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Insulin Pump Therapy

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https://www.readbyqxmd.com/read/28647690/acute-kidney-injury-after-primary-angioplasty-is-contrast-induced-nephropathy-the-culprit
#1
Oren Caspi, Manhal Habib, Yuval Cohen, Arthur Kerner, Ariel Roguin, Eitan Abergel, Monther Boulos, Michael R Kapeliovich, Rafael Beyar, Eugenia Nikolsky, Doron Aronson
BACKGROUND: Acute kidney injury (AKI) following primary percutaneous coronary intervention (pPCI) is frequently interpreted as contrast-induced AKI but may result from other insults. We aimed to determine the causal association of contrast material exposure and the incidence of AKI following pPCI using a control group of propensity score-matched patients with ST-segment-elevation myocardial infarction who were not exposed to contrast material. METHODS AND RESULTS: We studied 2025 patients with ST-segment-elevation myocardial infarction who underwent pPCI and 1025 patients receiving fibrinolysis or no reperfusion who were not exposed to contrast material during the first 72 hours of hospital stay (control group)...
June 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28636773/comparison-of-different-insulin-pump-makes-under-routine-care-conditions-in-adults-with-type-1-diabetes
#2
L Leelarathna, S A Roberts, A Hindle, K Markakis, T Alam, A Chapman, J Morris, A Urwin, P Jinadev, M K Rutter
AIMS: To compare long-term HbA1c changes associated with different insulin pumps during routine care in a large cohort of adults with Type 1 diabetes representative of other clinic populations. METHODS: Observational, retrospective study of 508 individuals starting pump therapy between 1999 and 2014 (mean age, 40 years; 55% women; diabetes duration, 20 years; 94% Type 1 diabetes; median follow-up, 3.7 years). Mixed linear models compared covariate-adjusted HbA1c changes associated with different pump makes...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28631849/experiences-of-closed-loop-insulin-delivery-among-pregnant-women-with-type-1-diabetes
#3
C Farrington, Z A Stewart, K Barnard, R Hovorka, H R Murphy
AIMS: To explore the experiences of pregnant women with Type 1 diabetes, and the relationships between perceptions of glucose control, attitudes to technology and glycaemic responses with regard to closed-loop insulin delivery. METHODS: We recruited 16 pregnant women with Type 1 diabetes [mean ± sd age 34.1 ± 4.6 years, duration of diabetes 23.6 ± 7.2 years, baseline HbA1c 51±5 mmol/mol (6.8 ± 0.6%)] to a randomized crossover trial of sensor-augmented pump therapy vs automated closed-loop therapy...
June 20, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28613947/the-effects-of-basal-insulin-suspension-at-the-start-of-exercise-on-blood-glucose-levels-during-continuous-versus-circuit-based-exercise-in-individuals-with-type-1-diabetes-on-continuous-subcutaneous-insulin-infusion
#4
Dessi Zaharieva, Loren Yavelberg, Veronica Jamnik, Ali Cinar, Kamuran Turksoy, Michael C Riddell
BACKGROUND: Exercise causes glycemic disturbances in individuals with type 1 diabetes (T1D). Continuous moderate-intensity aerobic exercise (CON) generally lowers blood glucose (BG) levels and often leads to hypoglycemia. In comparison, circuit-based exercise (CIRC) may attenuate the drop in BG. The goal of this study is to contrast the effects of basal insulin suspension at the onset of two different forms of exercise (CON vs. CIRC). METHODS: Twelve individuals (six men and six women) with T1D on insulin pump therapy were recruited for the study...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28585879/continuous-glucose-monitoring-a-review-of-recent-studies-demonstrating-improved-glycemic-outcomes
#5
David Rodbard
Continuous Glucose Monitoring (CGM) has been demonstrated to be clinically valuable, reducing risks of hypoglycemia and hyperglycemia, glycemic variability (GV), and improving patient quality of life for a wide range of patient populations and clinical indications. Use of CGM can help reduce HbA1c and mean glucose. One CGM device, with accuracy (%MARD) of approximately 10%, has recently been approved for self-adjustment of insulin dosages (nonadjuvant use) and approved for reimbursement for therapeutic use in the United States...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28584075/application-of-zone-model-predictive-control-artificial-pancreas-during-extended-use-of-infusion-set-and-sensor-a-randomized-crossover-controlled-home-use-trial
#6
Gregory P Forlenza, Sunil Deshpande, Trang T Ly, Daniel P Howsmon, Faye Cameron, Nihat Baysal, Eric Mauritzen, Tatiana Marcal, Lindsey Towers, B Wayne Bequette, Lauren M Huyett, Jordan E Pinsker, Ravi Gondhalekar, Francis J Doyle, David M Maahs, Bruce A Buckingham, Eyal Dassau
OBJECTIVE: As artificial pancreas (AP) becomes standard of care, consideration of extended use of insulin infusion sets (IIS) and continuous glucose monitors (CGMs) becomes vital. We conducted an outpatient randomized crossover study to test the safety and efficacy of a zone model predictive control (zone-MPC)-based AP system versus sensor augmented pump (SAP) therapy in which IIS and CGM failures were provoked via extended wear to 7 and 21 days, respectively. RESEARCH DESIGN AND METHODS: A smartphone-based AP system was used by 19 adults (median age 23 years [IQR 10], mean 8...
June 5, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28581817/insulin-pump-use-in-young-children-with-type-1-diabetes-sociodemographic-factors-and-parent-reported-barriers
#7
Persis V Commissariat, Claire T Boyle, Kellee M Miller, Manasa G Mantravadi, Daniel J DeSalvo, William V Tamborlane, Michelle A Van Name, Barbara J Anderson, Linda A DiMeglio, Lori M Laffel
BACKGROUND: Managing type 1 diabetes (T1D) in young children presents challenges to families and caregivers. Pump therapy may reduce challenges and benefit glycemic control. However, pump use is not universal; parent-reported reasons for lack of uptake are not well described. METHODS: Parents of children <7, with T1D for ≥1 year, in the T1D Exchange registry completed surveys capturing demographic and clinical characteristics, as well as barriers to pump use...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28574182/optimizing-the-combination-insulin-bolus-split-for-a-high-fat-high-protein-meal-in-children-and-adolescents-using-insulin-pump-therapy
#8
P E Lopez, C E Smart, P McElduff, D C Foskett, D A Price, M A Paterson, B R King
AIMS: To determine the optimum combination bolus split to maintain postprandial glycaemia with a high-fat and high-protein meal in young people with Type 1 diabetes. METHODS: A total of 19 young people (mean age 12.9 ± 6.7 years) participated in a randomized, repeated-measures trial comparing postprandial glycaemic control across six study conditions after a high-fat and high-protein meal. A standard bolus and five different combination boluses were delivered over 2 h in the following splits: 70/30 = 70% standard /30% extended bolus; 60/40=60% standard/40% extended bolus; 50/50=50% standard/50% extended bolus; 40/60=40% standard/60% extended bolus; and 30/70=30% standard/70% extended bolus...
June 2, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28573460/brain-glp-1-igf-1-signaling-and-autophagy-mediate-exendin-4-protection-against-apoptosis-in-type-2-diabetic-rats
#9
Emanuel Candeias, Inês Sebastião, Susana Cardoso, Cristina Carvalho, Maria Sancha Santos, Catarina Resende Oliveira, Paula I Moreira, Ana I Duarte
Type 2 diabetes (T2D) is a modern socioeconomic burden, mostly due to its long-term complications affecting nearly all tissues. One of them is the brain, whose dysfunctional intracellular quality control mechanisms (namely autophagy) may upregulate apoptosis, leading to cognitive dysfunction and Alzheimer disease (AD). Since impaired brain insulin signaling may constitute the crosslink between T2D and AD, its restoration may be potentially therapeutic herein. Accordingly, the insulinotropic anti-T2D drugs from glucagon-like peptide-1 (GLP-1) mimetics, namely, exendin-4 (Ex-4), could be a promising therapy...
June 2, 2017: Molecular Neurobiology
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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...
July 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
#17
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
#18
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
#19
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
#20
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
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