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Diabetes algorithm

Charrise M Ramkissoon, Pau Herrero, Jorge Bondia, Josep Vehi
The artificial pancreas (AP) system is designed to regulate blood glucose in subjects with type 1 diabetes using a continuous glucose monitor informed controller that adjusts insulin infusion via an insulin pump. However, current AP developments are mainly hybrid closed-loop systems that include feed-forward actions triggered by the announcement of meals or exercise. The first step to fully closing the loop in the AP requires removing meal announcement, which is currently the most effective way to alleviate postprandial hyperglycemia due to the delay in insulin action...
March 16, 2018: Sensors
Mukesh M Agarwal, John Punnose, Komal Sukhija, Asha Sharma, Naimaa K Choudhary
OBJECTIVES: To evaluate the value of the fasting plasma glucose (FPG) level for simplifying the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic algorithm of gestational diabetes mellitus (GDM) in a South Asian population. METHODS: In 6,520 pregnant women undergoing universal screening with the 75 g oral glucose tolerance test (OGTT), the area under receiver operating characteristic curve was used to determine the overall FPG performance to detect GDM (IADPSG criteria)...
December 15, 2017: Canadian Journal of Diabetes
Piotr Chudzik, Somshubra Majumdar, Francesco Calivá, Bashir Al-Diri, Andrew Hunter
BACKROUND AND OBJECTIVES: Diabetic retinopathy is a microvascular complication of diabetes that can lead to sight loss if treated not early enough. Microaneurysms are the earliest clinical signs of diabetic retinopathy. This paper presents an automatic method for detecting microaneurysms in fundus photographies. METHODS: A novel patch-based fully convolutional neural network with batch normalization layers and Dice loss function is proposed. Compared to other methods that require up to five processing stages, it requires only three...
May 2018: Computer Methods and Programs in Biomedicine
Fen Chen, Shulin Li, Dong Sun
Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) has recently been utilized as a noninvasive tool for evaluating renal oxygenation. Several methods have been proposed for analyzing BOLD images. Regional ROI selection is the earliest and most widely used method for BOLD analysis. In the last 20 years, many investigators have used this method to evaluate cortical and medullary oxygenation in patients with ischemic nephropathy, hypertensive nephropathy, diabetic nephropathy, chronic kidney disease (CKD), acute kidney injury and renal allograft rejection...
March 8, 2018: Kidney & Blood Pressure Research
Felix Stickel, Stephan Buch, Hans Dieter Nischalke, Karl Heinz Weiss, Daniel Gotthardt, Janett Fischer, Jonas Rosendahl, Pierre Deltenre, Astrid Marot, Mona Elamly, Markus Casper, Frank Lammert, Andrew McQuillin, Steffen Zopf, Ulrich Spengler, Silke Marhenke, Martha M Kirstein, Arndt Vogel, Florian Eyer, Johann von Felden, Henning Wege, Thorsten Buch, Clemens Schafmayer, Felix Braun, Thomas Berg, Marsha Y Morgan, Jochen Hampe
OBJECTIVES: Variants in patatin-like phospholipase domain-containing 3 (PNPLA3; rs738409), transmembrane 6 superfamily member 2 (TM6SF2; rs58542926), and membrane bound O-acyltransferase domain containing 7 (MBOAT7; rs641738) are risk factors for the development of alcohol-related cirrhosis. Within this population, PNPLA3 rs738409 is also an established risk factor for the development of hepatocellular carcinoma (HCC). The aim of this study was to explore possible risk associations of TM6SF2 rs58542926 and MBOAT7 rs641738 with HCC...
March 13, 2018: American Journal of Gastroenterology
Annie Dude, Charlotte M Niznik, Emily D Szmuilowicz, Alan M Peaceman, Lynn M Yee
Achieving maternal euglycemia in women with pregestational and gestational diabetes mellitus is critical to decreasing the risk of neonatal hypoglycemia, as maternal blood glucose levels around the time of delivery are directly related to the risk of hypoglycemia in the neonate. Many institutions use continuous insulin and glucose infusions during the intrapartum period, although practices are widely variable. At Northwestern Memorial Hospital, the "Management of the Perinatal Patient with Diabetes" policy and protocol was developed to improve consistency of management while also allowing individualization appropriate for the patient's specific diabetic needs...
March 13, 2018: American Journal of Perinatology
Giada Acciaroli, Martina Vettoretti, Andrea Facchinetti, Giovanni Sparacino
Minimally invasive continuous glucose monitoring (CGM) sensors are wearable medical devices that provide real-time measurement of subcutaneous glucose concentration. This can be of great help in the daily management of diabetes. Most of the commercially available CGM devices have a wire-based sensor, usually placed in the subcutaneous tissue, which measures a "raw" current signal via a glucose-oxidase electrochemical reaction. This electrical signal needs to be translated in real-time to glucose concentration through a calibration process...
March 13, 2018: Biosensors
Stuart Keel, Pei Ying Lee, Jane Scheetz, Zhixi Li, Mark A Kotowicz, Richard J MacIsaac, Mingguang He
The purpose of this study is to evaluate the feasibility and patient acceptability of a novel artificial intelligence (AI)-based diabetic retinopathy (DR) screening model within endocrinology outpatient settings. Adults with diabetes were recruited from two urban endocrinology outpatient clinics and single-field, non-mydriatic fundus photographs were taken and graded for referable DR ( ≥ pre-proliferative DR). Each participant underwent; (1) automated screening model; where a deep learning algorithm (DLA) provided real-time reporting of results; and (2) manual model where retinal images were transferred to a retinal grading centre and manual grading outcomes were distributed to the patient within 2 weeks of assessment...
March 12, 2018: Scientific Reports
Wenli Chang, Hongzhi Lv, Chen Feng, Peizhi Yuwen, Ning Wei, Wei Chen, Yingze Zhang
OBJECTIVE: Although many studies have reported risk factors of mortality following hip fracture surgery, the preventable risk factors of mortality following hip fracture surgery have not been well-identified. The aim of this study was to identify the preventable risk factors of mortality following hip fracture surgery. METHODS: We searched PubMed, Web of Science, Google scholar, and the Chinese National Knowledge Infrastructure (CNKI) databases from January 1997 to March 2017 for studies reporting risk factors of mortality following hip fracture surgery...
March 9, 2018: International Journal of Surgery
Di Zhao, Na-Sui Wang, Fu Chen, Zheng-Bing Li, Xi-Tao Li, Xu-Xin Zhu
BACKGROUND: miR-34a is a multifunctional post-translational modulator, which is involved in several diabetes-related complications. However, miR-34a remains to be fully elucidated in the diabetic endothelium from rats. In this study, the role of miR-34a/NOTCH1 signaling in the progression of hyperglycemia-vascular endothelial dysfunction was investigated. METHODS: In intravenous injection of miR-34a mimics and inhibitors in streptozotocin (STZ)-induced diabetic rats, the biomarkers of endothelial dysfunction was measured...
March 12, 2018: Experimental and Clinical Endocrinology & Diabetes
Lee M Jampol, Adam R Glassman, Danni Liu, Lloyd Paul Aiello, Neil M Bressler, Elia J Duh, Susan Quaggin, John A Wells, Charles C Wykoff
PURPOSE: To assess systemic vascular endothelial growth factor (VEGF)-A levels after treatment with intravitreous aflibercept, bevacizumab, or ranibizumab. DESIGN: Comparative-effectiveness trial with participants randomly assigned to 2 mg aflibercept, 1.25 mg bevacizumab, or 0.3 mg ranibizumab after a re-treatment algorithm. PARTICIPANTS: Participants with available plasma samples (N = 436). METHODS: Plasma samples were collected before injections at baseline and 4-week, 52-week, and 104-week visits...
March 7, 2018: Ophthalmology
Pierre Yves Benhamou, Erik Huneker, Sylvia Franc, Maeva Doron, Guillaume Charpentier
AIMS: Improvement in closed-loop insulin delivery systems could result from customization of settings to individual needs and remote monitoring. This pilot home study evaluated the efficacy and relevance of this approach. METHODS: A bicentric clinical trial was conducted for 3 weeks, using an MPC-based algorithm (Diabeloop Artificial Pancreas system) featuring five settings designed to modulate the reactivity of regulation. Remote monitoring was ensured by expert nurses with a web platform generating automatic Secured Information Messages (SIMs) and with a structured procedure...
March 9, 2018: Acta Diabetologica
Johannes M Werzowa, Marcus D Säemann, Alexander Mohl, Michael Bergmann, Christopher C Kaltenecker, Wolfgang Brozek, Andreas Thomas, Michael Haidinger, Marlies Antlanger, Johannes J Kovarik, Chantal Kopecky, Peter X K Song, Klemens Budde, Julio Pascual, Manfred Hecking
Treating hyperglycemia in previously non-diabetic individuals with exogenous insulin immediately after kidney transplantation reduced the odds of developing Posttransplantation Diabetes Mellitus (PTDM) in our previous proof-of-concept clinical trial. We hypothesized that insulin-pump therapy with maximal insulin dosage during the afternoon would improve glycemic control compared to basal insulin and standard-of-care. In a multi-center, randomized, controlled trial testing insulin isophane for PTDM prevention, we added a third study arm applying continuous subcutaneous insulin lispro infusion (CSII) treatment...
2018: PloS One
Fan Cai, Fang Wu, Jiumei Cao, Xiaonan Chen
Diabetes has been considered as an independent risk factor for cerebral infarction. However, the pathological mechanism of cerebral infarction with diabetes (DMCI) is still rarely known. In this study, we try to explore the relationship between microRNA-146b-3p (miR-146b-3p) and DMCI patients. The peripheral blood mononuclear cells were separated after the patients were selected from our hospital. Firstly, the content of IL-6 and COX-2 was detected by ELISA. Then, the total RNAs were extracted and analyzed by microRNA (miRNA) microarray...
2018: American Journal of Translational Research
Zhixi Li, Yifan He, Stuart Keel, Wei Meng, Robert T Chang, Mingguang He
PURPOSE: To assess the performance of a deep learning algorithm for detecting referable glaucomatous optic neuropathy (GON) based on color fundus photographs. DESIGN: A deep learning system for the classification of GON was developed for automated classification of GON on color fundus photographs. PARTICIPANTS: We retrospectively included 48 116 fundus photographs for the development and validation of a deep learning algorithm. METHODS: This study recruited 21 trained ophthalmologists to classify the photographs...
March 2, 2018: Ophthalmology
Kamlesh Khunti, Sudesna Chatterjee, Hertzel C Gerstein, Sophia Zoungas, Melanie J Davies
Sulphonylureas have been commercially available since the 1950s, but their use continues to be associated with controversy. Although adverse cardiovascular outcomes in some observational studies have raised concerns about sulphonylureas, findings from relatively recent, robust, and high-quality systematic reviews have indicated no increased risk of all-cause mortality associated with sulphonylureas compared with other active treatments. Results from large, multicentre, randomised controlled trials such as the UK Prospective Diabetes Study and ADVANCE have confirmed the microvascular benefits of sulphonylureas, a reduction in the incidence or worsening of nephropathy and retinopathy, and no increase in all-cause mortality, although whether these benefits were due to sulphonylurea therapy and not an overall glucose-lowering effect could not be confirmed...
February 28, 2018: Lancet Diabetes & Endocrinology
Fangying Xie, Juliana C N Chan, Ronald C W Ma
Diabetes has become a major burden of healthcare expenditure. Diabetes management following a uniform treatment algorithm is often associated with progressive treatment failure and development of diabetic complications. Recent advances in our understanding in the genomic architecture of diabetes and its complications have provided the framework for development of precision medicine to personalize diabetes prevention and management. In this review, we summarized recent advances in the understanding of the genetic basis of diabetes and its complications...
March 2, 2018: Journal of Diabetes Investigation
Arianna Dagliati, Valentina Tibollo, Giulia Cogni, Luca Chiovato, Riccardo Bellazzi, Lucia Sacchi
In this work we describe the application of a careflow mining algorithm to detect the most frequent patterns of care in a type 2 diabetes patients cohort. The applied method enriches the detected patterns with clinical data to define temporal phenotypes across the studied population. Novel phenotypes are discovered from heterogeneous data of 424 Italian patients, and compared in terms of metabolic control and complications. Results show that careflow mining can help to summarize the complex evolution of the disease into meaningful patterns, which are also significant from a clinical point of view...
March 2018: Journal of Diabetes Science and Technology
Thomas W Fuller, Katherine M Theisen, Anup Shah, Paul J Rusilko
PURPOSE OF REVIEW: Adult acquired buried penis is a morbid condition characterized by complete entrapment of the phallus as a result of morbid obesity, post-surgical cicatrix formation, or primary genital lymphedema. Hygienic voiding is not possible and urinary dribbling is frequent with accompanying inflammation, skin breakdown, and infection from the chronic moisture. The end result is penile skin fibrosis resulting in permanent functional loss. Herein, we describe the etiology of adult acquired buried penis, advances in its surgical management, and quality of life outcomes with treatment...
February 28, 2018: Current Urology Reports
Ying Zhu, Paul D Piehowski, Rui Zhao, Jing Chen, Yufeng Shen, Ronald J Moore, Anil K Shukla, Vladislav A Petyuk, Martha Campbell-Thompson, Clayton E Mathews, Richard D Smith, Wei-Jun Qian, Ryan T Kelly
Nanoscale or single-cell technologies are critical for biomedical applications. However, current mass spectrometry (MS)-based proteomic approaches require samples comprising a minimum of thousands of cells to provide in-depth profiling. Here, we report the development of a nanoPOTS (nanodroplet processing in one pot for trace samples) platform for small cell population proteomics analysis. NanoPOTS enhances the efficiency and recovery of sample processing by downscaling processing volumes to <200 nL to minimize surface losses...
February 28, 2018: Nature Communications
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