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https://www.readbyqxmd.com/read/28236571/multicentre-randomized-controlled-trial-with-sensor-augmented-pump-vs-multiple-daily-injections-in-hospitalized-patients-with-type-2-diabetes-in-china-time-to-reach-target-glucose
#1
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...
February 21, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28231890/-pancreatic-infringement-exocrine-and-endocrine-in-cystic-fibrosis
#2
L Kessler, M Abély
The exocrine pancreatic insufficiency affects more than 80% of cystic fibrosis (CF) infants. Pancreatic insufficiency is diagnosed by low levels of fecal elastase. An optimal caloric intake, a pancreatic enzyme treatment are the keys to maintain a good nutritional status. The fat soluble vitamins supplementation will be associated with pancreatic enzymes treatment and will be adapted to plasma levels. Iron and oligo-element deficiency such as zinc is common. The pancreatic enzymes function is not optimal in the proximal bowel: the intraluminal intestinal pH is low because of the absence of bicarbonate release by the pancreas...
December 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28231029/unintended-insulin-pump-delivery-in-hyperbaric-conditions
#3
Federico Bertuzzi, Basilio Pintaudi, Matteo Bonomo, Fabio Garuti
AIMS/HYPOTHESIS: Unintended pump insulin delivery was reported to occur as a consequence of decreased atmospheric pressure, probably mediated by air bubble formation and the expansion of existing bubbles. This observation has been used to explain some hypoglycemic episodes occurring in patients on insulin pump treatment in between 1 and 1 h 45 min after the flight takeoff. New models of insulin pumps have been introduced in the market, most of them are waterproof certified. It is not clear if in these new pumps the influence of atmospheric pressure changes on the insulin delivery is still present...
February 23, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28230659/sulfonylurea-blockade-of-k-atp-channels-unmasks-a-distinct-type-of-glucose-induced-ca-2-decrease-in-pancreatic-%C3%AE-cells
#4
Bo Hellman, Heléne Dansk, Eva Grapengiesser
OBJECTIVES: This study aimed to explore how sulfonylurea blockade of KATP channels affects the early Ca signals for glucose generation of insulin release. METHODS: Cytoplasmic Ca was measured with ratiometric microfluorometry in isolated mouse islets loaded with Fura-PE3. RESULTS: After sulfonylurea blockade of the KATP channels (50 μM-1 mM tolbutamide or 1 μM-1 mM gliclazide), increase of glucose from 3 to 20 mM resulted in suppression of elevated Ca during a 3- to 5-minute period...
February 23, 2017: Pancreas
https://www.readbyqxmd.com/read/28228583/food-responsiveness-regulates-episodic-behavioral-states-in-caenorhabditis-elegans
#5
Richard J McCloskey, Anthony D Fouad, Matthew A Churgin, Christopher Fang-Yen
Animals optimize survival and reproduction in part through control of behavioral states, which depend on the organism's internal and external environments. In the nematode C. elegans, a variety of behavioral states have been described, including roaming, dwelling, quiescence, and episodic swimming. These states have been considered in isolation, under varied experimental conditions, making it difficult to establish a unified picture of how they are regulated. Using long-term imaging, we examined C. elegans episodic behavioral states under varied mechanical and nutritional environments...
February 22, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28226536/evaluation-of-a-novel-portable-micro-pump-and-infusion-system-for-drug-delivery
#6
Paul Pankhurst, Zahra McGuinness Abdollahi, Paul Pankhurst, Zahra McGuinness Abdollahi, Zahra McGuinness Abdollahi, Paul Pankhurst
In this paper the design, fabrication and experimental results of a novel portable fixed-displacement micro-pump for controlled dosing and timing is described. The new pump is developed especially for high efficiency, high accuracy, ease of use and very low cost for single use drug delivery systems which can overcome many of the deficiencies of current portable pumps. Primary tests have been conducted and the results have demonstrated that the pump has the ability to deliver high performance and accuracy with less than +/-1% error over the whole operating flow rate range of 0...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28221823/evaluation-of-a-predictive-low-glucose-management-system-in-clinic
#7
Bruce A Buckingham, Timothy S Bailey, Mark Christiansen, Satish Garg, Stuart Weinzimer, Bruce Bode, Stacey M Anderson, Ron Brazg, Trang Ly, Francine R Kaufman
BACKGROUND: Predictions based on continuous glucose monitoring (CGM) data are the basis for automatic suspension and resumption of insulin delivery by a predictive low-glucose management feature termed "suspend before low," which is part of the Medtronic MiniMed(®) 640G combined insulin pump and CGM system. This study assessed the safety and performance characteristics of the system in an in-clinic setting at eight sites. MATERIALS AND METHODS: In-clinic standardized increases in basal insulin delivery rates were used to induce nocturnal hypoglycemia in subjects (14-75 years) with type 1 diabetes wearing the MiniMed 640G system...
February 16, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28219959/randomised-prospective-medico-economic-nationwide-french-study-of-islet-transplantation-in-patients-with-severely-unstable-type-1-diabetes-the-stabilot-study-protocol
#8
Sandrine Lablanche, Sandra David-Tchouda, Jennifer Margier, Edith Schir, Anne Wojtusciszyn, Sophie Borot, Laurence Kessler, Emmanuel Morelon, Charles Thivolet, François Pattou, Marie Christine Vantyghem, Thierry Berney, Pierre-Yves Benhamou
INTRODUCTION: Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy...
February 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28209654/replace-bg-a-randomized-trial-comparing-continuous-glucose-monitoring-with-and-without-routine-blood-glucose-monitoring-in-well-controlled-adults-with-type-1-diabetes
#9
Grazia Aleppo, Katrina J Ruedy, Tonya D Riddlesworth, Davida F Kruger, Anne L Peters, Irl Hirsch, Richard M Bergenstal, Elena Toschi, Andrew J Ahmann, Viral N Shah, Michael R Rickels, Bruce W Bode, Athena Philis-Tsimikas, Rodica Pop-Busui, Henry Rodriguez, Emily Eyth, Anuj Bhargava, Craig Kollman, Roy W Beck
OBJECTIVE: To determine whether the use of continuous glucose monitoring (CGM) without confirmatory blood glucose monitoring (BGM) measurements is as safe and effective as using CGM adjunctive to BGM in well-controlled adults with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: A randomized noninferiority clinical trial was conducted at 14 sites in the T1D Exchange Clinic Network. Participants were ≥18 years of age (mean 44 ± 14 years), had T1D for ≥1 year (mean duration 24 ± 12 years), used an insulin pump, and had an HbA1c ≤9...
February 16, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28192024/insulin-pumps
#10
John C Pickup
No abstract text is available yet for this article.
February 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28173843/staff-experiences-of-closing-out-a-clinical-trial-involving-withdrawal-of-treatment-qualitative-study
#11
Julia Lawton, David White, David Rankin, Jackie Elliott, Carolin Taylor, Cindy Cooper, Simon Heller, Nina Hallowell
BACKGROUND: The ending of a clinical trial may be challenging, particularly if staff are required to withdraw the investigated treatment(s); however, this aspect of trial work is surprisingly under-researched. To address this gap, we explored the experiences of staff involved in closing out a trial that entailed withdrawal of treatment (insulin pumps) from some patients. METHODS: Interviews were conducted with n = 22 staff, recruited from seven trial sites. Data were analysed thematically...
February 7, 2017: Trials
https://www.readbyqxmd.com/read/28164370/impact-of-neighbourhood-level-inequity-on-paediatric-diabetes-care
#12
A B M Clarke, D Daneman, J R Curtis, F H Mahmud
AIMS: To evaluate the association between neighbourhood-level inequity and glycaemic control in paediatric participants with Type 1 diabetes using the Neighbourhood Equity Index (NEI). METHODS: The NEI was linked to the clinical data of 519 children with diabetes followed at the Hospital for Sick Children (Toronto, Canada). The NEI is a composite measure of inequity developed using the World Health Organization's Urban Health Equity Assessment and Response Tool (HEART), which encompasses 15 weighted indicators evaluating economic, social, environmental and lifestyle factors...
February 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28161977/achieving-effective-glycaemic-control-using-an-insulin-micro-pump
#13
Peter Kelly
For those with type 1 diabetes mellitus (T1DM), a deranged blood glucose level can cause hypo/hyperglycaemic episodes and in the long term contribute to microvascular disease. Such outcomes can effect concordance with insulin management regimens and affect the patient's quality of life. A variety of insulin delivery methods are available, including continuous subcutaneous insulin infusion (CSII) via either a tethered or patch pump. Pumps have the potential to improve delivery, monitoring and adjustment of insulin regimens, thus freeing patient's time and affording more control of their disease...
February 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28147679/packaged-peristaltic-micropump-for-controlled-drug-delivery-application
#14
K B Vinayakumar, Girish Nadiger, Vikas R Shetty, N S Dinesh, M M Nayak, K Rajanna
Micropump technology has evolved significantly in the last two decades and is finding a variety of applications ranging from μTAS (micro Total Analysis System) to drug delivery. However, the application area of the micropump is limited owing to: simple pumping mechanism, ease of handling, controlled (microliter to milliliter) delivery, continuous delivery, and accuracy in flow rate. Here, the author presents the design, development, characterization, and precision flow controlling of a DC-motor driven peristaltic pump for controlled drug delivery application...
January 2017: Review of Scientific Instruments
https://www.readbyqxmd.com/read/28145047/influence-of-health-locus-of-control-and-fear-of-hypoglycaemia-on-glycaemic-control-and-treatment-satisfaction-in-people-with-type-1-diabetes-on-insulin-pump-therapy
#15
L Indelicato, V Mariano, S Galasso, F Boscari, E Cipponeri, C Negri, A Frigo, A Avogaro, E Bonora, M Trombetta, D Bruttomesso
AIM: To assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion. METHODS: People with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub-classified as an 'acceptable glucose control' group [HbA1c ≤58 mmol/mol (7.5%)] and a 'suboptimum glucose control' group [HbA1c >58 mmol/mol (7...
February 1, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28143733/fear-of-hypoglycemia-influence-on-glycemic-variability-and-self-management-behavior-in-young-adults-with-type-1-diabetes
#16
Pamela Martyn-Nemeth, Laurie Quinn, Sue Penckofer, Chang Park, Vanessa Hofer, Larisa Burke
PURPOSE: The purpose of this study was to examine how fear of hypoglycemia (FOH) is associated with glycemic variability (GV) and self-management behavior in young adults (aged 18-35) with type 1 diabetes (T1DM). PROCEDURES: Using a prospective repeated-measures design, in 35 young adults, within- and between-person and temporal associations of FOH, specific self-management behaviors, and GV were measured. The data were collected using questionnaires and real-time measures using daily diaries, insulin pump downloads, actigraphy, and continuous glucose monitoring...
January 20, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28135116/an-expert-opinion-on-advanced-insulin-pump-use-in-youth-with-type-1-diabetes
#17
Bruce W Bode, Francine R Kaufman, Nan Vint
Among children and adolescents with type 1 diabetes mellitus, the use of insulin pump therapy has increased since its introduction in the early 1980s. Optimal management of type 1 diabetes mellitus depends on sufficient understanding by patients, their families, and healthcare providers on how to use pump technology. The goal for the use of insulin pump therapy should be to advance proficiency over time from the basics taught at the initiation of pump therapy to utilizing advanced settings to obtain optimal glycemic control...
January 30, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28134397/-review-update-on-magnesium-metabolism
#18
Pasquale Fatuzzo, Luca Zanoli, Viviana Scollo, Grazia Portale, Agostino Gaudio, Alessandra Pani, Antonio Granata
Magnesium is the second intracellular cation and the fourth most abundant mineral in the body. Low levels of magnesium have been associated with insulin resistance and type-2 diabetes mellitus, asthma, osteoporosis and chronic kidney disease (CKD). The use of proton pump inhibitors (PPIs) represents the most common cause of hypomagnesemia. The risk of hypomagnesemia, and consequently worsening of the renal function, is increased when diuretics are added to therapy in subjects treated with PPIs. Interestingly, diuretics and PPIs are two of the most used drugs in subjects with CKD...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28130944/pediatric-insulin-pump-therapy-reflecting-on-the-first-10-years-of-a-universal-funding-program-in-ontario
#19
Rayzel Shulman, Fiona A Miller, Thérèse A Stukel, Denis Daneman, Astrid Guttmann
We evaluated the universal funding program for pediatric insulin pumps in Ontario by examining the dynamics underlying patterns of pump use and adverse events using population-based health administrative data available at the Institute for Clinical Evaluative Sciences (ICES), supplemented by other data. We found that (1) pump use has increased steadily since 2006 with variation across centres and disparity in use by socioeconomic status; (2) pump discontinuation is uncommon; (3) physicians value pump therapy in numerous ways that provide important insights into patterns of uptake; and (4) the safety profile of pump therapy is, in general, very good; however, individuals of lower socioeconomic status are at an increased risk of acute diabetes complications, most frequently diabetic ketoacidosis...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28118453/effect-of-continuous-glucose-monitoring-on-glycemic-control-in-adults-with-type-1-diabetes-using-insulin-injections-the-diamond-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Roy W Beck, Tonya Riddlesworth, Katrina Ruedy, Andrew Ahmann, Richard Bergenstal, Stacie Haller, Craig Kollman, Davida Kruger, Janet B McGill, William Polonsky, Elena Toschi, Howard Wolpert, David Price
Importance: Previous clinical trials showing the benefit of continuous glucose monitoring (CGM) in the management of type 1 diabetes predominantly have included adults using insulin pumps, even though the majority of adults with type 1 diabetes administer insulin by injection. Objective: To determine the effectiveness of CGM in adults with type 1 diabetes treated with insulin injections. Design, Setting, and Participants: Randomized clinical trial conducted between October 2014 and May 2016 at 24 endocrinology practices in the United States that included 158 adults with type 1 diabetes who were using multiple daily insulin injections and had hemoglobin A1c (HbA1c) levels of 7...
24, 2017: JAMA: the Journal of the American Medical Association
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