المؤلفون: Fatema Abdulhussein, W. John Boscardin, Stephen E. Gitelman, Hannah Chesser, Jenise C. Wong

المصدر: Diabetes Technol Ther
Diabetes technology & therapeutics, vol 23, iss 10

مصطلحات موضوعية: Blood Glucose, Endocrinology, Diabetes and Metabolism, Medical Physiology, Pediatrics, 0302 clinical medicine, Endocrinology, Pandemic, 030212 general & internal medicine, Child, Continuous glucose monitoring, Pediatric, Diabetes, Benchmarking, Medical Laboratory Technology, Type 1 diabetes, Child, Preschool, Mandate, Type 1, Adult, medicine.medical_specialty, 2019-20 coronavirus outbreak, Adolescent, Coronavirus disease 2019 (COVID-19), Clinical Sciences, 030209 endocrinology & metabolism, Autoimmune Disease, Endocrinology & Metabolism, Young Adult, 03 medical and health sciences, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, Preschool, Pandemics, Metabolic and endocrine, Retrospective Studies, Glycemic, SARS-CoV-2, business.industry, Blood Glucose Self-Monitoring, COVID-19, Original Articles, medicine.disease, Diabetes Mellitus, Type 1, Glucose, Time in range, Emergency medicine, business

الوصف: Background: The impact of the coronavirus disease-2019 (COVID-19) pandemic on glycemic metrics in children is uncertain. This study evaluates the effect of the shelter-in-place (SIP) mandate on glycemic metrics in youth with type 1 diabetes (T1D) using continuous glucose monitoring (CGM) in Northern California, United States. Methods: CGM and insulin pump metrics in youth 3-21 years old with T1D at an academic pediatric diabetes center were analyzed retrospectively. Data 2-4 months before (distant pre-SIP), 1 month before (immediate pre-SIP), 1 month after (immediate post-SIP), and 2-4 months after (distant post-SIP) the SIP mandate were compared using paired t-tests, linear regression, and longitudinal analysis using a mixed effects model. Results: Participants (n = 85) had reduced mean glucose (-10.3 ± 4.4 mg/dL, P = 0.009), standard deviation (SD) (-5.0 ± 1.3 mg/dL, P = 0.003), glucose management indicator (-0.2% ± 0.03%, P = 0.004), time above range (TAR) >250 mg/dL (-3.5% ± 1.7%, P = 0.01), and increased time in range (TIR) (+4.7% ± 1.7%, P = 0.0025) between the distant pre-SIP and distant post-SIP periods. Relationships were maintained using a mixed effects model, when controlling for other demographic variables. There was improvement in SD, TAR 180-250 mg/dL, and TIR for participants with private insurance, but changes in the opposite direction for participants with public insurance. Conclusions: Improvement in CGM metrics in youth with T1D during the COVID-19 pandemic suggests that diabetes management can be maintained in the face of sudden changes to daily living. Youth with public insurance deserve more attention in research and clinical practice.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f3d77b847d3e5102aa0edc3ec801de60Test
https://doi.org/10.1089/dia.2021.0131Test

المؤلفون: Shivani Agarwal, Victoria A. Miller, Judith A. Long, Gladys Crespo-Ramos

المصدر: Diabetes Technol Ther

مصطلحات موضوعية: Adult, Male, Gerontology, Technology, Endocrinology, Diabetes and Metabolism, MEDLINE, 030209 endocrinology & metabolism, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Qualitative analysis, Diabetes mellitus, Intervention (counseling), Ethnicity, medicine, Humans, 030212 general & internal medicine, Healthcare Disparities, Young adult, Child, Type 1 diabetes, business.industry, Racial Groups, Reproducibility of Results, Original Articles, medicine.disease, United States, Racial ethnic, Medical Laboratory Technology, Diabetes Mellitus, Type 1, Female, business

الوصف: Background: Racial-ethnic disparities in diabetes technology use are well documented in young adults (YA) with type 1 diabetes (T1D), but modifiable targets for intervention still need to be identified. Our objective was to explore YA perspectives on technology access and support in routine clinical care. Materials and Methods: Participants were YA with T1D of Hispanic or non-Hispanic Black race-ethnicity from pediatric and adult endocrinology clinics in the Bronx, NY. We conducted semistructured individual interviews to explore how health care and personal experiences affected technology use. Interviews were audio-recorded and transcribed for analysis. We used a modified inductive coding approach with two independent coders and iterative coding processes to improve data reliability and validity. Results: We interviewed 40 YA with T1D: mean age 22 years; 62% female; 72% Medicaid insured; 72% Hispanic; 28% non-Hispanic Black; and mean hemoglobin A1C 10.3%. Themes were categorized into potentially exacerbating and alleviating factors of racial-ethnic disparities in technology use. Exacerbating factors included perceptions that providers were gatekeepers of information and prescription access to technology, providers did not employ shared decision making for use, and YA biases against technology were left unaddressed. Alleviating factors included provider optimism and tailoring of technology benefits to YA needs, and adequate Medicaid insurance coverage. Conclusions: Our results reveal potential intervention targets at the provider level to increase technology uptake among underrepresented YA with T1D. Diabetes health care providers need to be aware of inadvertent withholding of information and prescription access to technology. Provider approaches that address YA technology concerns and promote shared decision making help to mitigate racial/ethnic disparities in technology use.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::13cd661090fb9d98a541d179a695e511Test
https://doi.org/10.1089/dia.2021.0075Test

المؤلفون: Jasmine Schipp, Renza Scibilia, Henriette Langstrup, Edith E. Holloway, Timothy Skinner, Christel Hendrieckx, Jane Speight

المصدر: Diabetes Technology & Therapeutics

مصطلحات موضوعية: Adult, Pancreas, Artificial, Gerontology, Endocrinology, Diabetes and Metabolism, MEDLINE, 030209 endocrinology & metabolism, Peer support, Artificial pancreas, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Diabetes mellitus, medicine, Humans, Insulin, 030212 general & internal medicine, Qualitative Research, Type 1 diabetes, business.industry, Australia, Middle Aged, medicine.disease, Medical Laboratory Technology, Diabetes Mellitus, Type 1, Open source, Quality of Life, ComputingMilieux_COMPUTERSANDSOCIETY, Female, business, Psychosocial, Qualitative research

الوصف: Objective: An emerging group of people with type 1 diabetes are building and using their own artificial pancreas systems (APS). Currently, these “user-led,” open-source systems are not endorsed by ...

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0f8584af30509bc9763a4541bdb807fbTest
https://doi.org/10.1089/dia.2020.0652Test

المؤلفون: Howard Wolpert, Amy Bartee, Eyal Dassau, Michelle Lynne Katz, Amy Lalonde, Richard E Jones, Jordan E. Pinsker

المصدر: Diabetes Technology & Therapeutics

مصطلحات موضوعية: Adult, Blood Glucose, medicine.medical_specialty, Carbohydrate, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Hypoglycemia, Predictive low-glucose suspend, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Insulin Infusion Systems, Diabetes mellitus, Internal medicine, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Low glucose suspend, Type 1 diabetes, business.industry, medicine.disease, Carbohydrate supplementation, Medical Laboratory Technology, Diabetes Mellitus, Type 1, Dietary Supplements, Brief Reports, business

الوصف: Current guidelines recommend 15-20 g of carbohydrate (CHO) for treatment of mild to moderate hypoglycemia. However, these guidelines do not account for reduced insulin during suspensions with predictive low-glucose suspend (PLGS). We assessed insulin suspensions, hypoglycemic events, and CHO treatment during a 20-h inpatient evaluation of an investigational system with a PLGS feature, including an overnight basal up-titration period to activate the PLGS. Among 10 adults with type 1 diabetes, there were 59 suspensions; 7 suspensions were associated with rescue CHO and 5 with hypoglycemia. Rescue treatment consisted of median 9 g CHO (range: 5-16 g), with no events requiring repeat CHO. No rescue CHO were given during or after insulin suspension for the overnight basal up-titration. To minimize rebound hyperglycemia and needless calorie intake from hypoglycemia overtreatment, updated guidance for PLGS systems should reflect possible need to reduce CHO amounts for hypoglycemia rescue associated with an insulin suspension. The clinical trial was registered with ClinicalTrials.gov (NCT03890003).

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::862f262f3938d73c1ccf571018c97938Test
http://europepmc.org/articles/PMC8252907Test

المؤلفون: Aimee Grieme, Krista Kleve, Lauren M. Huyett, Cari Berget, Mary K. Voelmle, Bruce A. Buckingham, R. Paul Wadwa, Amy Criego, Laya Ekhlaspour, Ryan S. Kingman, Sue A. Brown, Bonnie Dumais, Grenye O’Malley, Gregory P. Forlenza, Jennifer Boyd, Robert J. Slover, Jason O'Connor, Carol J. Levy, Erin Cobry, Todd Vienneau, Laurel H. Messer, Kaisa Kivilaid, Bruce W. Bode, Joon Bok Lee, Eric Benjamin, Trang T. Ly, Susan McCoy

المصدر: Diabetes Technology & Therapeutics

مصطلحات موضوعية: Adult, Blood Glucose, Pediatrics, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Insulin delivery, MEDLINE, Artificial pancreas, 030209 endocrinology & metabolism, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Endocrinology, Diabetes mellitus, Outpatients, medicine, Humans, Hypoglycemic Agents, Insulin, Prospective Studies, Closed-loop, 030212 general & internal medicine, Child, Omnipod, Type 1 diabetes, business.industry, Tubeless insulin pump, Original Articles, medicine.disease, Medical Laboratory Technology, Diabetes Mellitus, Type 1, Glucose, Automated insulin delivery, business, Closed loop

الوصف: Background: The objective of this study was to assess the safety and effectiveness of the first commercial configuration of a tubeless automated insulin delivery system, Omnipod® 5, in children (6–13.9 years) and adults (14–70 years) with type 1 diabetes (T1D) in an outpatient setting. Materials and Methods: This was a single-arm, multicenter, prospective clinical study. Data were collected over a 14-day standard therapy (ST) phase followed by a 14-day hybrid closed-loop (HCL) phase, where participants (n = 36) spent 72 h at each of three prespecified glucose targets (130, 140, and 150 mg/dL, 9 days total) then 5 days with free choice of glucose targets (110–150 mg/dL) using the Omnipod 5. Remote safety monitoring alerts were enabled during the HCL phase. Primary endpoints were difference in time in range (TIR) (70–180 mg/dL) between ST and HCL phases and proportion of participants reporting serious device-related adverse events. Results: Mean TIR was significantly higher among children in the free-choice period overall (64.9% ± 12.2%, P

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::088020a5c9597e828bca79063059f5fbTest
https://doi.org/10.1089/dia.2020.0546Test

المؤلفون: Christel Hendrieckx, Kavita Kumareswaran, Sara Vogrin, D Jane Holmes-Walker, Jane Speight, Leon A. Bach, Elizabeth A. Davis, David N O'Neal, Martin de Bock, Mary B Abraham, Timothy W. Jones, Roland W. McCallum, Richard J MacIsaac, Steven Trawley, Vijaya Sundararajan, Morton G. Burt, Catriona M. Sims, Alicia J. Jenkins, Anthony C Keech, Joey Kaye, Peter G. Colman, Barbora Paldus, Stephen N Stranks, Neale Cohen, Glenn M. Ward, Sybil A McAuley, Melissa H Lee

المصدر: Diabetes Technology & Therapeutics. 23:460-466

مصطلحات موضوعية: Adult, Blood Glucose, Insulin pump, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Hypoglycemia, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Endocrinology, Interquartile range, Internal medicine, Blood Glucose Self-Monitoring, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Glycated Hemoglobin, Type 1 diabetes, business.industry, Australia, nutritional and metabolic diseases, medicine.disease, Confidence interval, Medical Laboratory Technology, Diabetes Mellitus, Type 1, business

الوصف: Background: This prerandomization analysis from the Australian HCL-Adult trial (registration number: ACTRN12617000520336) compared masked continuous glucose monitoring (CGM) metrics among adults using insulin pumps versus multiple daily injections (MDIs), who were all self-monitoring blood glucose (SMBG). Methods: Adults with type 1 diabetes, using an insulin pump or MDIs without real-time CGM (and entering a trial of closed-loop technology), were eligible. MDI users were given an insulin dosage calculator. All participants received diabetes and carbohydrate-counting education, then wore masked CGM sensors for 3 weeks. Ethics Approval: HREC-D 088/16 Results: Adults using MDIs (n = 61) versus pump (n = 59) did not differ by age, sex, diabetes duration, insulin total daily dose, or HbA1c at baseline. After education, median (interquartile range) CGM time in range (TIR) 70-180 mg/dL (3.9-10.0 mmol/L) was 54% (47, 62) for those using MDIs and 56% (48, 66) for those using pump (P = 0.40). All CGM metrics were equivalent for 24 h/day for MDI and pump users. Overnight, those using MDIs (vs. pump) spent more time with glucose

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::17f9d3a2957bfa505bb82c8a9ab60d0eTest
https://doi.org/10.1089/dia.2020.0589Test

المؤلفون: Brandon Arbiter, Korey K. Hood, Victoria Barnes-Lomen, Daniel J. DeSalvo, Roy W. Beck, Adam S. Brown, Ryan Bailey, Peter Calhoun, Diana Naranjo, Rayhan A. Lal, Jeremy Pettus, John Lum

المصدر: Diabetes Technology & Therapeutics

مصطلحات موضوعية: Adult, Blood Glucose, Research design, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Insulin delivery, MEDLINE, 030209 endocrinology & metabolism, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Endocrinology, Physical medicine and rehabilitation, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Insulin, Prospective Studies, 030212 general & internal medicine, Child, Prospective cohort study, Type 1 diabetes, business.industry, Blood Glucose Self-Monitoring, Infant, Original Articles, medicine.disease, Loop (topology), Medical Laboratory Technology, Diabetes Mellitus, Type 1, Closed-loop control, Child, Preschool, Automated insulin delivery, Observational study, Continuous glucose monitors, Safety, business

الوصف: Objective: To evaluate the safety and effectiveness of the Loop Do-It-Yourself automated insulin delivery system. Research Design and Methods: A prospective real-world observational study was conducted, which included 558 adults and children (age range 1–71 years, mean HbA1c 6.8% ± 1.0%) who initiated Loop either on their own or with community-developed resources and provided data for 6 months. Results: Mean time-in-range 70–180 mg/dL (TIR) increased from 67% ± 16% at baseline (before starting Loop) to 73% ± 13% during the 6 months (mean change from baseline 6.6%, 95% confidence interval [CI] 5.9%–7.4%; P

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::089d027a3e226716d1febee9297effa8Test
https://doi.org/10.1089/dia.2020.0535Test

المؤلفون: Denis Raccah, Yannis Préau, Sébastien Galie, Pauline Schaepelynck, Martine Armand

المساهمون: Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Service Nutrition & Diabète, Hôpital Ste Marguerite, APHM, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )

المصدر: Diabetes Technology and Therapeutics
Diabetes Technology and Therapeutics, 2020, ⟨10.1089/dia.2020.0515⟩
Diabetes Technology and Therapeutics, Mary Ann Liebert, 2020, ⟨10.1089/dia.2020.0515⟩
Diabetes Technology & Therapeutics

مصطلحات موضوعية: Adult, Blood Glucose, Pediatrics, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Intermittently scanned continuous glucose monitoring, Hypoglycemia, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Diabetes mellitus, Real-time continuous glucose monitoring, Humans, Hypoglycemic Agents, Medicine, 030212 general & internal medicine, Glycemic variability, Glycated Hemoglobin, Type 1 diabetes, business.industry, Continuous glucose monitoring, Blood Glucose Self-Monitoring, Insulin sensitivity, Original Articles, medicine.disease, 3. Good health, Medical Laboratory Technology, Diabetes Mellitus, Type 1, Cohort, Observational study, France, Diabetic patient, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology

الوصف: International audience; Aim: Assess the impact of switching from intermittently scanned (FreeStyle Libre [FSL]) to real-time (Dexcom G4 platinum [DG4]) continuous glucose monitoring systems on glycemia control in type 1 diabetes (T1D) patients with high risk of hypoglycemia and/or elevated glycated hemoglobin (HbA1c). Methods: We conducted an observational study in 18 T1D adults with poor glycemic control on FSL. Ambulatory glucose profile data were collected during the last 3 months of FSL use before inclusion (M0 period), during the first 3 months (M3 period) and the last 3 months (M6 period) of DG4 use. Data were then expressed as 24-h averages. Biological HbA1c was measured for all three periods. Patients were their own-controls and statistics were performed using paired t-test or Wilcoxon for matched-pairs. Results: The switch to DG4 at M3 resulted in a higher time-in-range (TIR) 70-180 mg/dL (median [Q1;Q3], 53.1 [44.5;67.3] vs. 41.5 [28.5;62.0], P = 0.0008), and a lower time-below-range

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fb267daed232a011025b55cb023ec5b0Test
https://doi.org/10.1089/dia.2020.0515Test

المؤلفون: Ralph Ziegler, Winfried Keuthage, Tanja Wiedenmann, Stefan Kipper, Jörg Simon, Yasmin Kretzschmar, Thomas Danne, Matthias Axel Schweitzer

المصدر: Diabetes Technology & Therapeutics

مصطلحات موضوعية: Adult, Blood Glucose, Male, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Glycemic Control, Time-in-range, Insulin aspart, 03 medical and health sciences, Diabetes mellitus, 0302 clinical medicine, Endocrinology, Internal medicine, Humans, Hypoglycemic Agents, Insulin, Medicine, In patient, 030212 general & internal medicine, Continuous glucose monitoring, Insulin Aspart, Aged, Glycemic, Glycated Hemoglobin, Type 1 diabetes, business.industry, Blood Glucose Self-Monitoring, nutritional and metabolic diseases, Original Articles, Middle Aged, medicine.disease, Medical Laboratory Technology, Diabetes Mellitus, Type 1, Female, business, Prandial insulin, medicine.drug

الوصف: Background: The GoBolus study investigated the real-world effectiveness of faster aspart in patients with type 1 diabetes (T1D) using intermittent-scanning continuous glucose monitoring (iscCGM) systems. Methods: This 24-week, multicenter, single-arm, noninterventional study investigated adults with T1D (HbA1c, 7.5%–9.5%) receiving multiple daily injections (MDI) of insulin and using iscCGM within local healthcare settings for ≥6 months before switching to faster aspart at study start (week 0; baseline). Primary endpoint was HbA1c change from baseline to week 24. Exploratory endpoint was change in iscCGM metrics from baseline to week 24. Results: Overall, 243 patients were included (55.6% male), with mean age/diabetes duration, 49.9/18.8 years; mean HbA1c, 8.1%. By week 24, HbA1c had decreased by 0.19% (−2.1 mmol/mol, P 10.0 mmol/L, P = 0.026) and 20.4% to 17.9% (>13.9 mmol/L, P = 0.013), corresponding to 43.5 (P = 0.024) and 35.6 (P = 0.015) fewer minutes per day on average spent in these ranges, respectively; no change for time in hypoglycemia (

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ab485f466b4c72512e9b1a720ae6f03aTest
https://doi.org/10.1089/dia.2020.0360Test

المؤلفون: Addie L. Fortmann, William H. Polonsky

المصدر: Diabetes Technology & Therapeutics

مصطلحات موضوعية: Gerontology, Quality of life, Adult, Blood Glucose, endocrine system diseases, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Health outcomes, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Quality of life (healthcare), Diabetes mellitus, Outcome Assessment, Health Care, medicine, Humans, Hypoglycemic Agents, 030212 general & internal medicine, Continuous glucose monitoring, Type 1 diabetes, business.industry, Information Dissemination, Blood Glucose Self-Monitoring, nutritional and metabolic diseases, Original Articles, medicine.disease, Data sharing, Medical Laboratory Technology, Diabetes Mellitus, Type 1, business

الوصف: Background: To examine experiences with real-time continuous glucose monitoring (RT-CGM) data sharing and its impact on health-related outcomes. Methods: Adults with type 1 diabetes (T1D) (N = 302) using the Dexcom G5 Mobile or G6 RT-CGM system and sharing data with ≥1 family/friend follower completed a survey exploring their perceived value of data sharing, the impact of sharing on health and quality of life (QoL) outcomes, and how their chief follower (CF) used shared data to support their diabetes management. Regression analyses examined whether CF actions were linked to reported changes in health and QoL outcomes for the T1D adult. Results: The majority had lived with T1D >10 years, (76.5%), used RT-CGM >1 year (58.0%), and identified their spouse/partner as CF (51.9%). Data sharing reportedly contributed to improved hypoglycemic confidence (for 89.4% of respondents), improved overall well-being (54.3%), and reduced diabetes distress (36.1%). Benefits related to data sharing included fewer episodes of severe hypoglycemia (62.2%), better sleep (52.4%), and A1C improvement (47.3%). In particular, three positive CF actions were independent predictors of health and QoL benefits: celebrating success related to glycemic control, providing encouragement when glycemic control is challenging, and teamwork discussions about how CF should respond to out-of-range values. Conclusions: RT-CGM data sharing was associated with a range of health and QoL-related benefits. The occurrence of benefits was influenced by the collaborative management approaches taken by RT-CGM users and their data-sharing followers. Longitudinal trials are needed to determine the most effective patterns of collaborative data sharing, leading to their implementation into routine diabetes management.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d3c4c9dc9b820b3398011f833f62388fTest
http://europepmc.org/articles/PMC7906862Test