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https://www.readbyqxmd.com/read/28231029/unintended-insulin-pump-delivery-in-hyperbaric-conditions
#1
Federico Bertuzzi, Basilio Pintaudi, Matteo Bonomo, Fabio Garuti
AIMS/HYPOTHESIS: Unintended pump insulin delivery was reported to occur as a consequence of decreased atmospheric pressure, probably mediated by air bubble formation and the expansion of existing bubbles. This observation has been used to explain some hypoglycemic episodes occurring in patients on insulin pump treatment in between 1 and 1 h 45 min after the flight takeoff. New models of insulin pumps have been introduced in the market, most of them are waterproof certified. It is not clear if in these new pumps the influence of atmospheric pressure changes on the insulin delivery is still present...
February 23, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28221823/evaluation-of-a-predictive-low-glucose-management-system-in-clinic
#2
Bruce A Buckingham, Timothy S Bailey, Mark Christiansen, Satish Garg, Stuart Weinzimer, Bruce Bode, Stacey M Anderson, Ron Brazg, Trang Ly, Francine R Kaufman
BACKGROUND: Predictions based on continuous glucose monitoring (CGM) data are the basis for automatic suspension and resumption of insulin delivery by a predictive low-glucose management feature termed "suspend before low," which is part of the Medtronic MiniMed(®) 640G combined insulin pump and CGM system. This study assessed the safety and performance characteristics of the system in an in-clinic setting at eight sites. MATERIALS AND METHODS: In-clinic standardized increases in basal insulin delivery rates were used to induce nocturnal hypoglycemia in subjects (14-75 years) with type 1 diabetes wearing the MiniMed 640G system...
February 16, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28209654/replace-bg-a-randomized-trial-comparing-continuous-glucose-monitoring-with-and-without-routine-blood-glucose-monitoring-in-well-controlled-adults-with-type-1-diabetes
#3
Grazia Aleppo, Katrina J Ruedy, Tonya D Riddlesworth, Davida F Kruger, Anne L Peters, Irl Hirsch, Richard M Bergenstal, Elena Toschi, Andrew J Ahmann, Viral N Shah, Michael R Rickels, Bruce W Bode, Athena Philis-Tsimikas, Rodica Pop-Busui, Henry Rodriguez, Emily Eyth, Anuj Bhargava, Craig Kollman, Roy W Beck
OBJECTIVE: To determine whether the use of continuous glucose monitoring (CGM) without confirmatory blood glucose monitoring (BGM) measurements is as safe and effective as using CGM adjunctive to BGM in well-controlled adults with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: A randomized noninferiority clinical trial was conducted at 14 sites in the T1D Exchange Clinic Network. Participants were ≥18 years of age (mean 44 ± 14 years), had T1D for ≥1 year (mean duration 24 ± 12 years), used an insulin pump, and had an HbA1c ≤9...
February 16, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28192024/insulin-pumps
#4
John C Pickup
No abstract text is available yet for this article.
February 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28173843/staff-experiences-of-closing-out-a-clinical-trial-involving-withdrawal-of-treatment-qualitative-study
#5
Julia Lawton, David White, David Rankin, Jackie Elliott, Carolin Taylor, Cindy Cooper, Simon Heller, Nina Hallowell
BACKGROUND: The ending of a clinical trial may be challenging, particularly if staff are required to withdraw the investigated treatment(s); however, this aspect of trial work is surprisingly under-researched. To address this gap, we explored the experiences of staff involved in closing out a trial that entailed withdrawal of treatment (insulin pumps) from some patients. METHODS: Interviews were conducted with n = 22 staff, recruited from seven trial sites. Data were analysed thematically...
February 7, 2017: Trials
https://www.readbyqxmd.com/read/28164370/impact-of-neighbourhood-level-inequity-on-paediatric-diabetes-care
#6
A B M Clarke, D Daneman, J R Curtis, F H Mahmud
AIMS: To evaluate the association between neighbourhood-level inequity and glycaemic control in paediatric participants with Type 1 diabetes using the Neighbourhood Equity Index (NEI). METHODS: The NEI was linked to the clinical data of 519 children with diabetes followed at the Hospital for Sick Children (Toronto, Canada). The NEI is a composite measure of inequity developed using the World Health Organization's Urban Health Equity Assessment and Response Tool (HEART), which encompasses 15 weighted indicators evaluating economic, social, environmental and lifestyle factors...
February 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28145047/influence-of-health-locus-of-control-and-fear-of-hypoglycaemia-on-glycaemic-control-and-treatment-satisfaction-in-people-with-type-1-diabetes-on-insulin-pump-therapy
#7
L Indelicato, V Mariano, S Galasso, F Boscari, E Cipponeri, C Negri, A Frigo, A Avogaro, E Bonora, M Trombetta, D Bruttomesso
AIM: To assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion. METHODS: People with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub-classified as an 'acceptable glucose control' group [HbA1c ≤58 mmol/mol (7.5%)] and a 'suboptimum glucose control' group [HbA1c >58 mmol/mol (7...
February 1, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28143733/fear-of-hypoglycemia-influence-on-glycemic-variability-and-self-management-behavior-in-young-adults-with-type-1-diabetes
#8
Pamela Martyn-Nemeth, Laurie Quinn, Sue Penckofer, Chang Park, Vanessa Hofer, Larisa Burke
PURPOSE: The purpose of this study was to examine how fear of hypoglycemia (FOH) is associated with glycemic variability (GV) and self-management behavior in young adults (aged 18-35) with type 1 diabetes (T1DM). PROCEDURES: Using a prospective repeated-measures design, in 35 young adults, within- and between-person and temporal associations of FOH, specific self-management behaviors, and GV were measured. The data were collected using questionnaires and real-time measures using daily diaries, insulin pump downloads, actigraphy, and continuous glucose monitoring...
January 20, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28135116/an-expert-opinion-on-advanced-insulin-pump-use-in-youth-with-type-1-diabetes
#9
Bruce W Bode, Francine R Kaufman, Nan Vint
Among children and adolescents with type 1 diabetes mellitus, the use of insulin pump therapy has increased since its introduction in the early 1980s. Optimal management of type 1 diabetes mellitus depends on sufficient understanding by patients, their families, and healthcare providers on how to use pump technology. The goal for the use of insulin pump therapy should be to advance proficiency over time from the basics taught at the initiation of pump therapy to utilizing advanced settings to obtain optimal glycemic control...
January 30, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28130944/pediatric-insulin-pump-therapy-reflecting-on-the-first-10-years-of-a-universal-funding-program-in-ontario
#10
Rayzel Shulman, Fiona A Miller, Thérèse A Stukel, Denis Daneman, Astrid Guttmann
We evaluated the universal funding program for pediatric insulin pumps in Ontario by examining the dynamics underlying patterns of pump use and adverse events using population-based health administrative data available at the Institute for Clinical Evaluative Sciences (ICES), supplemented by other data. We found that (1) pump use has increased steadily since 2006 with variation across centres and disparity in use by socioeconomic status; (2) pump discontinuation is uncommon; (3) physicians value pump therapy in numerous ways that provide important insights into patterns of uptake; and (4) the safety profile of pump therapy is, in general, very good; however, individuals of lower socioeconomic status are at an increased risk of acute diabetes complications, most frequently diabetic ketoacidosis...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28118453/effect-of-continuous-glucose-monitoring-on-glycemic-control-in-adults-with-type-1-diabetes-using-insulin-injections-the-diamond-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
Roy W Beck, Tonya Riddlesworth, Katrina Ruedy, Andrew Ahmann, Richard Bergenstal, Stacie Haller, Craig Kollman, Davida Kruger, Janet B McGill, William Polonsky, Elena Toschi, Howard Wolpert, David Price
Importance: Previous clinical trials showing the benefit of continuous glucose monitoring (CGM) in the management of type 1 diabetes predominantly have included adults using insulin pumps, even though the majority of adults with type 1 diabetes administer insulin by injection. Objective: To determine the effectiveness of CGM in adults with type 1 diabetes treated with insulin injections. Design, Setting, and Participants: Randomized clinical trial conducted between October 2014 and May 2016 at 24 endocrinology practices in the United States that included 158 adults with type 1 diabetes who were using multiple daily insulin injections and had hemoglobin A1c (HbA1c) levels of 7...
24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28118046/reexamining-the-hypoglycemia-fear-survey-for-parents-of-young-children-in-a-sample-of-children-using-insulin-pumps
#12
Susana R Patton, Amy E Noser, Mark A Clements, Lawrence M Dolan, Scott W Powers
BACKGROUND: We update the psychometric properties of the Hypoglycemia Fear Survey-Parents of Young Children (HFS-PYC), a 26-item measure of parents' hypoglycemia fear for young children using an insulin pump. METHODS: We combined three similar datasets for the analyses. The data analyzed included parents' responses to the HFS-PYC and a demographic form. For a subset of children (n = 91), we also analyzed self-monitoring of blood glucose data. We used confirmatory factor analysis (CFA) to confirm the measure's original factor structure...
February 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28117542/the-additional-dose-of-insulin-for-high-protein-mixed-meal-provides-better-glycemic-control-in-children-with-type-1-diabetes-on-insulin-pumps-randomized-cross-over-study
#13
Katarzyna Piechowiak, Katarzyna Dżygało, Agnieszka Szypowska
BACKGROUND: Delivery of insulin for high-protein low-fat meals with carbohydrates on the basis of carbohydrates leads to higher late postprandial glycemia. Studies with mixed meals demonstrated lower blood glucose level after dual wave bolus. The objective of our study was to assess the impact of additional dose of insulin in dual wave bolus for high-protein mixed meal on the postprandial glycemia. MATERIALS AND METHODS: We performed a randomized, double-blind, two-way cross-over study, including 58 children with type 1 diabetes, aged 14...
January 24, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28100606/predictive-hyperglycemia-and-hypoglycemia-minimization-in-home-evaluation-of-safety-feasibility-and-efficacy-in-overnight-glucose-control-in-type-1-diabetes
#14
Tamara Spaic, Marsha Driscoll, Dan Raghinaru, Bruce A Buckingham, Darrell M Wilson, Paula Clinton, H Peter Chase, David M Maahs, Gregory P Forlenza, Emily Jost, Irene Hramiak, Terri Paul, B Wayne Bequette, Faye Cameron, Roy W Beck, Craig Kollman, John W Lum, Trang T Ly
OBJECTIVE: The objective of this study was to determine the safety, feasibility, and efficacy of a predictive hyperglycemia and hypoglycemia minimization (PHHM) system compared with predictive low-glucose insulin suspension (PLGS) alone in overnight glucose control. RESEARCH DESIGN AND METHODS: A 42-night trial was conducted in 30 individuals with type 1 diabetes in the age range 15-45 years. Participants were randomly assigned each night to either PHHM or PLGS and were blinded to the assignment...
January 18, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28099035/-let-the-algorithm-do-the-work-reduction-of-hypoglycemia-using-sensor-augmented-pump-therapy-with-predictive-insulin-suspension-smartguard-in-pediatric-type-1-diabetes-patients
#15
Torben Biester, Olga Kordonouri, Martin Holder, Kerstin Remus, Dorothee Kieninger-Baum, Tanja Wadien, Thomas Danne
BACKGROUND: A sensor-augmented insulin pump (SAP) using the MiniMed(®) 640G system with SmartGuard™ technology allows an automatic stop of insulin delivery based on prediction of low glucose levels. Since pediatric patients are particularly prone to hypoglycemia, this device may offer additional protection beyond conventional sensor-augmented therapy. METHODS: This prospective, pediatric multicenter user evaluation assessed 6 weeks of SAP with SmartGuard (threshold setting for hypoglycemia: 70 mg/dL) compared to a preceding period of 2 weeks with SAP only...
January 18, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28094136/day-and-night-glycaemic-control-with-closed-loop-insulin-delivery-versus-conventional-insulin-pump-therapy-in-free-living-adults-with-well-controlled-type-1-diabetes-an-open-label-randomised-crossover-study
#16
Lia Bally, Hood Thabit, Harald Kojzar, Julia K Mader, Jehona Qerimi-Hyseni, Sara Hartnell, Martin Tauschmann, Janet M Allen, Malgorzata E Wilinska, Thomas R Pieber, Mark L Evans, Roman Hovorka
BACKGROUND: Tight control of blood glucose concentration in people with type 1 diabetes predisposes to hypoglycaemia. We aimed to investigate whether day-and-night hybrid closed-loop insulin delivery can improve glucose control while alleviating the risk of hypoglycaemia in adults with HbA1c below 7·5% (58 mmol/mol). METHODS: In this open-label, randomised, crossover study, we recruited adults (aged ≥18 years) with type 1 diabetes and HbA1c below 7·5% from Addenbrooke's Hospital (Cambridge, UK) and Medical University of Graz (Graz, Austria)...
January 13, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28052468/young-people-with-type-1-diabetes-mellitus-attitudes-perceptions-and-experiences-of-diabetes-management-and-continuous-subcutaneous-insulin-infusion-therapy
#17
Lin Perry, Steven James, Katharine Steinbeck, Janet Dunbabin, Julia Lowe
RATIONALE, AIMS, AND OBJECTIVES: Continuous subcutaneous insulin infusion (CSII; insulin pump) use is increasing. However, there is little information about how this technology is used compared with other insulin delivery methods (ie, injections) by young people with type 1 diabetes mellitus in Australia. This study explored young people's attitudes, perceptions, and experiences with diabetes management comparing those using with those not using CSII, and proportions likely to transition to adult services requiring initiation and/or support for CSII use...
January 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28018888/health-care-for-children-with-diabetes-mellitus-from-low-income-families-in-ontario-and-california-a-population-based-cohort-study
#18
Sunitha V Kaiser, Vandana Sundaram, Eyal Cohen, Rayzel Shulman, Jun Guan, Lee Sanders, Astrid Guttmann
BACKGROUND: Children with diabetes mellitus in low-income families have poor outcomes, but little is known as to how this relates to healthcare system structure. Our objective was to gain insight into how best to structure health systems to serve these children by describing their health care use in 2 health system models: a Canadian model, with an organized diabetes care network that includes generalists, and an American model, with targeted support services for children from low-income families...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28008584/changes-in-quality-of-diabetes-care-and-morbidity-over-20-years-in-people-with-type-1-diabetes-and-long-diabetes-duration-the-jevin-trial
#19
T Heller, K Reise, J Roth, T Lehmann, R Schiel, S Lorkowski, U A Müller, N Müller
Background: The JEVIN trial started as a cross-sectional study in 1989/90 in Jena, a city of the former German Democratic Republic. At that time, the centralized diabetes care system was broken down and restarted 10 years later; structured treatment and teaching programs were implemented, blood glucose self-monitoring, insulin pump-systems and analogue insulin were introduced. We surveyed people with type-1-diabetes of the baseline JEVIN trial in a 20-year follow-up. Methods: 131 patients with type-1-diabetes were analyzed in 1989/90...
December 22, 2016: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28007348/home-use-of-a-bihormonal-bionic-pancreas-versus-insulin-pump-therapy-in-adults-with-type-1-diabetes-a-multicentre-randomised-crossover-trial
#20
Firas H El-Khatib, Courtney Balliro, Mallory A Hillard, Kendra L Magyar, Laya Ekhlaspour, Manasi Sinha, Debbie Mondesir, Aryan Esmaeili, Celia Hartigan, Michael J Thompson, Samir Malkani, J Paul Lock, David M Harlan, Paula Clinton, Eliana Frank, Darrell M Wilson, Daniel DeSalvo, Lisa Norlander, Trang Ly, Bruce A Buckingham, Jamie Diner, Milana Dezube, Laura A Young, April Goley, M Sue Kirkman, John B Buse, Hui Zheng, Rajendranath R Selagamsetty, Edward R Damiano, Steven J Russell
BACKGROUND: The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were living at home and participating in their normal daily routines without restrictions on diet or physical activity. METHODS: We did a random-order crossover study in volunteers at least 18 years old who had type 1 diabetes and lived within a 30 min drive of four sites in the USA...
January 28, 2017: Lancet
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