia was observed...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28942668/recent-exposure-to-hypoglycemia-increases-glucose-variability-following-a-hyper-hypoglycemic-metabolic-challenge-in-t1d
#11
Chiara Fabris, Leon S Farhy, Stacey M Anderson, Ralf M Nass, Boris P Kovatchev, Marc D Breton
AIMS: In type 1 diabetes (T1D), repeated hypoglycemic episodes may reduce hormonal defenses and increase the risk for severe hypoglycemia. In this work, we investigate the effect of a structured hyper/hypoglycemic metabolic challenge on the postintervention glucose variability in T1D subjects studied at home. METHODS: Thirty T1D subjects using insulin pump were monitored with blood glucose meters (SMBG) during a 1-month observation period. After 2 weeks of monitoring, participants were admitted at the University of Virginia Clinical Research Unit to undergo an 8-hour metabolic challenge...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28942594/keeping-up-with-the-diabetes-technology-2016-endocrine-society-guidelines-of-insulin-pump-therapy-and-continuous-glucose-monitor-management-of-diabetes
#12
REVIEW
Alfonso Galderisi, Elise Schlissel, Eda Cengiz
PURPOSE OF REVIEW: Decades after the invention of insulin pump, diabetes management has encountered a technology revolution with the introduction of continuous glucose monitoring, sensor-augmented insulin pump therapy and closed-loop/artificial pancreas systems. In this review, we discuss the significance of the 2016 Endocrine Society Guidelines for insulin pump therapy and continuous glucose monitoring and summarize findings from relevant diabetes technology studies that were conducted after the publication of the 2016 Endocrine Society Guidelines...
September 23, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28924484/diabetic-ketoacidosis-producing-extreme-hyperkalemia-in-a-patient-with-type-1-diabetes-on-hemodialysis
#13
Hodaka Yamada, Shunsuke Funazaki, Masafumi Kakei, Kazuo Hara, San-E Ishikawa
Diabetic ketoacidosis (DKA) is a critical complication of type 1 diabetes associated with water and electrolyte disorders. Here, we report a case of DKA with extreme hyperkalemia (9.0 mEq/L) in a patient with type 1 diabetes on hemodialysis. He had a left frontal cerebral infarction resulting in inability to manage his continuous subcutaneous insulin infusion pump. Electrocardiography showed typical changes of hyperkalemia, including absent P waves, prolonged QRS interval and tented T waves. There was no evidence of total body water deficit...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28923465/continuous-glucose-monitoring-in-pregnant-women-with-type-1-diabetes-conceptt-a-multicentre-international-randomised-controlled-trial
#14
Denice S Feig, Lois E Donovan, Rosa Corcoy, Kellie E Murphy, Stephanie A Amiel, Katharine F Hunt, Elizabeth Asztalos, Jon F R Barrett, J Johanna Sanchez, Alberto de Leiva, Moshe Hod, Lois Jovanovic, Erin Keely, Ruth McManus, Eileen K Hutton, Claire L Meek, Zoe A Stewart, Tim Wysocki, Robert O'Brien, Katrina Ruedy, Craig Kollman, George Tomlinson, Helen R Murphy
BACKGROUND: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes. METHODS: In this multicentre, open-label, randomised controlled trial, we recruited women aged 18-40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy...
September 15, 2017: Lancet
https://www.readbyqxmd.com/read/28918653/setting-expectations-for-successful-artificial-pancreas-hybrid-closed-loop-automated-insulin-delivery-adoption
#15
Dana Lewis
Hybrid closed loop (or automated insulin delivery systems) and artificial pancreas technology will dramatically change the quality of life for people living with diabetes. However, this technology is not a cure. Without having expectations set, patients may assume that APs will replace critical self-care behaviors. It is important for patients to understand several key things before choosing to adopt and switching to APs for diabetes management. Like any technology, APs will have a learning curve. But like switching from MDI to standard pump therapy, it is not insurmountable...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28913745/management-of-type-1-diabetes-in-the-hospital-setting
#16
REVIEW
Carlos E Mendez, Guillermo E Umpierrez
PURPOSE OF REVIEW: The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. RECENT FINDINGS: Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described...
September 14, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28905659/comparative-handling-analysis-of-different-insulin-pump-systems
#17
Delia Waldenmaier, Katharina Schöllkopf, Antje Westhoff, Lutz Heinemann, Guido Freckmann
Insulin pumps are used by many patients with diabetes to manage their diabetes therapy. Adequate handling of the systems is important to avoid errors. In this study, one aspect of device handling-the number of steps required to operate the system-was evaluated for different insulin pump systems. Specific tasks that are usually performed by insulin pump users were simulated and all necessary actions were documented. Differences between the required numbers of steps strongly depended on the specific task. So did the level of guidance for these tasks provided by the systems...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28899222/effects-of-sotagliflozin-added-to-insulin-in-patients-with-type-1-diabetes
#18
Satish K Garg, Robert R Henry, Phillip Banks, John B Buse, Melanie J Davies, Gregory R Fulcher, Paolo Pozzilli, Diane Gesty-Palmer, Pablo Lapuerta, Rafael Simó, Thomas Danne, Darren K McGuire, Jake A Kushner, Anne Peters, Paul Strumph
Background In most patients with type 1 diabetes, adequate glycemic control is not achieved with insulin therapy alone. We evaluated the safety and efficacy of sotagliflozin, an oral inhibitor of sodium-glucose cotransporters 1 and 2, in combination with insulin treatment in patients with type 1 diabetes. Methods In this phase 3, double-blind trial, which was conducted at 133 centers worldwide, we randomly assigned 1402 patients with type 1 diabetes who were receiving treatment with any insulin therapy (pump or injections) to receive sotagliflozin (400 mg per day) or placebo for 24 weeks...
September 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28898340/-from-insulin-pump-and-continuous-glucose-monitoring-to-the-artificial-pancreas
#19
Pamela Apablaza, Néstor Soto, Ethel Codner
Technology for diabetes care has undergone major development during recent decades. These technological advances include continuous subcutaneous insulin infusion (CSII), also known as insulin pumps, and real-time continuous glucose monitoring system (RT-CGMS). The integration of CSII and RT-CGMS into a single device has led to sensor-augmented pump therapy and more recently, a technology that has automated delivery of basal insulin therapy, known as hybrid system. These new technologies have led to benefits in attaining better metabolic control and decreasing the incidence of severe hypoglycemia, especially in patients with type 1 diabetes...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28872765/digital-therapy-in-diabetes
#20
REVIEW
Avivit Cahn, Amit Akirov, Itamar Raz
Diabetes care is largely dependent on patient self-management and empowerment, given that patients with diabetes must make numerous daily decisions of what to eat, when to exercise, and determine their insulin dose and timing if required. Additionally, patients and providers are generating vast amounts of data from many sources including electronic medical records, insulin pumps, sensors, glucometers, other wearables, as well as evolving genomic, proteomic, metabolomic and microbiomic data. Multiple digital tools and apps have been developed to assist patients to choose wisely, as well as enhance their compliance by employing motivational tools and incorporating incentives from social media and gaming techniques...
September 5, 2017: Journal of Diabetes
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