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Continuous subcutaneous insulin infusion

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https://www.readbyqxmd.com/read/28636773/comparison-of-different-insulin-pump-makes-under-routine-care-conditions-in-adults-with-type-1-diabetes
#1
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
https://www.readbyqxmd.com/read/28613947/the-effects-of-basal-insulin-suspension-at-the-start-of-exercise-on-blood-glucose-levels-during-continuous-versus-circuit-based-exercise-in-individuals-with-type-1-diabetes-on-continuous-subcutaneous-insulin-infusion
#2
Dessi Zaharieva, Loren Yavelberg, Veronica Jamnik, Ali Cinar, Kamuran Turksoy, Michael C Riddell
BACKGROUND: Exercise causes glycemic disturbances in individuals with type 1 diabetes (T1D). Continuous moderate-intensity aerobic exercise (CON) generally lowers blood glucose (BG) levels and often leads to hypoglycemia. In comparison, circuit-based exercise (CIRC) may attenuate the drop in BG. The goal of this study is to contrast the effects of basal insulin suspension at the onset of two different forms of exercise (CON vs. CIRC). METHODS: Twelve individuals (six men and six women) with T1D on insulin pump therapy were recruited for the study...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28609547/intensive-insulin-therapy-combined-with-metformin-is-associated-with-reduced-glucose-variability-and-nocturnal-hypoglycemia-in-patients-with-type-2-diabetes
#3
Yifei Zhang, Zhiyun Zhao, Shujie Wang, Wei Zhu, Yiran Jiang, Shouyue Sun, Chen Chen, Kai Wang, Liangshan Mu, Jinyi Cao, Yingxia Zhou, Weiqiong Gu, Jie Hong, Weiqing Wang, Guang Ning
BACKGROUND: The effect on glucose variability in patients with intensive insulin therapy has not been fully understood. This observational study investigated the different glucose variability and hypoglycemia pattern in type 2 diabetes patients treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) with or without metformin administration. METHODS: During hospitalization, totally 501 patients with poor glycemic control and in initial treatment with either CSII alone (n = 187), CSII + Metformin (n = 81), MDI alone (n = 146) or MDI + Metformin (n = 87), were involved in the final analysis...
June 13, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28586529/reproducibility-of-the-plasma-glucose-response-to-moderate-intensity-exercise-in-adolescents-with-type-1-diabetes
#4
M B Abraham, R J Davey, M N Cooper, N Paramalingam, M J O'Grady, T T Ly, T W Jones, P A Fournier, E A Davis
AIMS: The aim of the study was to evaluate the reproducibility of the plasma glucose response to moderate-intensity exercise performed on different days under controlled conditions in adolescents with Type 1 diabetes. METHODS: Eight adolescents with Type 1 diabetes on continuous subcutaneous insulin infusion completed two exercise sessions, each on two separate days, under basal insulin and fasting conditions. On each day, participants cycled twice for 30 min at 55% of their peak rate of oxygen consumption, with each exercise session separated by a 30-min rest...
June 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28585879/continuous-glucose-monitoring-a-review-of-recent-studies-demonstrating-improved-glycemic-outcomes
#5
David Rodbard
Continuous Glucose Monitoring (CGM) has been demonstrated to be clinically valuable, reducing risks of hypoglycemia and hyperglycemia, glycemic variability (GV), and improving patient quality of life for a wide range of patient populations and clinical indications. Use of CGM can help reduce HbA1c and mean glucose. One CGM device, with accuracy (%MARD) of approximately 10%, has recently been approved for self-adjustment of insulin dosages (nonadjuvant use) and approved for reimbursement for therapeutic use in the United States...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28585876/cgm-pregnancy-and-remote-monitoring
#6
Sarit Polsky, Rachel Garcetti
The glycemic goals of pregnancy are very narrow to reduce excess risks for numerous maternal and fetal complications. Continuous glucose monitors (CGMs) may help women achieve glucose goals and reduce hypoglycemia. CGM use has been found to be safe and effective in pregnancies associated with diabetes. CGM use can accurately identify glycemic patterns among women with and without diabetes in pregnancy. The data on the effects of CGM use on maternal and fetal outcomes are conflicting. Using CGMs in conjunction with continuous subcutaneous insulin infusion therapy in pregnancies complicated by diabetes may improve outcomes...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28573460/brain-glp-1-igf-1-signaling-and-autophagy-mediate-exendin-4-protection-against-apoptosis-in-type-2-diabetic-rats
#7
Emanuel Candeias, Inês Sebastião, Susana Cardoso, Cristina Carvalho, Maria Sancha Santos, Catarina Resende Oliveira, Paula I Moreira, Ana I Duarte
Type 2 diabetes (T2D) is a modern socioeconomic burden, mostly due to its long-term complications affecting nearly all tissues. One of them is the brain, whose dysfunctional intracellular quality control mechanisms (namely autophagy) may upregulate apoptosis, leading to cognitive dysfunction and Alzheimer disease (AD). Since impaired brain insulin signaling may constitute the crosslink between T2D and AD, its restoration may be potentially therapeutic herein. Accordingly, the insulinotropic anti-T2D drugs from glucagon-like peptide-1 (GLP-1) mimetics, namely, exendin-4 (Ex-4), could be a promising therapy...
June 2, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28571200/inhaled-insulin-current-direction-of-insulin-research
#8
REVIEW
Rashmi Ranjan Mohanty, Smita Das
Diabetes Mellitus (DM) is a metabolic disorder characterized by relative or absolute deficiency of insulin, resulting in hyperglycemia. Subcutaneous insulin and Oral Hypoglycaemic Agents (OHA) constitute the main treatment option for DM. Insulin is administered by injection or continuous infusion to control glucose levels mainly in Type I diabetes. Newer routes both oral and non oral, for insulin administration are current direction of insulin research as insulin injection therapy is burdensome and painful for many patients...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28569076/clinical-impact-of-blood-glucose-monitoring-accuracy-an-in-silico-study
#9
Enrique Campos-Náñez, Kurt Fortwaengler, Marc D Breton
BACKGROUND: Patients with diabetes rely on blood glucose (BG) monitoring devices to manage their condition. As some self-monitoring devices are becoming more and more accurate, it becomes critical to understand the relationship between system accuracy and clinical outcomes, and the potential benefits of analytical accuracy. METHODS: We conducted a 30-day in-silico study in type 1 diabetes mellitus (T1DM) patients using continuous subcutaneous insulin infusion (CSII) therapy and a variety of BG meters, using the FDA-approved University of Virginia (UVA)/Padova Type 1 Simulator...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28568379/ketoacidosis-at-onset-of-type-1-diabetes-is-a-predictor-of-long-term-glycemic-control
#10
Shlomit Shalitin, Sharon Fisher, Michal Yackbovitch-Gavan, Liat de Vries, Liora Lazar, Yael Lebenthal, Moshe Phillip
BACKGROUND: Few studies have evaluated the impact of diabetic ketoacidosis (DKA) at diabetes onset on long-term glycemic control in patients with type 1 diabetes (T1D). OBJECTIVE: We aimed to determine any differences in long-term glycemic control between children/adolescents with T1D presenting with DKA at diabetes onset and those without. METHODS: This retrospective study comprised 335 patients diagnosed with T1D from September 2007 to December 2012, among which 132 (39...
June 1, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28544684/insulin-glulisine-for-continuous-subcutaneous-insulin-infusion-in-pediatric-type-1-diabetes
#11
Tatsuhiko Urakami, Yusuke Mine, Masako Aoki, Misako Okuno, Junichi Suzuki
We evaluated the efficacy and safety of insulin glulisine (GLU) used for continuous s.c. insulin infusion (CSII) in 20 children with type 1 diabetes after 1 year of GLU treatment. There were no significant differences in mean plasma glucose before breakfast and before dinner between before and after using GLU, but the levels after breakfast and after dinner significantly improved, from 192.5 ± 31.7 to 162.0 ± 27.3 mg/dL for breakfast, and from 191.1 ± 33.3 to 161.1 ± 24.5 mg/dL for dinner (P < 0...
May 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28541131/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-1-diabetes
#12
David Slattery, Pratik Choudhary
With the emphasis on intensive management of type 1 diabetes, data from studies support frequent monitoring of glucose levels to improve glycemic control and reduce glucose variability, which can be related to an increase in macro and microvascular complications. However, few perform capillary blood glucose that frequently. There are currently two available alternatives that this review will discuss, continuous glucose monitoring (CGM) and flash glucose monitoring. CGM has become an important diagnostic and therapeutic option in optimizing diabetes management...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28533136/effect-of-artificial-pancreas-systems-on-glycaemic-control-in-patients-with-type-1-diabetes-a-systematic-review-and-meta-analysis-of-outpatient-randomised-controlled-trials
#13
Alanna Weisman, Johnny-Wei Bai, Marina Cardinez, Caroline K Kramer, Bruce A Perkins
BACKGROUND: Closed-loop artificial pancreas systems have been in development for several years, including assessment in numerous varied outpatient clinical trials. We aimed to summarise the efficacy and safety of artificial pancreas systems in outpatient settings and explore the clinical and technical factors that can affect their performance. METHODS: We did a systematic review and meta-analysis of randomised controlled trials comparing artificial pancreas systems (insulin only or insulin plus glucagon) with conventional pump therapy (continuous subcutaneous insulin infusion [CSII] with blinded continuous glucose monitoring [CGM] or unblinded sensor-augmented pump [SAP] therapy) in adults and children with type 1 diabetes...
May 19, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28527646/high-dose-amino-acid-administration-achieves-an-anabolic-response-in-type-2-diabetic-patients-that-is-independent-of-glycaemic-control-a-randomized-clinical-trial
#14
Chelsia Gillis, Patricia S Roque, Jürgen Bläss, Albert Urwyler, Harald Schepperle, Guido Kunz, Thomas Peters, Thomas Schricker, Linda Wykes, Andrea Kopp Lugli
BACKGROUND & AIMS: Surgical stress provokes protein catabolism and hyperglycaemia that is enhanced in patients with type 2 diabetes (T2DM), and increases perioperative morbidity. This study hypothesized that perioperative administration of high dose intravenous (IV) amino acids (AA) will augment protein balance in T2DM patients receiving tight plasma glucose control via continuous IV insulin compared to standard plasma glucose control via subcutaneous (SC) insulin sliding scale. METHODS: Eighteen patients with well-controlled T2DM (HbA1C% < 7...
May 3, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28527303/insulin-therapy-in-neonatal-diabetes-mellitus-a-review-of-the-literature
#15
REVIEW
Ivana Rabbone, Fabrizio Barbetti, Raffaella Gentilella, Gilberto Mossetto, Riccardo Bonfanti, Claudio Maffeis, Dario Iafusco, Elvira Piccinno
AIMS: Neonatal diabetes mellitus (NDM) is a rare disorder, and guidance is limited regarding its optimal management. We reviewed insulin usage in NDM, with a focus on continuous subcutaneous insulin infusion (CSII). METHODS: A PubMed search identified 40 reports of patients with NDM treated with insulin published between 1994 and 2016. RESULTS: Data concerning treatment of NDM are limited. CSII resolves some of the issues associated with insulin therapy in neonates...
July 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#16
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28503717/a-review-of-the-current-challenges-associated-with-the-development-of-an-artificial-pancreas-by-a-double-subcutaneous-approach
#17
REVIEW
Sverre Christian Christiansen, Anders Lyngvi Fougner, Øyvind Stavdahl, Konstanze Kölle, Reinold Ellingsen, Sven Magnus Carlsen
INTRODUCTION: Patients with diabetes type 1 (DM1) struggle daily to achieve good glucose control. The last decade has seen a rush of research groups working towards an artificial pancreas (AP) through the application of a double subcutaneous approach, i.e., subcutaneous (SC) continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion. Few have focused on the fundamental limitations of this approach, especially regarding outcome measures beyond time in range. METHODS: Based on insulin physiology, the limitations of CGM, SC insulin absorption, meal challenge, and physical activity in DM1 patients, we discuss the limitations of the double SC approach...
June 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28489810/a-case-report-of-hereditary-neuropathy-with-liability-to-pressure-palsies-accompanied-by-type-2-diabetes-mellitus-and-psoriasis
#18
Jing Li, Bing Niu, Xiaoling Wang, Huaiqiang Hu, Bingzhen Cao
RATIONALE: Hereditary neuropathy with liability to pressure palsy (HNPP) is an episodic, multifocal neuropathy, with a typical clinical presentation of recurrent transient pressure palsies, which is induced by a PMP22 deletion. Another neuropathy caused by a PMP22 duplication is Charcot-Marie-Tooth disease type 1A (CMT1A). PMP22 is a gene coding a protein called peripheral myelin protein 22 (PMP22), which plays an essential role in the formation and maintenance of compact myelin. Coexistence of type 2 diabetes mellitus (T2DM) and CMT1A has been reported in many work, however HNPP patients with T2DM are rare, and comorbidity of HNPP and psoriasis has not been reported previously...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28484424/continuous-subcutaneous-insulin-infusion-in-children-a-pilot-study-validating-a-protocol-to-avoid-hypoglycemia-at-initiation
#19
Despoina Manousaki, Johnny Deladoëy, Louis Geoffroy, Patricia Olivier
BACKGROUND: The occurrence of hypoglycemia and hyperglycemia during the first days after transition to continuous subcutaneous insulin infusion (CSII) in patients with type 1 diabetes has not been systematically studied in children. The aim of this prospective study was to demonstrate that the protocol applied in our diabetes clinic is safe at CSII initiation in children. METHODS: We assessed 22 pediatric patients with type 1 diabetes, using continuous glucose monitoring (CGM) before and after CSII initiation (±3 days)...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28437786/the-effect-of-retraining-on-treatment-success-life-quality-and-metabolic-parameters-in-patients-with-type-1-diabetes-using-insulin-pump
#20
Basak Ozgen Saydam, Fatma Yilmazmis, Nalan Aydin, Belgin Bektas, Simge Yilmaz, Umit Cavdar, Secil Ozisik, Baris Akinci
OBJECTIVE: To investigate the effect of insulin pump user retraining on treatment success, quality of life, and metabolic parameters of patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII). SUBJECTS AND METHODS: A total of 35 subjects participated in this prospective study. All patients were given insulin pump user retraining. Their knowledge level and application skills, metabolic parameters, life qualities and satisfaction from treatment were evaluated at baseline and after 6 months...
April 23, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
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