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https://www.readbyqxmd.com/read/29118986/sensor-augmented-csii-therapy-with-predictive-low-glucose-suspend-following-total-pancreatectomy
#1
E S Scott, G R Fulcher, R J Clifton-Bligh
Pancreatogenic diabetes is characterised by recurrent severe hypoglycaemia due to changes in both endocrine and exocrine functions. There are no guidelines to manage these individuals. Herein, we describe the post-operative management of two people who developed pancreatogenic diabetes following total pancreatectomy for neuroendocrine malignancy. In both individuals, diabetes was managed using sensor-augmented predictive low-glucose suspend continuous subcutaneous insulin infusion (CSII). We demonstrate the benefit of sensor-augmented CSII in averting hypoglycaemia whilst optimising glycaemic control...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29091477/evaluation-of-a-new-digital-automated-glycemic-pattern-detection-tool
#2
María José Comellas, Emma Albiñana, Maite Artes, Rosa Corcoy, Diego Fernández-García, Jorge García-Alemán, Beatriz García-Cuartero, Cintia González, María Teresa Rivero, Núria Casamira, Jörg Weissmann
BACKGROUND: Blood glucose meters are reliable devices for data collection, providing electronic logs of historical data easier to interpret than handwritten logbooks. Automated tools to analyze these data are necessary to facilitate glucose pattern detection and support treatment adjustment. These tools emerge in a broad variety in a more or less nonevaluated manner. The aim of this study was to compare eDetecta, a new automated pattern detection tool, to nonautomated pattern analysis in terms of time investment, data interpretation, and clinical utility, with the overarching goal to identify early in development and implementation of tool areas of improvement and potential safety risks...
November 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29077488/perspectives-on-long-distance-air-travel-with-type-1-diabetes
#3
Jordan E Pinsker, Benjamen E Schoenberg, Colleen Garey, Asher Runion, Arianna Larez, David Kerr
We sought to determine the real-life experiences of individuals traveling long distance (across five or more time-zones) with type 1 diabetes (T1D). Five hundred three members of the T1D Exchange online community ( www.myglu.org ) completed a 45-question survey about their travel experiences flying long distance. The cohort was stratified by duration of T1D and whether or not participants used continuous subcutaneous insulin infusion (CSII) therapy and/or a continuous glucose monitor (CGM). In the last 5 years, 71% of participants had flown long distance...
October 27, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29032696/impact-of-improving-postprandial-glycemic-control-with-intensifying-insulin-therapy-in-type-2-diabetes
#4
Tamer Yacoub
Worldwide, many people with type 2 diabetes are not at recommended glycemic targets and remain at increased risk of microvascular and macrovascular complications. Reaching recommended glycemic targets requires normalizing both fasting and postprandial glucose (PPG). For some patients, this will require addition of a prandial insulin delivered by injection to control PPG excursions. Evidence from epidemiological studies suggests an association between postprandial hyperglycemia and cardiovascular disease, and thus, expert guidelines recommend that treatment for elevated PPG not be delayed...
October 14, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28981324/detailed-analysis-of-insulin-absorption-variability-and-the-tissue-response-to-continuous-subcutaneous-insulin-infusion-catheter-implantation-in-swine
#5
Jasmin R Hauzenberger, Brian R Hipszer, Channy Loeum, Peter A McCue, Mark DeStefano, Marc C Torjman, Mahmut T Kaner, Alek R Dinesen, Inna Chervoneva, Thomas R Pieber, Jeffrey I Joseph
BACKGROUND: Worldwide, ∼1 million people manage their type 1 diabetes with an insulin pump and a continuous subcutaneous insulin infusion (CSII) catheter. Patients routinely insert a new catheter every 2-3 days due to increasing variability of insulin absorption over time. Catheter insertion and maintenance damage capillaries, lymphatics, cells, and connective tissue leading to an acute inflammatory response. METHODS: We compared an investigational CSII catheter (IC) and a commercial CSII catheter (CC) regarding insulin absorption pharmacokinetics (PK) and tissue inflammation...
November 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28976785/type-1-diabetes-and-long-term-continuous-subcutaneous-insulin-infusion-therapy-a-10-year-experience-from-macedonia
#6
Goran Petrovski, Marija Zivkovic, Slavica Subeska Stratrova, Biljana Jovanovska Todorova
BACKGROUND: Subcutaneous insulin infusion (CSII) therapy is a challenge for both patients and healthcare providers. The long-term CSII use is scarce. The aim of this study is to describe the impact of CSII therapy for 10 years of use at our center. METHODS: This single-center retrospective study includes 162 type 1 diabetes patients using CSII for >3 years during October 2004 until October 2014. Data were collected through the electronic medical record system, cross-sectional analysis (telephone, e-mail, or social media), and CSII reports generated by Carelink Therapy Management Software (Medtronic, Northridge, CA)...
October 4, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28951342/the-impact-of-ethnicity-educational-and-economic-status-on-the-prescription-of-insulin-therapeutic-regimens-and-on-glycemic-control-in-patients-with-type-1-diabetes-a-nationwide-study-in-brazil
#7
Marilia Brito Gomes, Melanie Rodacki, Elizabeth João Pavin, Roberta Arnoldi Cobas, João S Felicio, Lenita Zajdenverg, Carlos Antonio Negrato
AIMS: Establish the relationship between demographic, educational and economic status on insulin therapeutic regimens (ITRs) and on glycemic control in patients with type 1 diabetes. METHODS: This was a cross-sectional, multicenter study with 1760 patients conducted between August 2011 and August 2014 in 10 Brazilian cities. RESULTS: Patients were stratified according to ITRs as follows: only NPH insulin (group 1, n=80(4.5%)); only long-acting insulin analogs (group 2, n=6(0...
September 23, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28918652/investigation-of-pump-compatibility-of-fast-acting-insulin-aspart-in-subjects-with-type-1-diabetes
#8
Eric Zijlstra, Marek Demissie, Tina Graungaard, Tim Heise, Leszek Nosek, Bruce Bode
BACKGROUND: Ultra-fast-acting insulins, such as fast-acting insulin aspart (faster aspart), have pharmacokinetic properties that may be advantageous for patients using continuous subcutaneous insulin infusion (CSII), provided that they are compatible with and safe to use in CSII. METHODS: Randomized, double-blind, parallel-group, actively controlled trial evaluating compatibility, efficacy, and safety of faster aspart in adults with type 1 diabetes using their own MiniMed Paradigm pump with Quick-Set or Silhouette infusion sets...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28913778/neural-basis-of-early-somatosensory-change-detection-a-magnetoencephalography-study
#9
G Naeije, T Vaulet, V Wens, B Marty, S Goldman, X De Tiège
The mismatch negativity (MMN) reflects the early detection of changes in sensory stimuli at the cortical level. The mechanisms underlying its genesis remain debated. This magnetoencephalography study investigates the spatio-temporal dynamics and the neural mechanisms of the magnetic somatosensory MMN. Somatosensory evoked magnetic fields elicited by tactile stimulation of the right fingertip (Single), tactile stimulation of the right middle phalanx and fingertip (Double) or omissions (Omitted) of tactile stimuli were studied in different paradigms: in oddballs where Double/Omitted followed a sequence of four Single, in sequences of two stimuli where Double occurred after one Single, and in random presentation of Double only...
September 14, 2017: Brain Topography
https://www.readbyqxmd.com/read/28902790/impact-of-treatments-on-diabetic-control-and-gastrointestinal-symptoms-after-total-pancreatectomy
#10
Maarten R Struyvenberg, Zhi Ven Fong, Camilia R Martin, Jennifer F Tseng, Thomas E Clancy, Carlos Fernández-Del Castillo, Hanna J Tillman, Melena D Bellin, Steven D Freedman
OBJECTIVES: The aims of this study were to compare the safety, efficacy, and patients' quality of life with continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDIs) in type 3c diabetes mellitus (T3cDM) following total pancreatectomy (TP) and pancreatic enzyme usage. METHODS: Thirty-nine patients with T3cDM (18 CSII patients vs 21 MDI patients) who underwent TP between 2000 and 2016 at 3 Harvard-affiliated hospitals and the University of Minnesota returned prospectively obtained questionnaires examining quality of life and both endocrine and exocrine pancreatic functions...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28898340/-from-insulin-pump-and-continuous-glucose-monitoring-to-the-artificial-pancreas
#11
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/28880188/a-review-of-safety-and-hazards-associated-with-the-artificial-pancreas
#12
Charrise M Ramkissoon, Brian Aufderheide, B Wayne Bequette, Josep Vehi
The artificial pancreas (AP) is a closed-loop (CL) device with the potential to reduce the complications associated with type 1 diabetes mellitus (T1DM) by maintaining euglycemia in patients. The AP encompasses an algorithm that determines the amount of insulin (and other hormones) to be administered to the patient via a continuous subcutaneous insulin infusion (CSII) pump using information provided by a continuous glucose monitor (CGM) and other sensors. As the AP approaches commercialization special attention must be given to safety within all the individual components, including physiological changes in the patient, as well as, safety issues that can arise when these components are combined into a single system...
September 4, 2017: IEEE Reviews in Biomedical Engineering
https://www.readbyqxmd.com/read/28871565/cost-effectiveness-analysis-of-sensor-augmented-insulin-pump-therapy-with-automated-insulin-suspension-versus-standard-insulin-pump-therapy-in-patients-with-type-1-diabetes-in-sweden
#13
Johan Jendle, Jayne Smith-Palmer, Alexis Delbaere, Simona de Portu, Natalie Papo, William Valentine, Stéphane Roze
INTRODUCTION: In Sweden an estimated 10,000 people with type 1 diabetes use continuous subcutaneous insulin infusion (CSII). Sensor-augmented pump therapy (SAP) is associated with higher acquisition costs but provides additional clinical benefits (e.g. reduced rate of hypoglycemic events) over and above that of CSII alone. The aim of the analysis was to assess the cost-effectiveness of SAP with automated insulin suspension relative to CSII alone in two different groups of patients with type 1 diabetes in Sweden...
October 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28817302/comparative-effectiveness-and-costs-of-insulin-pump-therapy-for-diabetes
#14
Ronald T Ackermann, Amisha Wallia, Raymond Kang, Andrew Cooper, Theodore A Prospect, Lewis G Sandy, Deneen Vojta
OBJECTIVES: Continuous subcutaneous insulin infusion (CSII), or "insulin pump" therapy, is an alternative to multiple daily insulin injections (MDII) for management of diabetes. This study evaluates patterns of healthcare utilization, costs, and blood glucose control for patients with diabetes who initiate CSII. STUDY DESIGN: Pre-post with propensity-matched comparison design involving commercially insured US adults (aged 18-64 years) with insulin-requiring diabetes who transitioned from MDII to CSII between July 1, 2009, and June 30, 2012 ("CSII initiators"; n = 2539), or who continued using MDI (n = 2539)...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28799221/repose-repositioning-insulin-pump-therapy-in-type-1-diabetes
#15
N S Oliver
In 2008, the National Institute for Health and Care Excellence (NICE) technology appraisal of continuous subcutaneous insulin infusion (CSII, insulin pump therapy) for people with Type 1 diabetes was published [1]. Implementation of this enables children under the age of 12 years to access CSII, and consideration of CSII for adults and children over 12 years with challenging hypo- or hyperglycaemia. In Scotland, the Scottish Intercollegiate Guidelines Network (SIGN) guidance for management of diabetes states that CSII therapy should be considered for people unable to achieve their glycaemic targets, for those who experience recurring episodes of severe hypoglycaemia, and in infants and very young children with very low basal insulin requirements, for whom even small doses of basal insulin analogue may result in hypoglycaemia [2]...
August 11, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28763121/proportion-of-daily-capillary-blood-glucose-readings-required-in-the-target-range-for-target-glycaemic-control-shift-of-focus-from-target-range-to-proportion-in-range
#16
S Sivasubramaniyam, S A Amiel, P Choudhary
AIM: Most guidelines provide people with Type 1 diabetes with pre- and post-meal capillary blood glucose (CBG) targets to achieve optimal glycaemic control. We evaluated the proportion of daily CBG readings between 4 and 10 mmol/l in people achieving different HbA1c levels. METHOD: We analysed CBG data from routine pump/meter downloads from 201 adults treated with continuous subcutaneous insulin infusion (CSII) at a single hospital clinic. Exclusion criteria were CSII < 6 months, < 3 CBG/day, pregnancy, haemoglobinopathy and continuous sensor use...
August 1, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28745609/budget-impact-of-continuous-subcutaneous-insulin-infusion-therapy-in-patients-with-type-1-diabetes-who-experience-severe-recurrent-hypoglycemic-episodes-in-spain
#17
Marga Giménez, Isabel Elías, María Álvarez, Carmen Quirós, Ignacio Conget
OBJECTIVE: Hypoglycemia is one of the most common complications to achieve a good metabolic control, and has been listed by several scientific associations as a common indication to start treatment with continuous subcutaneous insulin infusion (CSII). Use of CSII is still residual in Spain as compared to neighbouring countries, and cost of acquisition cost is one of the main reasons. This study estimates the budget impact of treatment with CSII, as compared to multiple daily insulin injections, of patients with type 1 diabetes mellitus who experience recurrent severe hypoglycemia episodes from the National Healthcare System perspective...
August 2017: Endocrinología, diabetes y nutrición
https://www.readbyqxmd.com/read/28745091/continuous-glucose-monitoring-use-in-type-1-diabetes-longitudinal-analysis-demonstrates-meaningful-improvements-in-hba1c-and-reductions-in-health-care-utilization
#18
Christopher G Parkin, Claudia Graham, John Smolskis
BACKGROUND: Real-time continuous glucose monitoring (rtCGM) improves glycemic control in type 1 diabetes (T1D) patients treated with continuous subcutaneous insulin infusion (CSII). However, the benefits of rtCGM in T1D patients treated with multiple daily insulin injection (MDI) therapy has not been well studied. We explored the effects of rtCGM versus self-monitoring of blood glucose (SMBG) on clinical outcomes within a large T1D population treated with either CSII or MDI therapy. METHODS: This retrospective, longitudinal analysis utilized datasets from T1D patients enrolled in a commercial health plan to assess changes in HbA1c in 187 naïve to rtCGM users and 6260 SMBG users...
May 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28736738/preserving-and-restoring-bone-with-continuous-insulin-infusion-therapy-in-a-mouse-model-of-type-1-diabetes
#19
Jeffry S Nyman, Evangelia Kalaitzoglou, R Clay Bunn, Sasidhar Uppuganti, Kathryn M Thrailkill, John L Fowlkes
Those with type 1 diabetes (T1D) are more likely to suffer a fracture than age- and sex-matched individuals without diabetes, despite daily insulin therapy. In rodent studies examining the effect of bone- or glucose-targeting therapies on preventing the T1D-related decrease in bone strength, insulin co-therapy is often not included, despite the known importance of insulin signaling to bone mass accrual. Therefore, working toward a relevant pre-clinical model of diabetic bone disease, we assessed the effect of continuous subcutaneous insulin infusion (CSII) therapy at escalating doses on preserving bone and the effect of delayed CSII on rescuing the T1D-related bone deterioration in an established murine model of T1D...
December 2017: Bone Reports
https://www.readbyqxmd.com/read/28719154/progression-of-skin-autofluorescence-of-ages-over-4%C3%A2-years-in-patients-with-type-1-diabetes
#20
Kalina Rajaobelina, Catherine Helmer, Fritz-Line Vélayoudom-Céphise, Sovanndany Nov, Blandine Farges, Emilie Pupier, Laurence Blanco, Marie Hugo, Henri Gin, Vincent Rigalleau
BACKGROUND: The deposit of advanced glycation end-products is involved in diabetic complications. It can be evaluated by measuring the skin autofluorescence (sAF). We searched whether sAF progressed over 4 years in type 1 diabetes and analysed its relationship with the development of nephropathy. METHODS: Two measurements of skin autofluorescence (sAF) were completed on 154 patients during years 2009 and 2013. Baseline factors associated with the progression of sAF were analysed by multivariate regression analysis...
October 2017: Diabetes/metabolism Research and Reviews
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