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CGMS insulin pumps

Anthony Pease, Clement Lo, Arul Earnest, Danny Liew, Sophia Zoungas
BACKGROUND: Technology has been implemented since the 1970s with the hope of improving glycaemic control and reducing the burden of complications for those living with type 1 diabetes. A clinical and cost-effectiveness comparison of all available technologies including continuous subcutaneous insulin infusion (CSII), continuous glucose monitors (CGMs), sensor-augmented pump therapy (including either low-glucose suspend or predictive low-glucose suspend), hybrid closed-loop systems, closed-loop (single-hormone or dual-hormone) systems, flash glucose monitoring (FGM), insulin bolus calculators, and 'smart-device' applications is currently lacking...
March 12, 2018: Systematic Reviews
Eric D Buras, Emily Weatherup, Jennifer Wyckoff
Background: Ectopic insulin-like growth factor (IGF)-2 production is a rare complication of an array of epithelial and mesenchymal tumors, and can clinically manifest as life-threatening hypoglycemia. Case presentation: A 49-year-old woman with 13-year history of metastatic hemangiopericytoma, previously treated with multiple rounds of chemotherapy and palliative radiation, presented to the emergency department after a hypoglycemic seizure. On arrival, glucose was 18 mg/dL (1...
2018: Clinical Diabetes and Endocrinology
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
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...
August 2017: Diabetes Care
W Gu, Y Liu, Y Chen, W Deng, X Ran, L Chen, D Zhu, J Yang, J Shin, S W Lee, T L Cordero, Y Mu
AIM: Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM). METHODS: Adults (aged 18-65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period...
September 2017: Diabetes & Metabolism
Molly L Tanenbaum, Sarah J Hanes, Kellee M Miller, Diana Naranjo, Rachel Bensen, Korey K Hood
OBJECTIVE: Diabetes devices (insulin pumps, continuous glucose monitors [CGMs]) are associated with benefits for glycemic control, yet uptake of these devices continues to be low. Some barriers to device uptake may be modifiable through psychosocial intervention, but little is known about which barriers and which patients to target. RESEARCH DESIGN AND METHODS: We surveyed 1,503 adult T1D Exchange participants (mean age 35.3 [SD 14.8] years, mean diagnosis duration 20...
February 2017: Diabetes Care
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...
June 12, 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 1, 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
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