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Insulin Pump Therapy

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https://www.readbyqxmd.com/read/28550194/the-risk-of-severe-hypoglycemia-in-type-1-diabetes-over-30-years-of-follow-up-in-the-dcct-edic-study
#1
Rose A Gubitosi-Klug, Barbara H Braffett, Neil H White, Robert S Sherwin, F John Service, John M Lachin, William V Tamborlane
OBJECTIVE: During the DCCT, intensive diabetes therapy achieving a mean HbA1c of ∼7% was associated with a threefold increase in the rate of severe hypoglycemia (defined as requiring assistance) compared with conventional diabetes therapy with a mean HbA1c of 9% (61.2 vs. 18.7 per 100 patient-years). After ∼30 years of follow-up, we investigated the rates of severe hypoglycemia in the DCCT/EDIC cohort. RESEARCH DESIGN AND METHODS: Rates of severe hypoglycemia were reported quarterly during DCCT and annually during EDIC (i...
May 26, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28535306/examination-of-psychosocial-and-physiological-risk-for-bulimic-symptoms-in-youth-with-type-1-diabetes-transitioning-to-an-insulin-pump-a-pilot-study
#2
Claire M Peterson, Deborah Young-Hyman, Sarah Fischer, Jessica T Markowitz, Andrew B Muir, Lori M Laffel
This study tested hypotheses drawn from a risk model positing that psychosocial risk plus disease-related and treatment factors contribute to bulimic symptoms in youth with type 1 diabetes (T1D) transitioning to an insulin pump. The goal of this study was to examine whether disease-related factors, particularly disease- and treatment-based disruption in hunger and satiety, contribute to report of bulimic symptoms in youth with T1D after accounting for psychosocial risk factors. 43 youth (ages 10-17, 54% female) with established T1D were recruited before transition from multiple daily injections to insulin-pump therapy from three tertiary pediatric diabetes centers...
May 23, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28533136/effect-of-artificial-pancreas-systems-on-glycaemic-control-in-patients-with-type-1-diabetes-a-systematic-review-and-meta-analysis-of-outpatient-randomised-controlled-trials
#3
Alanna Weisman, Johnny-Wei Bai, Marina Cardinez, Caroline K Kramer, Bruce A Perkins
BACKGROUND: Closed-loop artificial pancreas systems have been in development for several years, including assessment in numerous varied outpatient clinical trials. We aimed to summarise the efficacy and safety of artificial pancreas systems in outpatient settings and explore the clinical and technical factors that can affect their performance. METHODS: We did a systematic review and meta-analysis of randomised controlled trials comparing artificial pancreas systems (insulin only or insulin plus glucagon) with conventional pump therapy (continuous subcutaneous insulin infusion [CSII] with blinded continuous glucose monitoring [CGM] or unblinded sensor-augmented pump [SAP] therapy) in adults and children with type 1 diabetes...
May 19, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28531599/bolus-wizard-use-has-a-beneficial-effect-in-glycemic-control-among-people-with-diabetes-type-1-on-insulin-pump-therapy
#4
Parthena Giannoulaki, Iro Gounitsioti, Fotios Iliadis, Apostolos Hatzitolios, Aggelos Pappas, Despoina Daskalaki, Triantafyllos Didangelos
No abstract text is available yet for this article.
June 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531597/underestimation-of-actual-insulin-needs-among-people-with-diabetes-type-1-on-insulin-pump-therapy
#5
Parthena Giannoulaki, Iro Gounitsioti, Fotis Iliadis, Apostolos Hatzitolios, Aggelos Pappas, Despoina Daskalaki, Triantafillos Didangelos
No abstract text is available yet for this article.
June 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530380/diabetes-update-primary-care-of-patients-with-type-1-diabetes
#6
Beth Choby
The incidence and prevalence of type 1 diabetes (T1D) are increasing among white, black, Hispanic, and Asian individuals in the United States. Children often present with acute symptoms, including severe polyuria, polydipsia, weight loss, and ketonemia; adults may develop more gradual symptoms that initially appear similar to those of type 2 diabetes (T2D). Latent autoimmune diabetes of adults and maturity-onset diabetes of the young are conditions that may be confused with T1D, although they are actually more closely related to T2D...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28527303/insulin-therapy-in-neonatal-diabetes-mellitus-a-review-of-the-literature
#7
REVIEW
Ivana Rabbone, Fabrizio Barbetti, Raffaella Gentilella, Gilberto Mossetto, Riccardo Bonfanti, Claudio Maffeis, Dario Iafusco, Elvira Piccinno
AIMS: Neonatal diabetes mellitus (NDM) is a rare disorder, and guidance is limited regarding its optimal management. We reviewed insulin usage in NDM, with a focus on continuous subcutaneous insulin infusion (CSII). METHODS: A PubMed search identified 40 reports of patients with NDM treated with insulin published between 1994 and 2016. RESULTS: Data concerning treatment of NDM are limited. CSII resolves some of the issues associated with insulin therapy in neonates...
April 13, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#8
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28514821/-the-way-to-closed-loop-dream-and-reality
#9
Torben Biester, Thomas Danne, Olga Kordonouri
An old dream of patients with type 1 diabetes and medical teams alike is a fully automated insulin therapy. Available sensor-augmented insulin-pumps are able to intervene in insulin therapy by reducing the dose. Aim of several studies is to add an algorithm to the interaction of pump and sensor, so that insulin doses can be regulated fully automatically. Totally closed loop systems are currently not yet available for outpatient use. Hybrid closed loop systems have been approved in the US. They can improve the metabolic status of patients with type 1 diabetes...
May 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28509784/pharmacotherapy-options-for-pediatric-diabetes
#10
Maria Loredana Marcovecchio, Francesco Chiarelli
PURPOSE OF REVIEW: Type 1 diabetes (T1D) and type 2 diabetes (T2D) are frequent conditions during childhood and adolescence. The present review offers an update on current available treatment strategies for T1D and T2D approved for use in children and adolescents. RECENT FINDINGS: Insulin remains the main and essential therapeutic strategy in youth with T1D. A second generation of insulin analogues is being evaluated and could help in improving glycemic control...
May 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28486917/long-lasting-insulin-treatment-via-a-single-subcutaneous-administration-of-liposomes-in-thermoreversible-pluronic%C3%A2-f127-based-hydrogel
#11
Xiaoyu Chen, Blenda Chi Kwan Wong, Hubiao Chen, Shiping Zhang, Zhaoxiang Bian, Ge Zhang, Congcong Lin, Muhammad Kashif Riaz, Deependra Tyagi, Aiping Lu, Zhijun Yang
BACKGROUND: Repeated administrations of insulin injection on daily basis accompany pain and arise numerous complications with adverse effects on the diabetic patients life quality. Moreover, wearing insulin pump is also associated with several problems of diabetic ketoacidosis, catheter site infection, contact dermatitis and high cost. METHODS: We have developed an in situ gel system, consisting of insulin-loaded liposomes dispersed within a thermoreversible gel (Pluronic® F127 gel), which increases the duration of insulin action for the treatment of diabetes...
May 9, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28483790/effect-of-hormone-secretory-syndromes-on-neuroendocrine-tumor-prognosis
#12
Wouter T Zandee, Kimberly Kamp, R C S van Adrichem, R A Feelders, Wouter W de Herder
The treatment of hormone hypersecretory syndromes caused by neuroendocrine tumors (NETs) can be a major challenge. NETs originating from the small intestine often secrete serotonin causing flushing, diarrhea and valve fibrosis, leading to dehydration or heart failure in severe cases. NETs from the pancreas can secrete a wider variety of hormones, like insulin, glucagon and gastrin leading to distinct clinical syndromes. Historically mortality in patients with functioning NETs was high due to the complications caused by the hypersecretion of hormones...
May 8, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28463010/behavioral-patterns-and-associations-with-glucose-control-during-12-week-randomized-free-living-clinical-trial-of-day-and-night-hybrid-closed-loop-insulin-delivery-in-adults-with-type-1-diabetes
#13
Ali Emami, Malgorzata E Willinska, Hood Thabit, Lalantha Leelarathna, Sara Hartnell, Sibylle Dellweg, Carsten Benesch, Julia K Mader, Manuel Holzer, Harald Kojzar, Thomas R Pieber, Sabine Arnolds, Mark L Evans, Roman Hovorka
OBJECTIVES: We evaluated patterns of meal intake, insulin bolus delivery, and fingerstick glucose measurements during hybrid closed-loop and sensor-augmented pump (SAP) therapy, including associations with glucose control. METHODS: Data were retrospectively analyzed from pump-treated adults with type 1 diabetes who underwent, in random order, 12 weeks free-living closed-loop (n = 32) and 12 weeks SAP (n = 33) periods. We quantified daily patterns of main meals, snacks, prandial insulin boluses, correction boluses, and fingerstick glucose measurements by analyzing data recorded on the study glucometer and on study insulin pump...
May 2, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28459603/closed-loop-control-of-postprandial-glycemia-using-an-insulin-on-board-limitation-through-continuous-action-on-glucose-target
#14
Paolo Rossetti, Carmen Quirós, Vanessa Moscardó, Anna Comas, Marga Giménez, F Javier Ampudia-Blasco, Fabián León, Eslam Montaser, Ignacio Conget, Jorge Bondia, Josep Vehí
BACKGROUND: Postprandial (PP) control remains a challenge for closed-loop (CL) systems. Few studies with inconsistent results have systematically investigated the PP period. OBJECTIVE: To compare a new CL algorithm with current pump therapy (open loop [OL]) in the PP glucose control in type 1 diabetes (T1D) subjects. METHODS: A crossover randomized study was performed in two centers. Twenty T1D subjects (F/M 13/7, age 40.7 ± 10.4 years, disease duration 22...
May 1, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28440211/a-cluster-randomised-trial-cost-effectiveness-analysis-and-psychosocial-evaluation-of-insulin-pump-therapy-compared-with-multiple-injections-during-flexible-intensive-insulin-therapy-for-type-1-diabetes-the-repose-trial
#15
Simon Heller, David White, Ellen Lee, Julia Lawton, Daniel Pollard, Norman Waugh, Stephanie Amiel, Katharine Barnard, Anita Beckwith, Alan Brennan, Michael Campbell, Cindy Cooper, Munyaradzi Dimairo, Simon Dixon, Jackie Elliott, Mark Evans, Fiona Green, Gemma Hackney, Peter Hammond, Nina Hallowell, Alan Jaap, Brian Kennon, Jackie Kirkham, Robert Lindsay, Peter Mansell, Diana Papaioannou, David Rankin, Pamela Royle, W Henry Smithson, Carolin Taylor
BACKGROUND: Insulin is generally administered to people with type 1 diabetes mellitus (T1DM) using multiple daily injections (MDIs), but can also be delivered using infusion pumps. In the UK, pumps are recommended for patients with the greatest need and adult use is less than in comparable countries. Previous trials have been small, of short duration and have failed to control for training in insulin adjustment. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of pump therapy compared with MDI for adults with T1DM, with both groups receiving equivalent structured training in flexible insulin therapy...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28432898/cost-effectiveness-of-sensor-augmented-pump-therapy-versus-standard-insulin-pump-therapy-in-patients-with-type-1-diabetes-in-denmark
#16
S Roze, S de Portu, J Smith-Palmer, A Delbaere, W Valentine, M Ridderstråle
AIMS: The use of continuous subcutaneous insulin infusion (CSII) in type 1 diabetes (T1D) has increased in recent years. Sensor-augmented pump therapy (SAP) with low glucose suspend (LGS) (allowing temporary suspension of insulin delivery if blood glucose level falls below a pre-defined threshold level) provides additional benefits over CSII alone, but is associated with higher acquisition costs. Therefore, a cost-effectiveness analysis of SAP+LGS versus CSII in patients with T1D was performed...
February 16, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28430381/continuous-subcutaneous-insulin-infusion-csii-therapy-at-derby-teaching-hospitals-sustained-benefits-in-glucose-control
#17
U Anyanwagu, H Olaoye, P Jennings, S Ashton-Cleary, S Sugunendran, D Hughes, I Idris, E G Wilmot
AIM: In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. METHOD: Patient-level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self-management...
April 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28425167/continuous-subcutaneous-insulin-infusion-special-needs-for-children
#18
REVIEW
Peter Adolfsson, Ralph Ziegler, Ragnar Hanas
Continuous subcutaneous insulin infusion (CSII) is a very common therapy for children with type 1 diabetes. Due to physiological differences they have other requirements for their insulin pump than adults. The main difference is the need for very low basal rates. Even though most available insulin pumps reach a high accuracy at usual basal rates, accuracy decreases for lower rates. In addition, the lowest delivered amount at 1 time is limiting the fine tuning of the basal rate as well as the option for temporary basal rates...
June 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28406034/analysis-of-a-new-optimized-percutaneous-access-system-for-cipii
#19
Eric Renard
While only used initially in cases with resistance to subcutaneous insulin therapy, intraperitoneal insulin therapy provides an overall more stable glucose control than subcutaneous insulin therapy thanks to its pharmacokinetics as pointed by Garcia-Verdugo et al from the experience of implantable insulin pumps. The expansion of these devices has been limited by underdelivery issues and high cost. The availability of a new percutaneous access to intraperitoneal route could allow a similar glucose control with less constraints of follow-up and expected lower cost...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28371223/faster-insulin-action-is-associated-with-improved-glycemic-outcomes-during-closed-loop-insulin-delivery-and-sensor-augmented-pump-therapy-in-adults-with-type-1-diabetes
#20
Yue Ruan, Hood Thabit, Lalantha Leelarathna, Sara Hartnell, Malgorzata E Willinska, Martin Tauschmann, Sibylle Dellweg, Carsten Benesch, Julia K Mader, Manuel Holzer, Harald Kojzar, Mark L Evans, Thomas R Pieber, Sabine Arnolds, Roman Hovorka
AIMS: To evaluate relationship between insulin pharmacodynamics and glycemic outcomes during closed-loop insulin delivery and sensor-augmented pump therapy. METHODS: We retrospectively analyzed data from multicenter randomized control trial involving 32 adults with type 1 diabetes receiving day-and-night closed-loop insulin delivery and sensor-augmented pump therapy over 12 weeks. We estimated time-to-peak insulin action (tmax,IA ) and insulin sensitivity (SI ) during both interventions and correlated these with demographic factors and glycemic outcomes...
March 30, 2017: Diabetes, Obesity & Metabolism
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