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https://www.readbyqxmd.com/read/29348570/systematic-in-vivo-evaluation-of-the-time-dependent-inflammatory-response-to-steel-and-teflon-insulin-infusion-catheters
#1
Jasmin R Hauzenberger, Julia Münzker, Petra Kotzbeck, Martin Asslaber, Vladimir Bubalo, Jeffrey I Joseph, Thomas R Pieber
Continuous subcutaneous insulin infusion (CSII) catheters are considered the weak link of insulin pump therapy. Wear-time considerably varies between patients and the choice of catheter material is based on personal preferences rather than scientific facts. Therefore, we systematically assessed and quantified the inflammatory tissue response to steel versus Teflon CSII catheters over a maximum wear-time of 7 days in swine. Tissue surrounding catheters was analysed using histopathology and quantitative real-time PCR...
January 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29344829/rapid-acting-and-regular-insulin-are-equal-for-high-fat-protein-meal-in-individuals-with-type-1-diabetes-treated-with-multiple-daily-injections
#2
Karolina Jabłońska, Piotr Molęda, Krzysztof Safranow, Lilianna Majkowska
INTRODUCTION: The fat and protein content can impact late postprandial glycemia; therefore, prolonged insulin boluses for high-fat/-protein meals are recommended for patients with type 1 diabetes on insulin pump therapy. It is not clear how to translate these findings to multiple daily injection (MDI) therapy. We hypothesized that regular insulin with a slower onset and a longer duration of action might be advantageous for such meals. METHODS: Twenty-five patients with well-controlled type 1 diabetes (mean HbA1c 6...
January 17, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29343452/a-cell-penetrating-peptide-conjugated-carboxymethyl-%C3%AE-cyclodextrin-to-improve-intestinal-absorption-of-insulin
#3
Liuqing Yang, Manman Li, Yusheng Sun, Liefeng Zhang
In this study, a cell-penetrating peptide conjugate, R8-carboxymethyl-β-cyclodextrin (R8-CM-β-CD), was synthesized, and then we prepared the supramolecular complex (insulin/R8-CM-β-CD). The physicochemical properties of the complex were characterized. The supramolecular complex could facilitate the uptake of insulin, meanwhile, induce a significantly higher internalization of insulin. Interestingly, the transportation efficiency of insulin/R8-CM-β-CD across the Caco-2 cell monolayer was about 3 times greater than that of insulin/CM-β-CD...
January 14, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29342264/effect-of-continuous-glucose-monitoring-on-glycemic-control-acute-admissions-and-quality-of-life-a-real-world-study
#4
Sara Charleer, Chantal Mathieu, Frank Nobels, Christophe De Block, Regis P Radermecker, Michel P Hermans, Youri Taes, Chris Vercammen, Guy T'Sjoen, Laurent Crenier, Steffen Fieuws, Bart Keymeulen, Pieter Gillard
Context: Randomized controlled trials evaluating real-time continuous glucose monitoring (RT-CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use. Objective: To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism and quality of life (QOL). Design: Prospective, observational, multicenter, cohort study. Participants: Five hundred fifteen adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program...
January 12, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29340167/subcutaneous-glucagon-infusion-and-continuous-glucose-monitoring-enable-effective-management-of-hypoglycemia-in-a-patient-with-igf-2-producing-hemangiopericytoma
#5
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
https://www.readbyqxmd.com/read/29337383/the-national-pregnancy-in-diabetes-npid-audit-challenges-and-opportunities-for-improving-pregnancy-outcomes
#6
H R Murphy, R Bell, A Dornhorst, R Forde, N Lewis-Barned
Our aim was to review the data from the National Pregnancy in Diabetes (NPID) audit, and to identify the challenges and opportunities for improving pregnancy outcomes in women with diabetes. We reviewed three years of NPID data and relevant diabetes and obstetric literature, and found that there has been little change in pregnancy preparation or outcomes over the past 3 years, with substantial clinic-to clinic variations in care. Women with Type 2 diabetes remain less likely to take 5 mg preconception folic acid (22...
January 16, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29332422/unexpected-management-behaviors-in-adolescents-with-type-1-diabetes-using-sensor-augmented-pump-therapy
#7
Mary Binsu Abraham, Kristine Heels, Jennifer A Nicholas, Carol Cole, Rebecca Gebert, Julie Klimek, Tracey Jopling, Geoffrey Ambler, Fergus Cameron, Elizabeth Davis, Timothy W Jones
BACKGROUND: Continuous glucose monitoring can improve glycemic outcomes in individuals with type 1 diabetes. However, the constant exposure to real-time glucose levels can sometimes lead the individual to make some risky choices to address the glycemic excursions. Hence, the purpose of this study was to explore the aberrant management behaviors of youth with type 1 diabetes on sensor-augmented pump therapy (SAPT). METHODS: Participants in a clinical trial using SAPT on Medtronic MiniMed™ 640G pump who experienced deteriorating glycemic control or unexplained hypoglycemia were identified by the health care professional...
January 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29327220/patient-perceptions-and-preferences-for-a-mealtime-insulin-delivery-patch
#8
Mark Peyrot, Darlene Dreon, Vivien Zraick, Brett Cross, Meng H Tan
INTRODUCTION: A basal-bolus insulin regimen is needed to achieve glycated hemoglobin A1c (HbA1c) below 7.0% in people with type 1 (T1D) or type 2 (T2D) diabetes who have significant loss of beta-cell function. Nonadherence to therapy is common and negatively affects the ability to reach treatment goals. We examined patient assessment of a new, wearable mealtime insulin-delivery system (patch) relative to their current mealtime insulin-delivery system (syringe, pen, or pump). The patch is designed to deliver only boluses of fast-acting insulin (no basal insulin), mechanically controlled by the patient...
January 11, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29324494/myocardial-protection-by-glucose-insulin-potassium-in-moderate-to-high-risk-patients-undergoing-elective-on-pump-cardiac-surgery-a-randomized-controlled-trial
#9
Christoph Ellenberger, Tornike Sologashvili, Lukas Kreienbühl, Mustafa Cikirikcioglu, John Diaper, Marc Licker
BACKGROUND: Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose-insulin-potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery. METHODS: A randomized controlled trial was performed in adult patients (Bernstein-Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29321388/suppression-of-abdominal-aortic-aneurysm-formation-in-mice-by-teneligliptin-a-dipeptidyl-peptidase-4-inhibitor
#10
Yusuke Takahara, Tomotake Tokunou, Toshihiro Ichiki
AIM: Dipeptidyl peptidase-4 (DPP-4) inhibitors lower blood glucose levels through inhibition of incretin degradation, which stimulates insulin secretion. Recent studies reported that DPP-4 inhibitors suppressed atherogenesis in apolipoprotein E-knockout (ApoEKO) mice. In this study, we investigated whether teneligliptin, a DPP-4 inhibitor, affects the development of abdominal aortic aneurysms (AAA) in ApoEKO mice. METHODS: ApoEKO mice were fed a high-fat diet (HFD) and infused with angiotensin (Ang) II by osmotic mini pumps for 4 weeks to induce AAA with (DPP-4i group) or without (control group) teneligliptin administered orally from 1 week before HFD and Ang II infusion to the end of the experiment...
January 10, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29316338/efficacy-of-automatic-bolus-calculator-with-automatic-speech-recognition-in-patients-with-type-1-diabetes-a-randomized-crossover-trial
#11
Piotr Foltynski, Piotr Ladyzynski, Ewa Pankowska, Karolina Mazurczak
BACKGROUND: Patients using an insulin pump as part of their diabetes treatment need to calculate insulin bolus to compensate for a meal. Some patients do not modify their meal boluses according to the changing amount and composition of food products in a meal. The lack of correct meal boluses leads to unstable, and therefore harmful blood glucose levels. The aim of the current study was to test the system supporting bolus determination based on the voice description of a meal. METHODS: The developed bolus calculator consists of the smartphone application and three remote servers for automatic speech recognition, text analysis, and insulin dosage calculation...
January 8, 2018: Journal of Diabetes
https://www.readbyqxmd.com/read/29306619/comparative-study-between-conventional-fasting-versus-overnight-infusion-of-lipid-or-carbohydrate-on-insulin-and-free-fatty-acids-in-obese-patients-undergoing-elective-on-pump-coronary-artery-bypass-grafting-a-prospective-randomized-trial
#12
Hisham Hosny, Mohamed Ibrahim, Wael El-Siory, Amr Abdel-Monem
OBJECTIVES: Postoperative insulin resistance represents a major component of postoperative metabolic disorder. The authors compared the effects of preoperative infusion of lipid emulsion or carbohydrate to conventional preoperative fasting on postoperative insulin and free fatty acid (FFA) levels. DESIGN: A prospective randomized double-blinded study. SETTINGS: Tertiary university hospital. PARTICIPANTS: Sixty-three patients undergoing coronary artery bypass grafting...
November 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29303370/the-effects-of-subcutaneous-insulin-infusion-versus-multiple-insulin-injections-on-glucose-variability-in-young-adults-with-type-1-diabetes-the-2-year-follow-up-of-the-observational-metro-study
#13
Maria Ida Maiorino, Giuseppe Bellastella, Ofelia Casciano, Paolo Cirillo, Vittorio Simeon, Paolo Chiodini, Michela Petrizzo, Maurizio Gicchino, Ornella Romano, Paola Caruso, Dario Giugliano, Katherine Esposito
BACKGROUND: Type 1 diabetic patients have high instability of daily glucose levels. The aim of this study was to evaluate the long-term effects of continuous subcutaneous insulin infusion (CSII) therapy, compared with multiple daily injections of insulin (MDI), on glucose variability, in young type 1 diabetic patients transitioned to the adult diabetes care. METHODS: Patients aged 18-30 years and considered eligible for insulin pump therapy were included in the study...
January 5, 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29298818/fifteen-minute-consultation-insulin-pumps-for-type-1-diabetes-in-children-and-young-people
#14
Philippa Prentice, Daniela Elleri
There is increasing worldwide use of continuous subcutaneous insulin infusions in paediatric type 1 diabetes (T1D), reflecting recent research outcomes and guidance, as well as families' wishes. Children/young people may present acutely with medical or surgical problems, in addition to issues related to T1D. This review provides general paediatricians with an introduction to pump therapy, highlighting common problems, management issues and when to seek specialist advice.
January 3, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29295580/diabetic-ketoacidosis-severity-at-diagnosis-and-glycaemic-control-in-the-first-year-of-childhood-onset-type-1-diabetes-a-longitudinal-cohort-study
#15
Amal R Khanolkar, Rakesh Amin, David Taylor-Robinson, Russell M Viner, Justin Warner, Evelien F Gevers, Terence Stephenson
It is unclear whether diabetic ketoacidosis (DKA) severity at diagnosis affects the natural history of type 1 diabetes (T1D). We analysed associations between DKA severity at diagnosis and glycaemic control during the first year post-diagnosis. We followed 341 children with T1D, <19 years (64% non-white) attending paediatric diabetes clinics in East London. Data were extracted from routine medical registers. Subjects were categorized with normal, mild, moderate, or severe DKA. Linear mixed-effects modelling was used to assess differences in longitudinal HbA1c trajectories (glycaemic control) during 12 months post-diagnosis (1288 HbA1c data-points) based on DKA, adjusting for sex, age, ethnicity, SES (Socioeconomic Status) and treatment type...
December 25, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29288524/insulin-deficiency-with-and-without-glucagon-a-comparative-study-between-total-pancreatectomy-and-type-1-diabetes
#16
Fumimaru Niwano, Yoshihisa Hiromine, Shinsuke Noso, Naru Babaya, Hiroyuki Ito, Sara Yasutake, Ippei Matsumoto, Yoshifumi Takeyama, Yumiko Kawabata, Hiroshi Ikegami
AIMS: Patients with total pancreatectomy and type 1 diabetes are similar in absolute insulin deficiency, but different in glucagon, providing unique opportunity to study the contribution of glucagon on glucose metabolism in insulin-dependent state. To investigate the contribution of glucagon to glucose homeostasis in complete insulin deficiency in vivo. METHODS: A total of 38 subjects with a complete lack of endogenous insulin (fasting C-peptide < 0.0066 nmol/L) and whose glycemic control was optimized with an insulin pump during hospitalization were retrospectively studied...
December 30, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29285796/weight-based-carbohydrate-treatment-of-hypoglycaemia-in-people-with-type-1-diabetes-using-insulin-pump-therapy-a-randomized-crossover-clinical-trial
#17
L McTavish, B Corley, M Weatherall, E Wiltshire, J D Krebs
AIM: To test whether weight-based treatment is more effective than usual care in people with Type 1 diabetes receiving continuous subcutaneous insulin infusion therapy with regard to both hypoglycaemia and avoiding excessive rebound hyperglycaemia. METHODS: Children and adults on continuous subcutaneous insulin infusion were enrolled into a study with a crossover design. Each episode of hypoglycaemia (defined as capillary glucose <4.0 mmol/l) was randomly assigned one of two treatment protocols using glucose tablets: either 0...
December 28, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29284290/occlusion-detection-time-in-insulin-pumps-at-two-different-basal-rates
#18
Guido Freckmann, Ulrike Kamecke, Delia Waldenmaier, Cornelia Haug, Ralph Ziegler
BACKGROUND: The detection of insulin infusion set (IIS) occlusions is an important feature of insulin pumps with regard to patient safety. However, there are no requirements for a time limit until an alarm has to be triggered after an occlusion occurred. The standard IEC 60601-2-24 is applicable for insulin pumps and describes test settings and procedures to determine occlusion detection time (ODT). METHODS: In this study, ODT of six different insulin pump models with different IIS (in total 10 different insulin pump systems) was tested for two basal rates (1...
December 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29277329/human-embryonic-stem-cell-derived-cardiomyocytes-as-an-in-vitro-model-to-study-cardiac-insulin-resistance
#19
Ilvy M E Geraets, Dipanjan Chanda, Florence H J van Tienen, Arthur van den Wijngaard, Rick Kamps, Dietbert Neumann, Yilin Liu, Jan F C Glatz, Joost J F P Luiken, Miranda Nabben
Patients with type 2 diabetes (T2D) and/or insulin resistance (IR) have an increased risk for the development of heart failure (HF). Evidence indicates that this increased risk is linked to an altered cardiac substrate preference of the insulin resistant heart, which shifts from a balanced utilization of glucose and long-chain fatty acids (FAs) towards an almost complete reliance on FAs as main fuel source. This shift leads to a loss of endosomal proton pump activity and increased cardiac fat accumulation, which eventually triggers cardiac dysfunction...
December 20, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29273897/impact-of-flash-glucose-monitoring-on-hypoglycaemia-in-adults-with-type-1-diabetes-managed-with-multiple-daily-injection-therapy-a-pre-specified-subgroup-analysis-of-the-impact-randomised-controlled-trial
#20
Per Oskarsson, Ramiro Antuna, Petronella Geelhoed-Duijvestijn, Jens Krӧger, Raimund Weitgasser, Jan Bolinder
AIMS/HYPOTHESIS: Evidence for the effectiveness of interstitial glucose monitoring in individuals with type 1 diabetes using multiple daily injection (MDI) therapy is limited. In this pre-specified subgroup analysis of the Novel Glucose-Sensing Technology and Hypoglycemia in Type 1 Diabetes: a Multicentre, Non-masked, Randomised Controlled Trial' (IMPACT), we assessed the impact of flash glucose technology on hypoglycaemia compared with capillary glucose monitoring. METHODS: This multicentre, prospective, non-masked, RCT enrolled adults from 23 European diabetes centres...
December 23, 2017: Diabetologia
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