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https://www.readbyqxmd.com/read/28799221/repose-repositioning-insulin-pump-therapy-in-type-1-diabetes
#1
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
#2
S Sivasubramaniyam, S 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
#3
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
#4
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
#5
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-years-in-patients-with-type-1-diabetes
#6
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 (AGEs) 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 sAF was realized on 154 patients during years 2009 and 2013. Baseline factors associated to the progression of sAF were analyzed by multivariate regression analysis...
July 18, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28711468/effect-of-initiating-use-of-an-insulin-pump-in-adults-with-type-1-diabetes-using-multiple-daily-insulin-injections-and-continuous-glucose-monitoring-diamond-a-multicentre-randomised-controlled-trial
#7
Roy W Beck, Tonya D Riddlesworth, Katrina J Ruedy, Craig Kollman, Andrew J Ahmann, Richard M Bergenstal, Anuj Bhargava, Bruce W Bode, Stacie Haller, Davida F Kruger, Janet B McGill, William Polonsky, David Price, Elena Toschi
BACKGROUND: The benefit of initiation of insulin pump therapy (continuous subcutaneous insulin infusion; CSII) in patients with type 1 diabetes using continuous glucose monitoring (CGM) has not been studied. We aimed to assess glycaemic outcomes when switching from multiple daily injections (MDI) to CSII in adults with type 1 diabetes using CGM. METHODS: In this multicentre, randomised controlled trial, 75 adults with type 1 diabetes in the CGM group of the DIAMOND trial were randomly assigned via the study website using a computer-generated sequence to continue MDI or switch to CSII, with continuation of CGM, for 28 weeks...
July 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28672172/baseline-red-blood-cell-distribution-width-predicts-long-term-glycemic-remission-in-patients-with-type-2-diabetes
#8
Lijuan Xu, Liangjiao Wang, Xinwei Huang, Liehua Liu, Weijian Ke, Xiaoying He, Zhimin Huang, Juan Liu, Xuesi Wan, Xiaopei Cao, Yanbing Li
AIMS: We explored whether red blood cell distribution width (RDW), a routinely checked item of complete blood cell counts, was an indicator of long-term euglycemia remission in patients with type 2 diabetes after short-term continuous subcutaneous insulin infusion (CSII). METHODS: We analyzed the original data of patients enrolled in three randomized control trials from 2002 to 2014. CSII was administered to drug-naїve patients with newly diagnosed type 2 diabetes to achieve and maintain euglycemia for 2weeks...
June 15, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28636773/comparison-of-different-insulin-pump-makes-under-routine-care-conditions-in-adults-with-type-1-diabetes
#9
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/28609547/intensive-insulin-therapy-combined-with-metformin-is-associated-with-reduction-in-both-glucose-variability-and-nocturnal-hypoglycaemia-in-patients-with-type-2-diabetes
#10
Yifei Zhang, Zhiyun Zhao, Shujie Wang, Wei Zhu, Yiran Jiang, Shouyue Sun, Chen Chen, Kai Wang, Liangshan Mu, Jinyi Cao, Yingxia Zhou, Weiqiong Gu, Jie Hong, Weiqing Wang, Guang Ning
BACKGROUND: The effect on glucose variability in patients with intensive insulin therapy has not been fully understood. This observational study investigated the different glucose variability and hypoglycaemia patterns in type 2 diabetes patients treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) with or without metformin administration. METHODS: During hospitalization, a total of 501 patients with poor glycaemic control and in initial treatment with either CSII alone (n = 187), CSII + Metformin (n = 81), MDI alone (n = 146), or MDI + Metformin (n = 87) were involved in the final analysis...
June 13, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28585879/continuous-glucose-monitoring-a-review-of-recent-studies-demonstrating-improved-glycemic-outcomes
#11
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/28569076/clinical-impact-of-blood-glucose-monitoring-accuracy-an-in-silico-study
#12
Enrique Campos-Náñez, Kurt Fortwaengler, Marc D Breton
BACKGROUND: Patients with diabetes rely on blood glucose (BG) monitoring devices to manage their condition. As some self-monitoring devices are becoming more and more accurate, it becomes critical to understand the relationship between system accuracy and clinical outcomes, and the potential benefits of analytical accuracy. METHODS: We conducted a 30-day in-silico study in type 1 diabetes mellitus (T1DM) patients using continuous subcutaneous insulin infusion (CSII) therapy and a variety of BG meters, using the FDA-approved University of Virginia (UVA)/Padova Type 1 Simulator...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28544684/insulin-glulisine-for-continuous-subcutaneous-insulin-infusion-in-pediatric-type-1-diabetes
#13
Tatsuhiko Urakami, Yusuke Mine, Masako Aoki, Misako Okuno, Junichi Suzuki
We evaluated the efficacy and safety of insulin glulisine (GLU) used for continuous s.c. insulin infusion (CSII) in 20 children with type 1 diabetes after 1 year of GLU treatment. There were no significant differences in mean plasma glucose before breakfast and before dinner between before and after using GLU, but the levels after breakfast and after dinner significantly improved, from 192.5 ± 31.7 to 162.0 ± 27.3 mg/dL for breakfast, and from 191.1 ± 33.3 to 161.1 ± 24.5 mg/dL for dinner (P < 0...
May 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28540738/somatosensory-gating-is-altered-and-associated-with-migraine-chronification-a-magnetoencephalographic-study
#14
Fu-Jung Hsiao, Shuu-Jiun Wang, Yung-Yang Lin, Jong-Ling Fuh, Yu-Chieh Ko, Pei-Ning Wang, Wei-Ta Chen
Background Brain excitability is changed in migraine but not fully characterized yet. This study explored if somatosensory gating is altered in migraine and linked to migraine chronification. Methods Paired electrical stimuli were delivered to the left index fingers of 21 patients with migraine without aura (MO), 22 patients with chronic migraine (CM), and 36 controls. The first and second responses to the paired stimuli were obtained from the contralateral primary (cSI), contralateral secondary (cSII) and ipsilateral secondary (iSII) somatosensory cortices to compute the gating ratios (second vs...
January 1, 2017: Cephalalgia: An International Journal of Headache
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
#15
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...
July 2017: Lancet Diabetes & Endocrinology
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/28484424/continuous-subcutaneous-insulin-infusion-in-children-a-pilot-study-validating-a-protocol-to-avoid-hypoglycemia-at-initiation
#17
Despoina Manousaki, Johnny Deladoëy, Louis Geoffroy, Patricia Olivier
BACKGROUND: The occurrence of hypoglycemia and hyperglycemia during the first days after transition to continuous subcutaneous insulin infusion (CSII) in patients with type 1 diabetes has not been systematically studied in children. The aim of this prospective study was to demonstrate that the protocol applied in our diabetes clinic is safe at CSII initiation in children. METHODS: We assessed 22 pediatric patients with type 1 diabetes, using continuous glucose monitoring (CGM) before and after CSII initiation (±3 days)...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28437786/the-effect-of-retraining-on-treatment-success-life-quality-and-metabolic-parameters-in-patients-with-type-1-diabetes-using-insulin-pump
#18
Basak Ozgen Saydam, Fatma Yilmazmis, Nalan Aydin, Belgin Bektas, Simge Yilmaz, Umit Cavdar, Secil Ozisik, Baris Akinci
OBJECTIVE: To investigate the effect of insulin pump user retraining on treatment success, quality of life, and metabolic parameters of patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII). SUBJECTS AND METHODS: A total of 35 subjects participated in this prospective study. All patients were given insulin pump user retraining. Their knowledge level and application skills, metabolic parameters, life qualities and satisfaction from treatment were evaluated at baseline and after 6 months...
April 23, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
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
#19
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
#20
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
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