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https://www.readbyqxmd.com/read/28927286/six-year-follow-up-after-insulin-pump-initiation-hba1c-is-significantly-reduced-without-weight-gain
#1
Henrik Ullits Andersen, Sine Hangaard, Eva Hommel, Martin Ridderstråle
No abstract text is available yet for this article.
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28924484/diabetic-ketoacidosis-producing-extreme-hyperkalemia-in-a-patient-with-type-1-diabetes-on-hemodialysis
#2
Hodaka Yamada, Shunsuke Funazaki, Masafumi Kakei, Kazuo Hara, San-E Ishikawa
Diabetic ketoacidosis (DKA) is a critical complication of type 1 diabetes associated with water and electrolyte disorders. Here, we report a case of DKA with extreme hyperkalemia (9.0 mEq/L) in a patient with type 1 diabetes on hemodialysis. He had a left frontal cerebral infarction resulting in inability to manage his continuous subcutaneous insulin infusion pump. Electrocardiography showed typical changes of hyperkalemia, including absent P waves, prolonged QRS interval and tented T waves. There was no evidence of total body water deficit...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28924481/euglycemic-diabetic-ketoacidosis-a-diagnostic-and-therapeutic-dilemma
#3
Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28924374/no-association-of-proton-pump-inhibitor-use-with-fasting-or-postload-glycaemia-in-patients-with-cardiovascular-disease-a-cross-sectional-retrospective-study
#4
Olga Kruszelnicka, Marcin Kuźma, Iwona Z Pena, Ian B Perera, Bernadeta Chyrchel, Ewa Wieczorek-Surdacka, Andrzej Surdacki
Background: Proton pump inhibitor (PPI) use was reportedly associated with an excess of adverse cardiovascular (CV) events, thus making their systemic effects relevant to public health. PPIs reduce gastric acid secretion, causing increased gastrin release. Gastrin stimulates β-cell neogenesis and enhances insulin release, exerting an incretin-like effect. Our aim was to assess, if PPI usage is associated with altered glycaemia in patients with CV disease. Methods: We retrospectively analyzed medical records of 102 subjects (80 with ischemic heart disease) who underwent a routine oral glucose tolerance test while hospitalized in a cardiology department...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28923465/continuous-glucose-monitoring-in-pregnant-women-with-type-1-diabetes-conceptt-a-multicentre-international-randomised-controlled-trial
#5
Denice S Feig, Lois E Donovan, Rosa Corcoy, Kellie E Murphy, Stephanie A Amiel, Katharine F Hunt, Elisabeth Asztalos, Jon F R Barrett, J Johanna Sanchez, Alberto de Leiva, Moshe Hod, Lois Jovanovic, Erin Keely, Ruth McManus, Eileen K Hutton, Claire L Meek, Zoe A Stewart, Tim Wysocki, Robert O'Brien, Katrina Ruedy, Craig Kollman, George Tomlinson, Helen R Murphy
BACKGROUND: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes. METHODS: In this multicentre, open-label, randomised controlled trial, we recruited women aged 18-40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy...
September 14, 2017: Lancet
https://www.readbyqxmd.com/read/28922582/relationship-between-optimum-mini-doses-of-glucagon-and-insulin-levels-when-treating-mild-hypoglycaemia-in-patients-with-type-1-diabetes-a-simulation-study
#6
Ajenthen Ranjan, Sabrina L Wendt, Signe Schmidt, Sten Madsbad, Jens J Holst, Henrik Madsen, Carsten B Knudsen, John B Jørgensen, Kirsten Nørgaard
Hypoglycaemia remains the main limiting factor in type 1 diabetes management. We developed an insulin-dependent glucagon dosing regimen for treatment of mild hypoglycaemia based on simulations. A validated glucose-insulin-glucagon model was used to describe seven virtual patients with insulin pump-treated type 1 diabetes. In each simulation, one of ten different and individualised subcutaneous insulin boluses was administered to decrease plasma glucose (PG) from 7.0 to ≤3.9 mmol/l. Insulin levels were estimated as ratio of actual to baseline serum insulin concentration (se/ba-insulin), insulin on board (IOB) or percentage of IOB to total daily insulin dose (IOB/TDD)...
September 18, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28918653/setting-expectations-for-successful-artificial-pancreas-hybrid-closed-loop-automated-insulin-delivery-adoption
#7
Dana Lewis
Hybrid closed loop (or automated insulin delivery systems) and artificial pancreas technology will dramatically change the quality of life for people living with diabetes. However, this technology is not a cure. Without having expectations set, patients may assume that APs will replace critical self-care behaviors. It is important for patients to understand several key things before choosing to adopt and switching to APs for diabetes management. Like any technology, APs will have a learning curve. But like switching from MDI to standard pump therapy, it is not insurmountable...
September 1, 2017: Journal of Diabetes Science and Technology
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/28913745/management-of-type-1-diabetes-in-the-hospital-setting
#9
REVIEW
Carlos E Mendez, Guillermo E Umpierrez
PURPOSE OF REVIEW: The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. RECENT FINDINGS: Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described...
September 14, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28905659/comparative-handling-analysis-of-different-insulin-pump-systems
#10
Delia Waldenmaier, Katharina Schöllkopf, Antje Westhoff, Lutz Heinemann, Guido Freckmann
Insulin pumps are used by many patients with diabetes to manage their diabetes therapy. Adequate handling of the systems is important to avoid errors. In this study, one aspect of device handling-the number of steps required to operate the system-was evaluated for different insulin pump systems. Specific tasks that are usually performed by insulin pump users were simulated and all necessary actions were documented. Differences between the required numbers of steps strongly depended on the specific task. So did the level of guidance for these tasks provided by the systems...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28905317/healthcare-resource-utilization-and-costs-associated-with-ketosis-events-in-pediatric-and-adult-patients-with-type-1-diabetes-mellitus-in-the-uk
#11
Nandu Thalange, Natalie Valerie Jane Aldhouse, Helen Kitchen, Daniel Howard, Deniz Tutkunkardas, Jonas Håkan-Bloch
INTRODUCTION: Ketosis is a metabolic state associated with insulin deficiency. Untreated, it develops into diabetic ketoacidosis, a significant contributor to mortality and morbidity in people with type 1 diabetes mellitus (T1DM). Little is understood about how patients utilize healthcare resources during ketosis events. This study aimed to identify and quantify healthcare resource utilization and provide estimates of associated costs of ketosis events in T1DM, treated unaided or with healthcare professional (HCP) assistance in the UK...
September 13, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28899222/effects-of-sotagliflozin-added-to-insulin-in-patients-with-type-1-diabetes
#12
Satish K Garg, Robert R Henry, Phillip Banks, John B Buse, Melanie J Davies, Gregory R Fulcher, Paolo Pozzilli, Diane Gesty-Palmer, Pablo Lapuerta, Rafael Simó, Thomas Danne, Darren K McGuire, Jake A Kushner, Anne Peters, Paul Strumph
Background In most patients with type 1 diabetes, adequate glycemic control is not achieved with insulin therapy alone. We evaluated the safety and efficacy of sotagliflozin, an oral inhibitor of sodium-glucose cotransporters 1 and 2, in combination with insulin treatment in patients with type 1 diabetes. Methods In this phase 3, double-blind trial, which was conducted at 133 centers worldwide, we randomly assigned 1402 patients with type 1 diabetes who were receiving treatment with any insulin therapy (pump or injections) to receive sotagliflozin (400 mg per day) or placebo for 24 weeks...
September 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28898340/-from-insulin-pump-and-continuous-glucose-monitoring-to-the-artificial-pancreas
#13
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
#14
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/28872765/digital-therapy-in-diabetes
#15
REVIEW
Avivit Cahn, Amit Akirov, Itamar Raz
Diabetes care is largely dependent on patient self-management and empowerment, given that patients with diabetes must make numerous daily decisions of what to eat, when to exercise, and determine their insulin dose and timing if required. Additionally, patients and providers are generating vast amounts of data from many sources including electronic medical records, insulin pumps, sensors, glucometers, other wearables, as well as evolving genomic, proteomic, metabolomic and microbiomic data. Multiple digital tools and apps have been developed to assist patients to choose wisely, as well as enhance their compliance by employing motivational tools and incorporating incentives from social media and gaming techniques...
September 5, 2017: Journal of Diabetes
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
#16
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...
September 4, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28868899/rate-of-change-of-premeal-glucose-measured-by-continuous-glucose-monitoring-predicts-postmeal-glycemic-excursions-in-patients-with-type-1-diabetes-implications-for-therapy
#17
Amit R Majithia, Alexander B Wiltschko, Hui Zheng, Geoffrey A Walford, David M Nathan
BACKGROUND: Patients with type 1 diabetes routinely utilize a single premeal fingerstick glucose to determine premeal insulin doses. Continuous glucose monitoring (CGM) provides much richer glycemic trend information, including glycemic slope (GS). How to incorporate this information into dosing decisions remains an open question. METHODS: We examined the relationship between premeal GS and postmeal glycemic excursions in 240 individuals with type 1 diabetes receiving CGM augmented insulin pump therapy...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28867311/distal-technologies-and-type-1-diabetes-management
#18
REVIEW
Danny C Duke, Samantha Barry, David V Wagner, Jane Speight, Pratik Choudhary, Michael A Harris
Type 1 diabetes requires intensive self-management to avoid acute and long-term health complications. In the past two decades, substantial advances in technology have enabled more effective and convenient self-management of type 1 diabetes. Although proximal technologies (eg, insulin pumps, continuous glucose monitors, closed-loop and artificial pancreas systems) have been the subject of frequent systematic and narrative reviews, distal technologies have received scant attention. Distal technologies refer to electronic systems designed to provide a service remotely and include heterogeneous systems such as telehealth, mobile health applications, game-based support, social platforms, and patient portals...
August 31, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28853898/direct-observation-of-insulin-association-dynamics-with-time-resolved-x-ray-scattering
#19
Dolev Rimmerman, Denis Leshchev, Darren J Hsu, Jiyun Hong, Irina Kosheleva, Lin X Chen
Biological functions frequently require protein-protein interactions that involve secondary and tertiary structural perturbation. Here we study protein-protein dissociation and reassociation dynamics in insulin, a model system for protein oligomerization. Insulin dimer dissociation into monomers was induced by a nanosecond temperature-jump (T-jump) of ∼8 °C in aqueous solution, and the resulting protein and solvent dynamics were tracked by time-resolved X-ray solution scattering (TRXSS) on time scales of 10 ns to 100 ms...
September 5, 2017: Journal of Physical Chemistry Letters
https://www.readbyqxmd.com/read/28850755/continuous-flow-reduced-pressure-infrared-laser-desorption-ionization-mass-spectrometry
#20
Yasunari Iguchi, Hisanao Hazama, Kunio Awazu
RATIONALE: Continuous flow ionization methods using infrared (IR) lasers have several favorable characteristics, including ionization without any additional matrices and tolerance to contaminants such as detergents and buffer salts. However, poor sensitivity due to low ion-transfer efficiency from the sample plate to the inlet capillary of the mass spectrometer under atmospheric pressure remains a serious problem. METHODS: We developed a new continuous flow IR laser desorption/ionization (IR-LDI) method using a frit plate and wavelength tunable mid-infrared laser with an optical parametric oscillator...
August 29, 2017: Rapid Communications in Mass Spectrometry: RCM
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