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CGMS insulin pumps

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
Sarah S Farabi, David W Carley, Ali Cinar, Lauretta Quinn
Type 1 Diabetes (T1DM) is characterized by altered glucose homeostasis resulting in wide glucose variations throughout a 24-h period. The relationship between routine daily physical activity and glucose variations has not been systematically investigated in adults with T1DM. The objectives of this study were to characterize and quantify the relationship between routine daily activity and glucose variations in a small group of adults with T1DM. Adults with T1DM treated with an insulin pump were recruited for the study...
December 2015: Physiological Reports
John Walsh, Ruth Roberts, Dietmar Weber, Gabriele Faber-Heinemann, Lutz Heinemann
BACKGROUND: This survey collected and evaluated user responses about routine tasks and preferences regarding insulin pumps and infusion sets (IIS) with comparison of intercountry differences between the United States (US) and Germany (GER), chosen for their large insulin pump populations. METHODS: A total of 985 subjects (534 US, 451 GER; 60% female) with type 1 diabetes on pump therapy anonymously answered 20 pump-related questions. US subjects also answered 11 questions about continuous glucose monitoring (CGM) usage...
September 2015: Journal of Diabetes Science and Technology
David R McCance
Diabetes in pregnancy is still considered a high-risk condition for both mother and baby. Even in the best centres, malformation and mortality rates are reportedly twofold to fivefold higher than in the background population, and pregnancy planning rates remain obstinately poor. Increasing global rates of type 2 diabetes are now extending into pregnancy, with similarly poor outcomes to type 1 diabetes, and excess maternal weight is adding to the complexity of management. Over the last 5-10 years, several randomised trials have offered new insight into the role of oral hypoglycaemic drugs and insulin analogues in pregnancy, while continuous subcutaneous insulin infusion (CSII) pumps and continuous glucose monitors (CGMs) are under scrutiny...
July 2015: Best Practice & Research. Clinical Obstetrics & Gynaecology
Katarzyna Piechowiak, Hanna Trippenbach-Dulska, Katarzyna Walicka-Serzysko
UNLABELLED: Diabetes is a common and severe complication of cystic fibrosis. If unrecognized, the condition not only causes deterioration of pulmonary function and failure to gain weight, but also a six-fold increase in mortality. AIM: 1. To evaluate the course of abnormal glucose tolerance and cystic fibrosis-related diabetes (CFRD), as well as the effects of treating these conditions in children with cystic fibrosis. 2. To analyze the association between the classes of mutations in both alleles of the CFTR gene and glucose intolerance...
January 2015: Developmental Period Medicine
Tomasz Klupa, Teresa Benbenek-Klupa, Bartlomiej Matejko, Sandra Mrozinska, Maciej T Malecki
We aimed to estimate the impact of ingestion of a pure protein load on the glucose levels in T1DM patients treated with insulin pumps. We examined 10 T1DM patients (6 females, mean age-32.3 years, mean HbA1c-6.8%) treated with insulin pumps equipped with a continuous glucose monitoring system (CGMS). In Phase I, baseline insulin infusion was optimized to minimize the differences in fasting glucose levels to less than 30 mg/dL between any two time points between 9 a.m. and 3 p.m. In Phase II, the patients were exposed to single pure protein load...
2015: International Journal of Endocrinology
Orla M Neylon, Timothy C Skinner, Michele A O'Connell, Fergus J Cameron
BACKGROUND AND OBJECTIVE: Controversy exists regarding which individuals will benefit most from commencement of diabetes technologies such as continuous subcutaneous insulin infusion (CSII) or continuous glucose monitoring systems (CGMS), such as 'real-time' sensor-augmented pumping (SAP). Because higher usage correlates with haemoglobin A1c (HbA1c) achieved, we aimed to predict future usage of technologies using a questionnaire-based tool. SUBJECTS: The tool was distributed to two groups of youth with type 1 diabetes; group A (n = 50; mean age 12 ± 2...
May 2016: Pediatric Diabetes
Nihat Baysal, Fraser Cameron, Bruce A Buckingham, Darrell M Wilson, H Peter Chase, David M Maahs, B Wayne Bequette
Continuous glucose monitors (CGMs) provide real-time interstitial glucose concentrations that are essential for automated treatment of individuals with type 1 diabetes. Miscalibration, noise spikes, dropouts, or pressure applied to the site (e.g., lying on the site while sleeping) can cause inaccurate glucose signals, which could lead to inappropriate insulin dosing decisions. These studies focus on the problem of pressure-induced sensor attenuations (PISAs) that occur overnight and can cause undesirable pump shut-offs in a predictive low glucose suspend system...
November 2014: Journal of Diabetes Science and Technology
Viral N Shah, Aaron Shoskes, Beshoy Tawfik, Satish K Garg
Intensive insulin therapy (IIT) has been shown to reduce micro- and macrovascular complications in patients with type 1 diabetes mellitus (T1DM). However, IIT is associated with a significant increase in severe hypoglycemic events, resulting in increased morbidity and mortality. Optimization of glycemic control without hypoglycemia (especially nocturnal) should be the next major goal for subjects on insulin treatment. The use of insulin pumps along with continuous glucose monitors (CGMs) has made it easier but requires significant resources and patient education...
August 2014: Diabetes Technology & Therapeutics
Md Saif, Akshay Kapoor, I P S Kochar, Radhika Jindal
Blood glucose monitoring is a way of testing the concentration of glucose in the blood. The most recent advance is the development of continuous glucose monitoring system (CGMS) which gives 24 hour trend of blood sugar levels thus helping both the patient and the physician in achieving better glycemic control. CGMS in pediatric population is generally used for those on insulin pumps and those who are having fluctuating blood glucose levels. This case highlights the use of CGMS for a child with congenital hyperinsulinemia...
April 2013: Indian Pediatrics
Tracey Neithercott
No abstract text is available yet for this article.
January 2013: Diabetes Forecast
Fraser Cameron, Darrell M Wilson, Bruce A Buckingham, Hasmik Arzumanyan, Paula Clinton, H Peter Chase, John Lum, David M Maahs, Peter M Calhoun, B Wayne Bequette
BACKGROUND: An insulin pump shutoff system can prevent nocturnal hypoglycemia and is a first step on the pathway toward a closed-loop artificial pancreas. In previous pump shutoff studies using a voting algorithm and a 1 min continuous glucose monitor (CGM), 80% of induced hypoglycemic events were prevented. METHODS: The pump shutoff algorithm used in previous studies was revised to a single Kalman filter to reduce complexity, incorporate CGMs with different sample times, handle sensor signal dropouts, and enforce safety constraints on the allowable pump shutoff time...
September 2012: Journal of Diabetes Science and Technology
Emilio García-García, Raúl Sánchez-Pérez, Rafael Galera, Purificación Aguilera, Juana Ramos, Antonio Bonillo
INTRODUCTION: Insulin pump therapy aims to improve glycemic control and decrease the risk of hypoglycemia in type 1 diabetes. OBJECTIVE: To evaluate interstitial glucose levels and the frequency, duration and symptoms of hypo- and hyperglycemia through the use of a continuous glucose monitoring system (GGMS) in children and adolescents with insulin pump-treated type 1 diabetes, and to determine whether this monitoring method is well tolerated by these patients. PATIENTS AND METHOD: Thirteen patients (4 boys) with insulin pump-treated type 1 diabetes mellitus were monitored...
June 2008: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
Amir Schechter, Ori Eyal, Nehama Zuckerman-Levin, Vered Amihai-Ben-Yaacov, Naomi Weintrob, Naim Shehadeh
BACKGROUND: Severe hypoglycemic events are a major consequence of tight diabetes control. Continuous glucose monitoring systems (CGMSs) were recently introduced in order to minimize the risk of hypoglycemia. However, the present CGMSs are invasive and costly and have been recently demonstrated to be intolerant for most children and adolescents. Hence there is a need for a simple, noninvasive, convenient, and inexpensive device to detect hypoglycemic events. The Gili Medical Hypoglycemia Non Invasive Monitoring System (GMHNIMS) (Gili Medical Ltd...
August 2012: Diabetes Technology & Therapeutics
Barbara Głowińska-Olszewska, Jolanta Jabłońska, Agnieszka Otocka, Bożena Florys, Milena Jamiołkowska, Monika Tobiaszewska, Kornel Semeran, Jadwiga Peczyńska, Włodzimierz Łuczyński, Artur Bossowski
INTRODUCTION: Experience with use of real-time continuous glucose monitoring systems (RT-CGMS) in teenagers with diabetes type 1 is limited, and in unselected groups of young patients did not show improvement in metabolic control. AIM OF THE STUDY: The objective of this study was to assess short-term RT-CGMS usage in teenagers with type 1 diabetes, in terms of possibility to improve metabolic control and acceptance of the system. MATERIAL AND METHODS: 40 subjects, aged 14...
2011: Pediatric Endocrinology, Diabetes, and Metabolism
C Vigeral, A Sola-Gazagnes, S Nejjar, J M'Bemba, C Boitard, G Slama, F Elgrably, E Larger
AIM: Prolonged fasting may be necessary in life for religious, medical and other reasons. For this reason, our study investigated the feasibility and safety of a 24-h fast conducted at home for patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Thirty-four patients with type 1 diabetes performed a 24-h complete fast at home. Thirteen patients were treated with multiple insulin injections using either glargine (n=12) or NPH (n=1) as basal insulin. The remaining patients were treated with an insulin pump...
December 2011: Diabetes & Metabolism
Catherine Carchidi, Cheryl Holland, Pantea Minnock, Diane Boyle
The purpose of this article is to provide nurses with an overview of the latest technologies used in the management of diabetes, as well as information about future goals of technology in this arena. Advances in technology have had a major impact on diabetes management in the inpatient and outpatient setting. Children with type 1 diabetes mellitus are increasingly utilizing continuous subcutaneous insulin infusions (insulin pumps) and continuous glucose monitoring systems (CGMS), both of which have been shown to improve glycemic control and quality of life...
January 2011: MCN. the American Journal of Maternal Child Nursing
Joakim Bragd, Anna von Döbeln, Per-Eric Lins, Ulf Adamson, Jakob Bergström, Per Oskarsson
BACKGROUND: It is generally held that basal insulin substitution with continuous subcutaneous insulin infusion (CSII) provides less variable glucose levels than with long-acting insulin analogs, e.g., glargine, in patients with type 1 diabetes, although this has not been convincingly demonstrated by continuous glucose monitoring. METHODS: To compare glucose control assessed by a continuous glucose monitoring system (CGMS) during basal insulin substitution with glargine versus CSII, we conducted a non-blinded, randomized, crossover trial in 15 type 1 diabetes patients experienced with CSII...
September 2010: Diabetes Technology & Therapeutics
William L Clarke, Stacey Anderson, Marc Breton, Stephen Patek, Laurissa Kashmer, Boris Kovatchev
BACKGROUND: Recent progress in the development of clinically accurate continuous glucose monitors (CGMs), automated continuous insulin infusion pumps, and control algorithms for calculating insulin doses from CGM data have enabled the development of prototypes of subcutaneous closed-loop systems for controlling blood glucose (BG) levels in type 1 diabetes. The use of a new personalized model predictive control (MPC) algorithm to determine insulin doses to achieve and maintain BG levels between 70 and 140 mg/dl overnight and to control postprandial BG levels is presented...
September 2009: Journal of Diabetes Science and Technology
Allen B King
BACKGROUND: Both pramlintide and insulin pump waveforms separately provide improved post-meal glucose control. However, when used together there may be a mismatch in actions leading to hypoglycemia. We studied the three currently available waveforms and a "modified combination wave" (MC) in pramlintide-treated patients. The MC was a "square" (SQ) wave combined with a "standard" (ST) bolus that was delayed 1 h into the mealtime. METHODS: Using the CGMS Gold (Medtronics, Northridge, CA) we measured the glucose response 0-4 h after the beginning of a meal and 15 min after the initiation of the insulin bolus wave and pramlintide (60 microg), bolus...
February 2010: Diabetes Technology & Therapeutics
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