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https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#1
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
July 18, 2017: Annals of Thoracic and Cardiovascular Surgery
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
#2
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/28710224/assessing-the-effectiveness-of-a-3-month-day-and-night-home-closed-loop-control-combined-with-pump-suspend-feature-compared-with-sensor-augmented-pump-therapy-in-youths-and-adults-with-suboptimally-controlled-type-1-diabetes-a-randomised-parallel-study-protocol
#3
Lia Bally, Hood Thabit, Martin Tauschmann, Janet M Allen, Sara Hartnell, Malgorzata E Wilinska, Jane Exall, Viki Huegel, Judy Sibayan, Sarah Borgman, Peiyao Cheng, Maxine Blackburn, Julia Lawton, Daniela Elleri, Lalantha Leelarathna, Carlo L Acerini, Fiona Campbell, Viral N Shah, Amy Criego, Mark L Evans, David B Dunger, Craig Kollman, Richard M Bergenstal, Roman Hovorka
INTRODUCTION: Despite therapeutic advances, many individuals with type 1 diabetes are unable to achieve tight glycaemic target without increasing the risk of hypoglycaemia. The objective of this study is to determine the effectiveness of a 3-month day-and-night home closed-loop glucose control combined with a pump suspend feature, compared with sensor-augmented insulin pump therapy in youths and adults with suboptimally controlled type 1 diabetes. METHODS AND ANALYSIS: The study adopts an open-label, multi-centre, multi-national (UK and USA), randomised, single-period, parallel design and aims for 84 randomised patients...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28709853/evaluation-of-current-trends-and-recent-development-in-insulin-therapy-for-management-of-diabetes-mellitus
#4
REVIEW
Muhammad Sarfraz Nawaz, Kifayat Ullah Shah, Tahir Mehmood Khan, Asim Ur Rehman, Haroon Ur Rashid, Sajid Mahmood, Shahzeb Khan, Muhammad Junaid Farrukh
OBJECTIVE: Diabetes mellitus is a major health problem in developing countries. There are various insulin therapies to manage diabetes mellitus. This systematic review evaluates various insulin therapies for management of diabetes mellitus worldwide. This review also focuses on recent developments being explored for better management of diabetes mellitus. RESEARCH DESIGN AND METHOD: We reviewed a number of published articles from 2002 to 2016 to find out the appropriate management of diabetes mellitus...
July 8, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28700272/accuracy-of-a-fourth-generation-subcutaneous-continuous-glucose-sensor
#5
Mark P Christiansen, Satish K Garg, Ronald Brazg, Bruce W Bode, Timothy S Bailey, Robert H Slover, Ashley Sullivan, Suiying Huang, John Shin, Scott W Lee, Francine R Kaufman
BACKGROUND: This study evaluated the accuracy and performance of a fourth-generation subcutaneous glucose sensor (Guardian(™) Sensor 3) in the abdomen and arm. METHODS: Eighty-eight subjects (14-75 years of age, mean ± standard deviation [SD] of 42.0 ± 19.1 years) with type 1 or type 2 diabetes participated in the study. Subjects wore two sensors in the abdomen that were paired with either a MiniMed(™) 640G insulin pump, or an iPhone(®) or iPod(®) touch(®) running a glucose monitoring mobile application (Guardian Connect system) and a third sensor in the arm, which was connected to a glucose sensor recorder (GSR)...
July 12, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28699150/effect-of-insulin-infusion-line-on-glycaemic-variability-in-a-perioperative-high-dependency-unit-hdu-a-prospective-randomised-controlled-trial
#6
Stéphanie Genay, Bertrand Décaudin, Sabine Ethgen, Arnaud Alluin, Elodie Babol, Julien Labreuche, Hélène Behal, Marie-Christine Vantyghem, Pascal Odou, Gilles Lebuffe
BACKGROUND: Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomised study was conducted in a fifteen-bed perioperative high dependency unit (HDU) in a university hospital. In total, 172 eligible patients receiving insulin therapy agreed to participate in the study...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28688482/enhancing-automatic-closed-loop-glucose-control-in-type-1-diabetes-with-an-adaptive-meal-bolus-calculator-in-silico-evaluation-under-intra-day-variability
#7
Pau Herrero, Jorge Bondia, Oloruntoba Adewuyi, Peter Pesl, Mohamed El-Sharkawy, Monika Reddy, Chris Toumazou, Nick Oliver, Pantelis Georgiou
BACKGROUND AND OBJECTIVE: Current prototypes of closed-loop systems for glucose control in type 1 diabetes mellitus, also referred to as artificial pancreas systems, require a pre-meal insulin bolus to compensate for delays in subcutaneous insulin absorption in order to avoid initial post-prandial hyperglycemia. Computing such a meal bolus is a challenging task due to the high intra-subject variability of insulin requirements. Most closed-loop systems compute this pre-meal insulin dose by a standard bolus calculation, as is commonly found in insulin pumps...
July 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28686045/challenges-of-diabetes-management-in-toddlers
#8
Asma Deeb
Toddlers with type 1 diabetes have distinctive combination of challenges to their families and healthcare providers. A major factor is the difficulty in achieving metabolic control without risking hypoglycemia. The rising incidence of type 1 diabetes in toddlers increases the magnitude of the problem and creates a greater need for providing specialized service to cater for this age group's unique need. Type 1 has a specific disease nature in younger children and its clinical presentation mimics common childhood diseases...
July 7, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28685509/stepwise-approach-to-problematic-hypoglycemia-in-korea-educational-technological-and-transplant-interventions
#9
REVIEW
Sang Man Jin
Impaired awareness of hypoglycemia has been found to be prevalent in 20% to 40% of people with type 1 diabetes. If a similar prevalence exists in Koreans with type 1 diabetes, at a minimum, thousands of people with type 1 diabetes suffer at least one unpredicted episode of severe hypoglycemia per year in Korea. For patients with problematic hypoglycemia, an evidence-based stepwise approach was suggested in 2015. The first step is structured education regarding multiple daily injections of an insulin analog, and the second step is adding a technological intervention, such as continuous subcutaneous insulin infusion or real-time continuous glucose monitoring...
June 2017: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28683888/intersecting-health-policy-and-the-social-determinants-of-health-in-pediatric-type-1-diabetes-management-and-care
#10
REVIEW
Sanja Visekruna, Linda McGillis Hall, Monica Parry, Karen Spalding
PURPOSE: Type 1 diabetes (T1D) health technologies are evolving. This is an expensive chronic condition to manage, hence a combination of public and private healthcare funding sources, as well as out-of-pocket payments support disease management. The aim of this paper is to describe two conceptual underpinnings, which can appropriately position the health policy and clinical context of pediatric T1D management and care. THEORETICAL PRINCIPLES: Dahlgren and Whitehead's (1991) "The Main Determinants of Health" framework positions pediatric T1D management and care within the model's four interconnected layers: the structural environment, social and material conditions, support systems and individual health behaviors (p...
July 3, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28682267/a-novel-authentication-and-key-agreement-scheme-for-implantable-medical-devices-deployment
#11
Mohammad Wazid, Ashok Kumar Das, Neeraj Kumar, Mauro Conti, Athanasios V Vasilakos
Implantable medical devices (IMDs) are man-made devices, which can be implanted in the human body to improve the functioning of various organs. The IMDs monitor and treat physiological condition of the human being (for example, monitoring of blood glucose level by insulin pump). The advancement of information and communication technology (ICT) enhances the communication capabilities of IMDs. In healthcare applications, after mutual authentication, a user (for example, doctor) can access the health data from the IMDs implanted in a patient's body...
June 29, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28681638/issues-and-ideas-in-bolus-advisor-research-with-commentary-on-a-methodology-to-compare-insulin-dosing-algorithms-in-real-life-settings
#12
John Walsh
The accompanying article by Groat et al in this issue presents a methodology to compare glucose outcomes from insulin bolus dose recommendations observed retrospectively from a novel iDecide bolus calculator with glucose outcomes from the prospective bolus recommendations provided by a current insulin pump. The methodology in this article evaluates a bolus calculator algorithm and also evaluates calculations for two additional lifestyle behaviors, exercise and alcohol intake, that are modifiable risk factors associated with diabetes...
June 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28677416/manual-closed-loop-insulin-delivery-using-a-saddle-point-model-predictive-control-algorithm-results-of-a-crossover-randomized-overnight-study
#13
Isabelle Guilhem, Maxime Penet, Anaïs Paillard, Marc Carpentier, Annabelle Esvant, Marie-Anne Lefebvre, Jean-Yves Poirier
BACKGROUND: The purpose was to assess the efficacy of a new closed-loop algorithm (Saddle Point Model Predictive Control, SP-MPC) in achieving nocturnal normoglycemia while reducing the risk of hypoglycemia in patients with type 1 diabetes. METHOD: In this randomized crossover study, 10 adult patients (mean hemoglobin A1c 7.35 ± 1.04%) were assigned to be treated overnight by open loop using sensor-augmented pump therapy (open-loop SAP) or manual closed-loop delivery...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28677414/self-reported-compensation-techniques-for-carbohydrate-exercise-and-alcohol-behaviors-in-patients-with-type-1-diabetes-on-insulin-pump-therapy
#14
Danielle Groat, Hiral Soni, Maria Adela Grando, Bithika Thompson, Curtiss B Cook
Studies have found variability in self-care behaviors in patients with type 1 diabetes, particularly when incorporating exercise and alcohol consumption. The objective of this study was to provide results from a survey to understand (1) insulin pump behaviors, (2) reported self-management behaviors for exercise and alcohol, and (3) perceptions of the effects of exercise and alcohol on blood glucose (BG) control. Fourteen participants from an outpatient endocrinology practice were recruited and administered an electronic survey...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28675686/the-challenges-of-achieving-postprandial-glucose-control-using-closed-loop-systems-in-patients-with-type-1-diabetes
#15
REVIEW
Véronique Gingras, Nadine Taleb, Amélie Roy-Fleming, Laurent Legault, Rémi Rabasa-Lhoret
For patients with type 1 diabetes, closed-loop delivery systems (CLS) combining an insulin pump, a glucose sensor and a dosing algorithm allowing a dynamic hormonal infusion have been shown to improve glucose control when compared to conventional therapy. Yet, reducing glucose excursion as well as simplification of prandial insulin doses remains a challenge. The objective of this literature review is to examine current meal-time strategies in the context of automated delivery systems in adults and children with type 1 diabetes...
July 4, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28667128/diabetic-ketoacidosis-at-diagnosis-of-type-1-diabetes-predicts-poor-long-term-glycemic-control
#16
Lindsey M Duca, Bing Wang, Marian Rewers, Arleta Rewers
OBJECTIVE: This study tested the hypothesis that diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control independently of established risk factors. RESEARCH DESIGN AND METHODS: This was a prospective cohort study of 3,364 Colorado residents diagnosed with type 1 diabetes before 18 years of age, in 1998-2012, and monitored for up to 15 years. Of those, 1,297 (39%) had DKA at diagnosis (blood glucose >250 mg/dL, and venous pH <7...
June 30, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28666360/overnight-closed-loop-control-improves-glycemic-control-in-a-multicenter-study-of-adults-with-type-1-diabetes
#17
Sue A Brown, Marc D Breton, Stacey M Anderson, Laura Kollar, Patrick Keith-Hynes, Carol J Levy, David W Lam, Camilla Levister, Nihat Baysal, Yogish C Kudva, Ananda Basu, Vikash Dadlani, Ling Hinshaw, Shelly McCrady-Spitzer, Daniela Bruttomesso, Roberto Visentin, Silvia Galasso, Simone Del Favero, Yenny Leal, Federico Boscari, Angelo Avogaro, Claudio Cobelli, Boris P Kovatchev
Context: Closed-loop control (CLC) for the management of T1D is a novel method for optimizing glucose control and strategies for individualized implementation are being developed. Objective: Analyze glycemic control in an Overnight CLC system designed to "reset" the patient to near normal glycemic targets every morning. Design: Randomized cross-over multicenter clinical trial. Participants: 44 subjects with T1D on insulin pump therapy...
June 28, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28647690/acute-kidney-injury-after-primary-angioplasty-is-contrast-induced-nephropathy-the-culprit
#18
Oren Caspi, Manhal Habib, Yuval Cohen, Arthur Kerner, Ariel Roguin, Eitan Abergel, Monther Boulos, Michael R Kapeliovich, Rafael Beyar, Eugenia Nikolsky, Doron Aronson
BACKGROUND: Acute kidney injury (AKI) following primary percutaneous coronary intervention (pPCI) is frequently interpreted as contrast-induced AKI but may result from other insults. We aimed to determine the causal association of contrast material exposure and the incidence of AKI following pPCI using a control group of propensity score-matched patients with ST-segment-elevation myocardial infarction who were not exposed to contrast material. METHODS AND RESULTS: We studied 2025 patients with ST-segment-elevation myocardial infarction who underwent pPCI and 1025 patients receiving fibrinolysis or no reperfusion who were not exposed to contrast material during the first 72 hours of hospital stay (control group)...
June 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28638147/sensitivity-of-human-pluripotent-stem-cells-to-insulin-precipitation-induced-by-peristaltic-pump-based-medium-circulation-considerations-on-process-development
#19
Diana Massai, Emiliano Bolesani, Diana Robles Diaz, Christina Kropp, Henning Kempf, Caroline Halloin, Ulrich Martin, Tudor Braniste, Giuseppe Isu, Vanessa Harms, Umberto Morbiducci, Gerald Dräger, Robert Zweigerdt
Controlled large-scale production of human pluripotent stem cells (hPSCs) is indispensable for their envisioned clinical translation. Aiming at advanced process development in suspension culture, the sensitivity of hPSC media to continuous peristaltic pump-based circulation, a well-established technology extensively used in hydraulically-driven bioreactors, was investigated. Unexpectedly, conditioning of low protein media (i.e. E8 and TeSR-E8) in a peristaltic pump circuit induced severe viability loss of hPSCs cultured as aggregates in suspension...
June 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28636773/comparison-of-different-insulin-pump-makes-under-routine-care-conditions-in-adults-with-type-1-diabetes
#20
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
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