المؤلفون: Klonoff, David C, Wang, Jing, Rodbard, David, Kohn, Michael A, Li, Chengdong, Liepmann, Dorian, Kerr, David, Ahn, David, Peters, Anne L, Umpierrez, Guillermo E, Seley, Jane Jeffrie, Xu, Nicole Y, Nguyen, Kevin T, Simonson, Gregg, Agus, Michael SD, Al-Sofiani, Mohammed E, Armaiz-Pena, Gustavo, Bailey, Timothy S, Basu, Ananda, Battelino, Tadej, Bekele, Sewagegn Yeshiwas, Benhamou, Pierre-Yves, Bequette, B Wayne, Blevins, Thomas, Breton, Marc D, Castle, Jessica R, Chase, James Geoffrey, Chen, Kong Y, Choudhary, Pratik, Clements, Mark A, Close, Kelly L, Cook, Curtiss B, Danne, Thomas, Doyle, Francis J, Drincic, Angela, Dungan, Kathleen M, Edelman, Steven V, Ejskjaer, Niels, Espinoza, Juan C, Fleming, G Alexander, Forlenza, Gregory P, Freckmann, Guido, Galindo, Rodolfo J, Gomez, Ana Maria, Gutow, Hanna A, Heinemann, Lutz, Hirsch, Irl B, Hoang, Thanh D, Hovorka, Roman, Jendle, Johan H, Ji, Linong, Joshi, Shashank R, Joubert, Michael, Koliwad, Suneil K, Lal, Rayhan A, Lansang, M Cecilia, Lee, Wei-An, Leelarathna, Lalantha, Leiter, Lawrence A, Lind, Marcus, Litchman, Michelle L, Mader, Julia K, Mahoney, Katherine M, Mankovsky, Boris, Masharani, Umesh, Mathioudakis, Nestoras N, Mayorov, Alexander, Messler, Jordan, Miller, Joshua D, Mohan, Viswanathan, Nichols, James H, Nørgaard, Kirsten, O’Neal, David N, Pasquel, Francisco J, Philis-Tsimikas, Athena, Pieber, Thomas, Phillip, Moshe, Polonsky, William H, Pop-Busui, Rodica, Rayman, Gerry, Rhee, Eun-Jung, Russell, Steven J, Shah, Viral N, Sherr, Jennifer L, Sode, Koji, Spanakis, Elias K, Wake, Deborah J, Waki, Kayo, Wallia, Amisha, Weinberg, Melissa E, Wolpert, Howard, Wright, Eugene E, Zilbermint, Mihail, Kovatchev, Boris

المصدر: Journal of Diabetes Science and Technology. 17(5)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Nutrition and Dietetics, Diabetes, Adult, Humans, Blood Glucose, Blood Glucose Self-Monitoring, Hypoglycemia, Hyperglycemia, Glucose, ambulatory glucose profile, composite metric, continuous glucose monitor, diabetes, glycemia risk index, hyperglycemia, hypoglycemia, time in range, Nutrition and dietetics

الوصف: BackgroundA composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data.MethodsWe assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low-glucose and low-glucose hypoglycemia; very high-glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation.ResultsThe analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals.ConclusionThe GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic effects of prescribed and investigational treatments.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/7ng0s8wtTest

المؤلفون: Klonoff, David C, Wang, Jing, Rodbard, David, Kohn, Michael A, Li, Chengdong, Liepmann, Dorian, Kerr, David, Ahn, David, Peters, Anne L, Umpierrez, Guillermo E, Seley, Jane Jeffrie, Xu, Nicole Y, Nguyen, Kevin T, Simonson, Gregg, Agus, Michael S D, Al-Sofiani, Mohammed E, Armaiz-Pena, Gustavo, Bailey, Timothy S, Basu, Ananda, Battelino, Tadej, Bekele, Sewagegn Yeshiwas, Benhamou, Pierre-Yves, Bequette, B Wayne, Blevins, Thomas, Breton, Marc D, Castle, Jessica R, Chase, James Geoffrey, Chen, Kong Y, Choudhary, Pratik, Clements, Mark A, Close, Kelly L, Cook, Curtiss B, Danne, Thomas, Doyle, Francis J, Drincic, Angela, Dungan, Kathleen M, Edelman, Steven V, Ejskjaer, Niels, Espinoza, Juan C, Fleming, G Alexander, Forlenza, Gregory P, Freckmann, Guido, Galindo, Rodolfo J, Gomez, Ana Maria, Gutow, Hanna A, Heinemann, Lutz, Hirsch, Irl B, Hoang, Thanh D, Hovorka, Roman, Jendle, Johan H, Ji, Linong, Joshi, Shashank R, Joubert, Michael, Koliwad, Suneil K, Lal, Rayhan A, Lansang, M Cecilia, Lee, Wei-An Andy, Leelarathna, Lalantha, Leiter, Lawrence A, Lind, Marcus, Litchman, Michelle L, Mader, Julia K, Mahoney, Katherine M, Mankovsky, Boris, Masharani, Umesh, Mathioudakis, Nestoras N, Mayorov, Alexander, Messler, Jordan, Miller, Joshua D, Mohan, Viswanathan, Nichols, James H, Nørgaard, Kirsten, O'Neal, David N, Pasquel, Francisco J, Philis-Tsimikas, Athena, Pieber, Thomas, Phillip, Moshe, Polonsky, William H, Pop-Busui, Rodica, Rayman, Gerry, Rhee, Eun-Jung, Russell, Steven J, Shah, Viral N, Sherr, Jennifer L, Sode, Koji, Spanakis, Elias K, Wake, Deborah J, Waki, Kayo, Wallia, Amisha, Weinberg, Melissa E, Wolpert, Howard, Wright, Eugene E, Zilbermint, Mihail, Kovatchev, Boris

المصدر: Journal of diabetes science and technology ; 19322968221085273 ; United States

مصطلحات موضوعية: ambulatory glucose profile, composite metric, continuous glucose monitor, diabetes, glycemia risk index, hyperglycemia, hypoglycemia, time in range

الوصف: Background: A composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data. Methods: We assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low–glucose and low-glucose hypoglycemia; very high–glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation. Results: The analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals. Conclusion: The GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic ...

العلاقة: Journal of Diabetes Science and Technology; http://hdl.handle.net/10713/18597Test

الإتاحة: https://doi.org/10.1177/19322968221085273Test
http://hdl.handle.net/10713/18597Test

المؤلفون: Klonoff, David C., Wang, Jing, Rodbard, David, Kohn, Michael A., Li, Chengdong, Liepmann, Dorian, Kerr, David, Ahn, David, Peters, Anne L., Umpierrez, Guillermo E., Seley, Jane Jeffrie, Xu, Nicole Y., Nguyen, Kevin T., Simonson, Gregg, Agus, Michael S.D., Al-Sofiani, Mohammed E., Armaiz-Pena, Gustavo, Bailey, Timothy S., Basu, Ananda, Battelino, Tadej, Bekele, Sewagegn Yeshiwas, Benhamou, Pierre Yves, Bequette, B. Wayne, Blevins, Thomas, Breton, Marc D., Castle, Jessica R., Chase, James Geoffrey, Chen, Kong Y., Choudhary, Pratik, Clements, Mark A., Close, Kelly L., Cook, Curtiss B., Danne, Thomas, Doyle, Francis J., Drincic, Angela, Dungan, Kathleen M., Edelman, Steven V., Ejskjaer, Niels, Espinoza, Juan C., Fleming, G. Alexander, Forlenza, Gregory P., Freckmann, Guido, Galindo, Rodolfo J., Gomez, Ana Maria, Gutow, Hanna A., Heinemann, Lutz, Hirsch, Irl B., Hoang, Thanh D., Hovorka, Roman, Jendle, Johan H., Ji, Linong, Joshi, Shashank R., Joubert, Michael, Koliwad, Suneil K., Lal, Rayhan A., Lansang, M. Cecilia, Lee, Wei An, Leelarathna, Lalantha, Leiter, Lawrence A., Lind, Marcus, Litchman, Michelle L., Mader, Julia K., Mahoney, Katherine M., Mankovsky, Boris, Masharani, Umesh, Mathioudakis, Nestoras N., Mayorov, Alexander, Messler, Jordan, Miller, Joshua D., Mohan, Viswanathan, Nichols, James H., Nørgaard, Kirsten, O’Neal, David N., Pasquel, Francisco J., Philis-Tsimikas, Athena, Pieber, Thomas, Phillip, Moshe, Polonsky, William H., Pop-Busui, Rodica, Rayman, Gerry, Rhee, Eun Jung, Russell, Steven J., Shah, Viral N., Sherr, Jennifer L., Sode, Koji, Spanakis, Elias K., Wake, Deborah J., Waki, Kayo, Wallia, Amisha, Weinberg, Melissa E., Wolpert, Howard, Wright, Eugene E., Zilbermint, Mihail, Kovatchev, Boris

المصدر: Klonoff , D C , Wang , J , Rodbard , D , Kohn , M A , Li , C , Liepmann , D , Kerr , D , Ahn , D , Peters , A L , Umpierrez , G E , Seley , J J , Xu , N Y , Nguyen , K T , Simonson , G , Agus , M S D , Al-Sofiani , M E , Armaiz-Pena , G , Bailey , T S , Basu , A , Battelino , T , Bekele , S Y , Benhamou , P ....

مصطلحات موضوعية: ambulatory glucose profile, composite metric, continuous glucose monitor, diabetes, glycemia risk index, hyperglycemia, hypoglycemia, time in range

الوصف: Background: A composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data. Methods: We assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low–glucose and low-glucose hypoglycemia; very high–glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation. Results: The analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals. Conclusion: The GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic ...

الإتاحة: https://doi.org/10.1177/19322968221085273Test
https://curis.ku.dk/portal/da/publications/a-glycemia-risk-index-gri-of-hypoglycemia-andTest-hyperglycemia-for-continuous-glucose-monitoring-validated-by-clinician-ratings(47aa6d42-3e6e-4ad0-9480-c0d880bbd805).html

المؤلفون: Lal, Rayhan A.^1,2 (AUTHOR), Leelarathna, Lalantha³ (AUTHOR)

المصدر: Diabetes Technology & Therapeutics. 2023 Supplement 1, Vol. 25, pS-30-S-43. 14p.

مصطلحات موضوعية: *INSULIN pumps, *HYPERGLYCEMIA, *TYPE 1 diabetes, *INSULIN, *INSULIN therapy, *TYPE 2 diabetes

مستخلص: Methods Participants with type 1 diabetes on insulin pump therapy and with an HbA1c <86 mmol/mol (10%) were asked to wear two Accu-Chek Spirit Combo insulin pumps with Accu-Chek FlexLink infusion sets inserted on the abdomen or hips for 7 days. Insulin pump manufacturers are making automated insulin dosing ubiquitous, and this is likely to increase the uptake of insulin pump technology. Higher baseline HbA1c levels and the presence of psychological/psychiatric disorders were predictors of having diabetes-related ketoacidosis after insulin pump therapy, once again highlighting the need for extra education to minimize the occurrence of this life-threatening complication after starting insulin pump therapy. INSULIN PUMPS IN TYPE 2 DIABETES Insulin Pump Therapy for Patients with Type 2 Diabetes Mellitus: Evidence, Current Barriers,... I Freckmann G SP 1 sp , Buck S SP 1 sp , Waldenmaier D SP 1 sp , Kulzer B SP 2 sp , Schnell O SP 3 sp , Gelchsheimer U SP 4 sp , Ziegler R SP 5 sp , Heinemann L SP 6 sp i I SP 1 sp Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany; SP 2 sp Forschungsinstitut Diabetes Akademie Bad Mergentheim, Germany; SP 3 sp Forschergruppe Diabetes e.V., Helmholtz Zentrum, Munich, Germany; SP 4 sp Roche Diabetes Care GmbH, Mannheim, Germany; SP 5 sp Diabetes Clinic for Children and Adolescents, Münster, Germany; SP 6 sp Science Consulting in Diabetes GmbH, Neuss, Germany i I J Diabetes Sci Technol 2021; i B I 15 i b I : 901-915 i Background Insulin pump therapy is well established in type 1 diabetes. [Extracted from the article]

المؤلفون: Lal, Rayhan^1,2 (AUTHOR), Leelarathna, Lalantha³ (AUTHOR)

المصدر: Diabetes Technology & Therapeutics. 2022 Supplement 1, Vol. 24, pS-21-S-34. 14p.

مصطلحات موضوعية: *HYPERGLYCEMIA, *DIABETIC retinopathy, *TYPE 1 diabetes, *INSULIN therapy, *MEDICAL personnel, *INSULIN, *TYPE 2 diabetes

مستخلص: Association of insulin pump therapy vs insulin injection therapy with severe hypoglycemia, ketoacidosis, and glycemic control among children, adolescents, and young adults with type 1 diabetes. This study evaluated differences in clinical outcomes for young adults on Medicaid living with type 1 diabetes (T1D) on insulin pump therapy versus injections. Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): A randomised open-label controlled trial. Comparison of Insulin Pump Bolus Calculators Reveals Wide Variation in Dose Recommendations I Buchanan J, Zabinsky JA, Ferrara-Cook C, Adi S, Wong JC i I Division of Endocrinology, Department of Pediatrics, University of California, San Francisco, CA i I J Diabetes Sci Technol 2021; B I 15 i b : 1290-1296 i Background Bolus calculators on insulin pumps were introduced with the Deltec Cozmo in 2002, and all current commercial insulin pumps include one. [Extracted from the article]

المؤلفون: Lal, Rayhan A.^1,2,3 (AUTHOR) inforay@stanford.edu, Hsu, Liana¹ (AUTHOR), Zhang, Jian² (AUTHOR), Schøndorff, Pernelle K.⁴ (AUTHOR), Heschel, Matthias⁴ (AUTHOR), Buckingham, Bruce^1,3 (AUTHOR)

المصدر: Diabetes, Obesity & Metabolism. Aug2021, Vol. 23 Issue 8, p1973-1977. 5p.

مصطلحات موضوعية: *TYPE 1 diabetes, *INSULIN pumps, *HYPERGLYCEMIA, *LONGEVITY, *ADULTS

مستخلص: Current insulin infusion sets are approved for only 2‐3 days. The novel ConvaTec infusion set with Lantern technology is designed to extend infusion set wear time. The goal of this pilot study was to evaluate the duration of wear for this set. This was a pilot safety study in adults with type 1 diabetes using tethered insulin pumps. Participants inserted the set and wore it for 10 days or until failure. Among 24 participants, two were excluded. Forty‐five per cent of the sets lasted 10 days. Median wear time was 9.1 (7.1, 10.0) days. Among 12 premature failures, six (50%) involved adhesive failures, four (33%) hyperglycaemia unresponsive to correction, one (8%) hyperglycaemia with ketones and one (8%) infection. Average CGM glucose per day of infusion set wear showed a statistically significant increase over time, while total daily insulin over the same period did not change. In this pilot study, the duration of wear for the novel infusion set exceeded previously reported commercial sets (P <.001). This extended wear technology may eventually allow for a combined glucose sensor and infusion set. [ABSTRACT FROM AUTHOR]

المؤلفون: Lal, Rayhan¹ (AUTHOR), Leelarathna, Lalantha² (AUTHOR)

المصدر: Diabetes Technology & Therapeutics. 2020 Supplement1, Vol. 22, pS-17-S-31. 14p.

مصطلحات موضوعية: *INSULIN pumps, *MEDICAL sciences, *HYPERGLYCEMIA, *MEDICAL personnel, *TYPE 1 diabetes, *INSULIN aspart, *POSTMORTEM changes, *BLOOD sugar analysis, *RESEARCH, *BLOOD sugar monitoring, *RESEARCH methodology, *HYPOGLYCEMIC agents, *MEDICAL cooperation, *EVALUATION research, *PATIENTS' attitudes, *TREATMENT effectiveness, *COMPARATIVE studies, *RESEARCH funding, *PATIENT education

مصطلحات جغرافية: AUSTRALIA

مستخلص: Meta-analyses of clinical trials comparing insulin pump therapy with traditional insulin injections usually show a small, but significant advantage of pumps with respect to HbA1c and risk of severe hypoglycemia. Faster-acting insulin aspart is aspart insulin formulated with the excipients niacinamide and l-arginine; it has an earlier onset and earlier glucose-lowering effect than insulin aspart and earlier offset of action. This study aimed to investigate the pharmacodynamics and pharmacokinetics of BioChaperone insulin Lispro (BCLIS), FIA, and insulin aspart (ASP) in patients with type 1 diabetes using an insulin pump. Clinicians should be aware of this variability when initiating insulin pump therapy, especially in insulin-sensitive patients with low insulin dose requirements. Association of insulin pump therapy vs insulin injection therapy with severe hypoglycemia, ketoacidosis, and glycemic control among children, adolescents, and young adults with type 1 diabetes. [Extracted from the article]

المؤلفون: Lal, Rayhan A.¹ inforay@stanford.edu, Maahs, David M.²

المصدر: Diabetes Technology & Therapeutics. 2017 Supplement, Vol. 19, pS-37-S-43. 7p.

مصطلحات موضوعية: *BLOOD sugar, *DIABETES

مستخلص: The article examines published pediatric data on use of continous glucose monitoring in diseases including type 1 and 2 diabetes mellitus, cystic fibrosis and adrenal insufficiency.