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Daniel E Alonso Martín, M Belén Roldán Martín, M Ángeles Álvarez Gómez, Rosa Yelmo Valverde, María Martín-Frías, Milagros Alonso Blanco, Raquel Barrio Castellanos
INTRODUCTION: Diabetes education is an essential tool to achieve treatment objectives in type1 diabetes mellitus (T1DM). The aim of this study was to determine if understanding of diabetes by caregivers/patients or sociodemographic factors affect blood glucose control in children and adolescents with T1DM. PATIENTS AND METHODS: The level of knowledge of 105 caregivers of children and adolescents with T1DM was assessed using a survey adapted to the type of treatment used (multiple dose insulin [MDI] or continuous subcutaneous insulin infusion [CSII])...
October 17, 2016: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
N F Shimkina, Yu G Nad', E R Barantsevich
: The study aims to examine the neurological complications of patients with type 1 diabetes treated with different methods of insulin therapy. MATERIAL AND METHODS: Thirty-four patients, aged from 18 to 40 years, with diabetes mellitus type 1 receiving insulinotherapy, with a duration of the disease 14.25±9.25 years, have been examined. By the time of the study the patients of the first group have been treated with continuous subcutaneous insulin infusion therapy (CSII) for 4...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Maria Felicia Faienza, Annamaria Ventura, Maurizio Delvecchio, Anna Fusillo, Laura Piacente, Gabriella Aceto, Graziana Colaianni, Silvia Colucci, Luciano Cavallo, Maria Grano, Giacomina Brunetti
CONTEXT: Childhood type 1 diabetes (T1DM) is associated with decreased bone mass. Sclerostin and dickkopf-1 (DKK-1) are Wnt inhibitors which regulate bone formation. OBJECTIVE: To evaluate sclerostin and DKK-1 levels in TD1M children and to analyze the influence of the glycaemic control on bone health. DESIGN AND SETTING: Cross-sectional study conducted at a clinical research center. Partecipants: One hundred and six T1DM subjects (12.2 ± 4 years), 66 on multiple daily injections (MDI) and 40 on continuous subcutaneous infusion of insulin (CSII), and 80 controls...
October 12, 2016: Journal of Clinical Endocrinology and Metabolism
Tim Heise, Eric Zijlstra, Leszek Nosek, Tord Rikte, Hanne Haahr
AIMS: Continuous subcutaneous insulin infusion (CSII) is increasingly used in patients with diabetes. Faster-acting insulin aspart (faster aspart) is insulin aspart (IAsp) in a new formulation with a faster time-action profile. We evaluated the pharmacological characteristics of faster aspart versus IAsp> during CSII. MATERIALS AND METHODS: In this randomised, double-blind, crossover trial, 48 men and women aged 18-64 years with type 1 diabetes mellitus (T1DM) received faster aspart and IAsp as a 0...
October 6, 2016: Diabetes, Obesity & Metabolism
Iván Contreras, Carmen Quirós, Marga Giménez, Ignacio Conget, Josep Vehi
BACKGROUND: The large intra-patient variability in type 1 diabetic patients dramatically reduces the ability to achieve adequate blood glucose control. A novel methodology to identify different blood glucose dynamics profiles will allow therapies to be more accurate and tailored according to patient's conditions and to the situations faced by patients (exercise, week-ends, holidays, menstruation, etc). MATERIALS AND METHODS: A clustering methodology based on the normalized compression distance is applied to identify different profiles for diabetic patients...
November 2016: Computer Methods and Programs in Biomedicine
A Chico, L Herranz, R Corcoy, O Ramírez, M M Goya, J Bellart, S González-Romero, M Codina, P Sánchez, A Cortázar, D Acosta, M J Picón, J A Rubio, A Megía, M A Sancho, M Balsells, E Solá, N L González, J López-López
OBJECTIVE: To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM). STUDY DESIGN: Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals. INCLUSION CRITERIA: T1DM, singleton pregnancies, delivery between 2002-2010, and use of the same basal and prandial insulin from before pregnancy until delivery. RESULTS: A total of 1534 pregnancies were included...
September 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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...
September 12, 2016: Journal of Diabetes Science and Technology
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
Y Tan, S H Luo, C M Wen, J H Yan, Y H Zhu, M Y Cai, B Yao, L Y Zeng, W Xu, J P Weng
OBJECTIVE: To evaluate the impact of continuous subcutaneous insulin infusion (CSII) on β-cell function assessment. METHODS: One hundred and twenty-five patients with type 2 diabetes (T2DM) admitted to Third Affiliated Hospital of Sun Yat-sen University treated with CSII were enrolled from May to December 2015. Blood samples were collected to measure their fasting blood glucose, haemoglobin A1c, blood lipids and plasma C peptide levels (fasting, 30 min and 120 min after a mixed meal) on the next day of their admission before CSII started...
August 23, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Barbara Bohn, Beate Karges, Christian Vogel, Klaus-Peter Otto, Wolfgang Marg, Sabine E Hofer, Elke Fröhlich-Reiterer, Martin Holder, Michaela Plamper, Martin Wabitsch, Wolfgang Kerner, Reinhard W Holl
BACKGROUND: To investigate changes in diabetes treatment over the last two decades in three age-groups of children and adolescents with type 1 diabetes (T1D) from Germany and Austria. METHODS: 63,967 subjects (<18yr) with T1D documented between 1995 and 2014 from the DPV-database were included and stratified according to age (0.5-<6, 6-<12, 12-<18yr). Regression models were applied for insulin regimens (<3 and ≥4 injection time points/day, or continuous subcutaneous insulin infusion (CSII)), use of rapid- and long acting insulin analogues, NPH insulin, and frequency of self-monitoring of blood glucose (SMBG)/day...
2016: PloS One
Jeremy Pettus, Steven V Edelman
The clinical benefits of real time continuous glucose monitoring (rtCGM) use have been well demonstrated in both CSII- and MDI-treated individuals in large clinical trials. However, recommendations for patient use of rtCGM in everyday life situations are lacking. This article provides guidance to clinicians and patients with type 1 diabetes (T1D) in effective use of rtCGM data, including glucose rate of change (ROC) arrows, for insulin dosing adjustments and other treatment decisions. The recommendations presented here are based on our own clinical experiences as endocrinologists, our personal experiences living with T1D using rtCGM, and findings from a recent survey of T1D patients who have successfully used rtCGM in their self-management...
August 16, 2016: Journal of Diabetes Science and Technology
Fu-Jung Hsiao, Wan-Yu Hsu, Wei-Ta Chen, Rou-Shayn Chen, Yung-Yang Lin
Paroxysmal kinesigenic dyskinesia (PKD) is a rare group of hyperkinetic movement disorders characterized by brief attacks of choreoathetosis or dystonia. To clarify the alterations of the functional connectivity within the somatosensory network in PKD patients, magnetoencephalographic (MEG) responses to paired median-nerve electrical stimulation were recorded in 10 PKD patients treated by carbamazepine or oxcarbamazepine and 22 age-matched controls. In patients, MEG recordings were obtained during drug-on and -off periods...
August 11, 2016: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
Sophie Heinke, Barbara Ludwig, Undine Schubert, Janine Schmid, Thomas Kiss, Anja Steffen, Stefan Bornstein, Stefan Ludwig
BACKGROUND: Safe and reliable diabetes models are a key prerequisite for advanced preclinical studies on diabetes. Chemical induction is the standard model of diabetes in rodents and also widely used in large animal models of non-human primates and minipigs. However, uncertain efficacy, the potential of beta-cell regeneration, and relevant side effects are debatable aspects particularly in large animals. Therefore, we aimed to evaluate a surgical approach of total pancreatectomy combined with splenectomy for diabetes induction in an exploratory study in Goettingen minipigs...
September 2016: Xenotransplantation
D Jane Holmes-Walker, Jenny E Gunton, Marlene Payk, Susan Donath, Wayne J Hawthorne, Tom Loudovaris, Patricia Anderson, Glenn M Ward, Thomas W H Kay, Philip J O'Connell
BACKGROUND: The aim was to compare efficacy of multiple daily injections, continuous subcutaneous insulin infusion (CSII) and islet transplantation to reduce hypoglycemia and glycemic variability in type 1 diabetes (T1D) subjects with severe hypoglycemia. METHODS: This was a within-subject, paired comparison of multiple daily injections (MDI) and CSII and CSII with 12 months' post islet transplantation in 10 T1D subjects referred with severe hypoglycemia, suitable for islet transplantation...
August 3, 2016: Transplantation
Allen B King, Akio Kuroda, Munehide Matsuhisa, Todd Hobbs
Dosing guidelines for patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII), which are historically based on clinical experience and retrospective studies of patients consuming an American diet, recommend that basal insulin should represent approximately 50 % of the total daily dose (TDD). Recent prospective studies in the USA and Japan conclude that the more appropriate proportion is closer to 30-40 % of TDD. In addition, currently used formulas for calculating the carbohydrate-to-insulin ratio (CIR) and correction factor (CF) may lead to underdosing of bolus insulin by as much as 12...
September 2016: Current Diabetes Reports
Ohad Cohen, Sebastiano Filetti, Javier Castañeda, Marianna Maranghi, Mariela Glandt
Treatment with insulin, alone or with oral or injectable hypoglycemic agents, is becoming increasingly common in patients with type 2 diabetes. However, approximately 40% of patients fail to reach their glycemic targets with the initially prescribed regimen and require intensification of insulin therapy, which increases the risks of weight gain and hypoglycemia. Many of these patients eventually reach a state in which further increases in the insulin dosage fail to improve glycemic control while increasing the risks of weight gain and hypoglycemia...
August 2016: Diabetes Care
Agnieszka Szypowska, Anke Schwandt, Jannet Svensson, Shlomit Shalitin, Roque Cardona-Hernandez, Gun Forsander, Frida Sundberg, Carine De Beaufort, David Maahs, Claudio Maffeis, Stephen M P O'Riordan, Iveta Dzivite Krisane, Mauro Scharf, Sofia Castro, Maia Konstantinova, Barbora Obermannova, Kristina Casteels, Damla Gökşen, Júlia Galhardo, Christina Kanaka-Gantenbein, Birgit Rami-Merhar, Laszlo Madacsy
BACKGROUND: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. OBJECTIVE: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI...
July 15, 2016: Pediatric Diabetes
Sanjeev N Mehta, Henrik Ullits Andersen, Martin J Abrahamson, Howard A Wolpert, Eva E Hommel, William McMullen, Martin Ridderstråle
BACKGROUND: Historically, intensive insulin therapy for type 1 diabetes (T1D) has improved glycemic control at the risk of adverse weight gain. The impact of continuous subcutaneous insulin infusion therapy (CSII) on weight in the current era remains unknown. We assessed changes in hemoglobin A1c (HbA1c) and weight in adults with T1D transitioning to CSII at 2 diabetes centers in Denmark and the United States. METHODS: Patients with T1D, aged ≥18 years, managed with multiple daily injections (MDI) who transitioned to CSII between 2002 and 2013 were identified using electronic health record data from the Steno Diabetes Center (n = 600) and Joslin Diabetes Center (n = 658)...
July 10, 2016: Journal of Diabetes Science and Technology
Kevin Kaiserman, Heike Jung, Imane Benabbad, Beate Karges, Michel Polak, Myriam Rosilio
BACKGROUND: Insulin lispro, the first rapid-acting insulin analog, was developed 20 years ago and has been studied in multiple situations and various populations. OBJECTIVE: To review the literature on the use of insulin lispro in children, adolescents, and young adults. PATIENTS: Children, adolescents, and young adults with type-1-diabetes. METHODS: One hundred and twenty-two relevant publications, identified by a systematic (MEDLINE) and manual literature search, were reviewed...
July 8, 2016: Pediatric Diabetes
H J Fan, J H Yu, G M Cui, W Y Zhang, X Yang, Q J Dong
Ulcerative foot infection is a chronic complication frequently seen in diabetic patients, and can result in disability. To evaluate insulin pump treatment for type 2 diabetes in combination with ulcerative foot infection, we selected 168 diabetic patients who developed foot ulcers and received treatment from April 2012 to April 2014 in the People’s Hospital of Zhengzhou, Henan, China. The patients were divided into a treatment group and a control group, 84 in each group. Besides anti-infection treatment, patients in the control group were given multiple subcutaneous insulin injection (MSII), while patients in the treatment group were given continuous subcutaneous insulin infusion (CSII)...
April 2016: Journal of Biological Regulators and Homeostatic Agents
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