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Insulin pump

I Schütz-Fuhrmann, J Castañeda, Y Reznik, R Aronson, I Conget, S Liabat, S Runzis, S de Portu, O Cohen
The recent OpT2mise randomized trial compared the efficacy of insulin pump therapy and multiple daily injections (MDI) in people with Type 2 diabetes and HbA1c levels that remained ≥64 mmol/mol (8.0%) despite insulin dose optimization [1,2]. During the initial 6-month randomized phase of the study, pump therapy was shown to produce a significant improvement in glycaemic control and a 20% reduction in total daily insulin dose, compared with MDI therapy [1], and these benefits were sustained during the subsequent 6-month extension phase during which all participants received pump therapy [2]...
October 22, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Ruth S Weinstock, Ingrid Schütz-Fuhrmann, Crystal G Connor, Julia M Hermann, David M Maahs, Morten Schütt, Shivani Agarwal, Sabine E Hofer, Roy W Beck, Reinhard W Holl
AIMS: Compare characteristics, therapies and clinical outcomes in older adults with type 1 diabetes in the United States T1D Exchange (T1DX) and German/Austrian Diabetes Patienten Verlaufsdokumentation (DPV) registries. METHODS: Cross-sectional study of adults ≥60years old with type 1 diabetes seen in 2011-2012 in the T1DX (n=1283) and DPV (n=2014) registries. Wilcoxon rank-sum test was used for continuous variables and chi-square test for categorical variables...
October 4, 2016: Diabetes Research and Clinical Practice
Hikari Takeshita, Masao Takeda, Koichi Yamamoto, Hiromi Rakugi
OBJECTIVE: Angiotensin converting enzyme2 (ACE2), an enzyme that produces the Angiotensin 1-7(A1-7) from Angiotensin II, is considered to suppress organ damage by inhibition of the activation of renin-angiotensin system. We recently found that ACE2 deficiency in mice ameliorated insulin sensitivity of skeletal muscle with reduced expression of glucose transporter 4 and myocyte enhancer factor 2, an important transcription factor to maintain homeostasis of skeletal muscle. In this study, we investigated whether ACE2-A1-7 axis plays a protective role in aging-associated loss of skeletal muscle function in mice...
September 2016: Journal of Hypertension
Jeniece Trast Ilkowitz, Steven Choi, Michael L Rinke, Kathy Vandervoot, Rubina A Heptulla
BACKGROUND: Diabetes ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM). Reducing DKA admissions in children with T1DM requires a coordinated, comprehensive management plan. We aimed to decrease DKA admissions, 30-day readmissions, and length of stay (LOS) for DKA admissions. METHODS: A multipronged intervention was designed in 2011 to reach all patients: (1) increase insulin pump use and basal-bolus regimen versus sliding scales, (2) transform educational program, (3) increased access to medical providers, and (4) support for patients and families...
October 2016: Quality Management in Health Care
William F Kendall, Emmanuel C Opara
Since the discovery of insulin by Banting and Best in 1921, the prognosis and treatment options for individuals with diabetes have improved. The development of various insulin types, various oral agents, and insulin pumps have improved the available medical options for individuals afflicted with diabetes. The current need for frequent blood glucose monitoring imposed by multiple daily insulin injections, result in significant life-style challenges for in individuals afflicted with Type 1 diabetes (T1D). In contrast the use of surgical interventions, such as whole organ pancreas transplantation (PT) requires less-intensive glucose monitoring while the organ is viable...
2017: Methods in Molecular Biology
Rebecca Johnson
Some people with well-managed insulin-dependent diabetes can dive safely. Those cleared to participate should control tightly the variables that impact blood glucose levels, including activity, timing, food and insulin. Honest self-assessment is critical. A diabetic diver should cancel a dive if seasick, unusually anxious, or following significant high or low blood glucose levels in the preceding 24 hours. The diver should enter the water with a blood glucose level above 8.3 mmol·L⁻¹ and below 14 mmol·L⁻¹ with a stable or rising trend in blood glucose established with glucose tests at 90, 60, and 30 minutes prior to a dive...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Anika Sahr, Carmen Wolke, Jonas Maczewsky, Peter Krippeit-Drews, Anja Tetzner, Gisela Drews, Simone Venz, Sarah Gürtler, Jens van den Brandt, Sabine Berg, Paula Döring, Frank Dombrowski, Thomas Walther, Uwe Lendeckel
The ACE2/angiotensin (Ang)-(1-7)/Mas axis of the renin-angiotensin system (RAS) often opposes the detrimental effects of the ACE/AngII/AT1 axis and has been associated with beneficial effects on glucose homeostasis, while underlying mechanisms are mostly unknown. Here, we investigate the effects of Ang-(1-7) and its receptor Mas on β-cell function. Isolated islets from Mas-deficient and wild-type mice were stimulated with Ang-(1-7) or its antagonists and effects on insulin secretion determined. Islets' cytoplasmic calcium and cAMP concentrations, mRNA amounts of Ins1, Ins2, Pdx1, and Mafa, and effects of inhibitors of cAMP downstream signaling were determined...
October 7, 2016: Endocrinology
Tim Heise, Eric Zijlstra, Leszek Nosek, Tord Rikte, Hanne Haahr
AIMS: Continuous subcutaneous insulin infusion (CSII) is increasingly used in patients with diabetes. Faster-acting insulin aspart (faster aspart) is insulin aspart (IAsp) in a new formulation with a faster time-action profile. We evaluated the pharmacological characteristics of faster aspart versus IAsp> during CSII. MATERIALS AND METHODS: In this randomised, double-blind, crossover trial, 48 men and women aged 18-64 years with type 1 diabetes mellitus (T1DM) received faster aspart and IAsp as a 0...
October 6, 2016: Diabetes, Obesity & Metabolism
Steef Kurstjens, Jeroen De Baaij, Hacene Bouras, René Bindels, Cees J Tack, Joost Hoenderop
Background Hypomagnesemia (plasma magnesium (Mg2+) concentration <0.7 mmol/L) has been described in patients with type 2 diabetes. Polypharmacy is inevitable when treating a complex disease such as type 2 diabetes and could explain disturbances in the plasma Mg2+ concentration. In this study, we aimed to establish the extent of hypomagnesemia in a cohort of type 2 diabetes patients and to identify determinants of plasma Mg2+ levels. Methods Patient data and samples of 395 type 2 diabetes patients were investigated...
October 5, 2016: European Journal of Endocrinology
J Kropff, J DeJong, S Del Favero, J Place, M Messori, B Coestier, A Farret, F Boscari, S Galasso, A Avogaro, D Bruttomesso, C Cobelli, E Renard, L Magni, J H DeVries
AIM: To assess the impact on fear of hypoglycaemia and treatment satisfaction with an artificial pancreas system used for 2 consecutive months, as well as participant acceptance of the artificial pancreas system. METHODS: In a randomized crossover trial participant-related outcomes associated with an evening-and-night artificial pancreas and sensor-augmented pump therapy were compared. Both intervention periods lasted 8 weeks. The artificial pancreas acceptance questionnaire (range 0-90, higher scores better), Hypoglycaemia Fear Survey II (range 0-72, higher scores worse) and Diabetes Treatment Satisfaction Questionnaire (range 0-36, higher scores better) were completed by 32 participants...
October 1, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Ravi Gondhalekar, Eyal Dassau, Francis J Doyle
A novel Model Predictive Control (MPC) law for an Artificial Pancreas (AP) to automatically deliver insulin to people with type 1 diabetes is proposed. The MPC law is an enhancement of the authors' zone-MPC approach that has successfully been trialled in-clinic, and targets the safe outpatient deployment of an AP. The MPC law controls blood-glucose levels to a diurnally time-dependent zone, and enforces diurnal, hard input constraints. The main algorithmic novelty is the use of asymmetric input costs in the MPC problem's objective function...
September 2016: Automatica: the Journal of IFAC, the International Federation of Automatic Control
Giovanni Landoni, Antonio Pisano, Vladimir Lomivorotov, Gabriele Alvaro, Ludhmila Hajjar, Gianluca Paternoster, Caetano Nigro Neto, Nicola Latronico, Evgeny Fominskiy, Laura Pasin, Gabriele Finco, Rosetta Lobreglio, Maria Luisa Azzolini, Giuseppe Buscaglia, Alberto Castella, Marco Comis, Adele Conte, Massimiliano Conte, Francesco Corradi, Erika Dal Checco, Giovanni De Vuono, Marco Ganzaroli, Eugenio Garofalo, Gordana Gazivoda, Rosalba Lembo, Daniele Marianello, Martina Baiardo Redaelli, Fabrizio Monaco, Valentina Tarzia, Marta Mucchetti, Alessandro Belletti, Paolo Mura, Mario Musu, Giovanni Pala, Massimiliano Paltenghi, Vadim Pasyuga, Desiderio Piras, Claudio Riefolo, Agostino Roasio, Laura Ruggeri, Francesco Santini, Andrea Székely, Luigi Verniero, Antonella Vezzani, Alberto Zangrillo, Rinaldo Bellomo
OBJECTIVE: Of the 230 million patients undergoing major surgical procedures every year, more than 1 million will die within 30 days. Thus, any nonsurgical interventions that help reduce perioperative mortality might save thousands of lives. The authors have updated a previous consensus process to identify all the nonsurgical interventions, supported by randomized evidence, that may help reduce perioperative mortality. DESIGN AND SETTING: A web-based international consensus conference...
August 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Linda A Gonder-Frederick, Jaclyn A Shepard, Jesse H Grabman, Lee M Ritterband
Use of technology in diabetes management is rapidly advancing and has the potential to help individuals with diabetes achieve optimal glycemic control. Over the past 40 years, several devices have been developed and refined, including the blood glucose meter, insulin pump, and continuous glucose monitor. When used in tandem, the insulin pump and continuous glucose monitor have prompted the Artificial Pancreas initiative, aimed at developing control system for fully automating glucose monitoring and insulin delivery...
October 2016: American Psychologist
Ioannis Christakis, Rebecca Scott, James Minnion, Joyceline Cuenco, Tricia Tan, Fausto Palazzo, Stephen Bloom
PURPOSE/AIM OF THE STUDY: The pharmacokinetic (PK) parameters in animal models can help optimize novel candidate drugs prior to human trials. However, due to the complexity of pharmacokinetic experiments, their use is limited in academia. We present a novel surgical rat model for investigation of pharmacokinetic parameters and its use in an anti-obesity drug development program. MATERIALS AND METHODS: The model uses anesthetized male Wistar rats, a jugular, a femoral catheter, and an insulin pump for peptide infusion...
September 30, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Alex Zhong, Pratik Choudhary, Chantal McMahon, Pratik Agrawal, John B Welsh, Toni L Cordero, Francine R Kaufman
BACKGROUND: Automated insulin management features of the MiniMed(®) 640G sensor-augmented pump system include suspension in response to predicted low sensor glucose (SG) values ("suspend before low"), suspension in response to existing low SG values ("suspend on low"), and automatic restarting of basal insulin delivery upon SG recovery. The effectiveness of these features was evaluated using CareLink(®) software data. METHODS: Anonymized data from MiniMed 640G system users (n = 4818), MiniMed 530G system users (n = 39,219), and MiniMed Paradigm(®) Veo™ system users (n = 43,193) who voluntarily uploaded pump and sensor data were retrospectively analyzed...
October 2016: Diabetes Technology & Therapeutics
Erin McKergow, Lianne Parkin, David J Barson, Katrina J Sharples, Benjamin J Wheeler
AIMS: Insulin pumps have been publically funded in New Zealand since 2012 for patients who meet certain clinical criteria; however, the patterns of utilization have not been described. We undertook a nationwide study to estimate the annual proportions of patients with type 1 diabetes mellitus who used a pump between 2012 and 2014, overall, and according to sex, age, ethnicity, socioeconomic position, and region. METHODS: We used data from the New Zealand Virtual Diabetes Register and routinely collected national demographic, health, and pharmaceutical dispensing data from the Ministry of Health to identify patients with type 1 diabetes and to calculate the overall, and subgroup, proportions using pumps...
September 20, 2016: Acta Diabetologica
Hikari Takeshita, Masao Takeda, Koichi Yamamoto, Hiromi Rakugi
OBJECTIVE: Angiotensin converting enzyme2 (ACE2), an enzyme that produces the Angiotensin 1-7(A1-7) from Angiotensin II, is considered to suppress organ damage by inhibition of the activation of renin-angiotensin system. We recently found that ACE2 deficiency in mice ameliorated insulin sensitivity of skeletal muscle with reduced expression of glucose transporter 4 and myocyte enhancer factor 2, an important transcription factor to maintain homeostasis of skeletal muscle. In this study, we investigated whether ACE2-A1-7 axis plays a protective role in aging-associated loss of skeletal muscle function in mice...
September 2016: Journal of Hypertension
Marzia Cescon, Daniel J DeSalvo, Trang T Ly, David M Maahs, Laurel H Messer, Bruce A Buckingham, Francis J Doyle, Eyal Dassau
BACKGROUND: Insulin infusion set failure resulting in prolonged hyperglycemia or diabetic ketoacidosis can occur with pump therapy in type 1 diabetes. Set failures are frequently characterized by variable and unpredictable patterns of increasing glucose values despite increased insulin infusion. Early detection may minimize the risk of prolonged hyperglycemia, an important consideration for automated insulin delivery and closed-loop applications. METHODS: A novel algorithm designed to alert the patient to the onset of infusion set failure was developed based upon continuous glucose sensor values and insulin delivered from an insulin pump...
September 12, 2016: Journal of Diabetes Science and Technology
Ohad Cohen, William Valentine
BACKGROUND: Continuous subcutaneous insulin infusion (CSII) is used less for type 2 than for type 1 diabetes because of inconsistencies in evidence of effectiveness. We reviewed published guidelines on intensive insulin therapy in type 2 diabetes to assess whether updating of guidance is needed with respect to evidence used and recommendations for CSII in diabetes management. METHODS: A literature review was performed to identify published national and international guidelines on type 2 diabetes management...
September 12, 2016: Journal of Diabetes Science and Technology
M I Maiorino, G Bellastella, F Castaldo, M Petrizzo, D Giugliano, K Esposito
PURPOSE: The aim of this study was to evaluate the prevalence and risk factors associated with female sexual dysfunction (FSD) in young women with type 1 diabetes treated with different intensive insulin regimens. METHODS: Type 1 diabetic women aged 18-35 years were included in this study if they had stable couple relationship and no oral contraceptive use. All women were asked to complete the Female Sexual Function Index (FSFI) and other validated multiple-choice questionnaires assessing sexual-related distress (Female Sexual Distress Scale, FSDS), quality of life (SF-36 Health Survey), physical activity (International Physical Activity Questionnaire), depressive symptoms (Zung Self-Rating Depression Scale, SRDS) and diabetes-related problems (Diabetes Integration Scale ATT-19)...
September 9, 2016: Journal of Endocrinological Investigation
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