المؤلفون: Russell, Steven, Beck, Roy, Damiano, Edward, El-Khatib, Firas, Ruedy, Katrina, Balliro, Courtney, Li, Zoey, Calhoun, Peter, Wadwa, R, Buckingham, Bruce, Zhou, Keren, Daniels, Mark, Raskin, Philip, White, Perrin, Lynch, Jane, Pettus, Jeremy, Hirsch, Irl, Goland, Robin, Buse, John, Kruger, Davida, Mauras, Nelly, Muir, Andrew, McGill, Janet, Cogen, Fran, Weissberg-Benchell, Jill, Sherwood, Jordan, Castellanos, Luz, Hillard, Mallory, Tuffaha, Marwa, Putman, Melissa, Sands, Mollie, Forlenza, Gregory, Slover, Robert, Messer, Laurel, Cobry, Erin, Shah, Viral, Polsky, Sarit, Lal, Rayhan, Ekhlaspour, Laya, Hughes, Michael, Basina, Marina, Hatipoglu, Betul, Olansky, Leann, Bhangoo, Amrit, Forghani, Nikta, Kashmiri, Himala, Sutton, Francoise, Choudhary, Abha, Penn, Jimmy, Jafri, Rabab, Rayas, Maria, Escaname, Elia, Kerr, Catherine, Favela-Prezas, Ruby, Trikudanathan, Subbulaxmi, Williams, Kristen, Leibel, Natasha, Kirkman, M, Bergamo, Kate, Klein, Klara, Dostou, Jean, Machineni, Sriram, Young, Laura, Diner, Jamie, Bhan, Arti, Jones, J, Benson, Matthew, Bird, Keisha, Englert, Kimberly, Permuy, Joe, Cossen, Kristina, Felner, Eric, Salam, Maamoun, Silverstein, Julie, Adamson, Samantha, Cedeno, Andrea, Meighan, Seema, Dauber, Andrew, Boeder, Schafer

المصدر: The New England Journal of Medicine. 387(13)

مصطلحات موضوعية: Adolescent, Adult, Aged, Bionics, Blood Glucose, Blood Glucose Self-Monitoring, Child, Diabetes Mellitus, Type 1, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Insulin Aspart, Insulin Infusion Systems, Insulin Lispro, Middle Aged, Young Adult

الوصف: BACKGROUND: Currently available semiautomated insulin-delivery systems require individualized insulin regimens for the initialization of therapy and meal doses based on carbohydrate counting for routine operation. In contrast, the bionic pancreas is initialized only on the basis of body weight, makes all dose decisions and delivers insulin autonomously, and uses meal announcements without carbohydrate counting. METHODS: In this 13-week, multicenter, randomized trial, we randomly assigned in a 2:1 ratio persons at least 6 years of age with type 1 diabetes either to receive bionic pancreas treatment with insulin aspart or insulin lispro or to receive standard care (defined as any insulin-delivery method with unblinded, real-time continuous glucose monitoring). The primary outcome was the glycated hemoglobin level at 13 weeks. The key secondary outcome was the percentage of time that the glucose level as assessed by continuous glucose monitoring was below 54 mg per deciliter; the prespecified noninferiority limit for this outcome was 1 percentage point. Safety was also assessed. RESULTS: A total of 219 participants 6 to 79 years of age were assigned to the bionic-pancreas group, and 107 to the standard-care group. The glycated hemoglobin level decreased from 7.9% to 7.3% in the bionic-pancreas group and did not change (was at 7.7% at both time points) in the standard-care group (mean adjusted difference at 13 weeks, -0.5 percentage points; 95% confidence interval [CI], -0.6 to -0.3; P

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/1m5021wbTest

المؤلفون: Walsh, Kimberly, Campbell, Donna, Permuy, Joe, Henson, Michael, Rodriguez, Larry, Machus, Brittany, Shiver, April, Smith, Katharine

المصدر: Journal of Pediatric Nursing ; volume 52, page 112 ; ISSN 0882-5963

مصطلحات موضوعية: Pediatrics

الإتاحة: https://doi.org/10.1016/j.pedn.2020.02.028Test
https://api.elsevier.com/content/article/PII:S0882596320301147?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0882596320301147?httpAccept=text/plainTest

المؤلفون: Russell, Steven J, Beck, Roy W, Damiano, Edward R, El-Khatib, Firas H, Ruedy, Katrina J, Balliro, Courtney A, Li, Zoey, Calhoun, Peter, Wadwa, R. Paul, Buckingham, Bruce, Zhou, Keren, Daniels, Mark, Raskin, Philip, White, Perrin C, Lynch, Jane, Pettus, Jeremy, Hirsch, Irl B, Goland, Robin, Buse, John B, Kruger, Davida F, Mauras, Nelly, Muir, Andrew, McGill, Janet B, Cogen, Fran, Weissberg-Benchell, Jill, Sherwood, Jordan S, Castellanos, Luz E, Hillard, Mallory A, Tuffaha, Marwa, Putman, Melissa S, Sands, Mollie Y, Forlenza, Gregory, Slover, Robert, Messer, Laurel H, Cobry, Erin, Shah, Viral N, Polsky, Sarit, Lal, Rayhan, Ekhlaspour, Laya, Hughes, Michael S, Basina, Marina, Hatipoglu, Betul, Olansky, Leann, Bhangoo, Amrit, Forghani, Nikta, Kashmiri, Himala, Sutton, Francoise, Choudhary, Abha, Penn, Jimmy, Jafri, Rabab, Rayas, Maria, Escaname, Elia, Kerr, Catherine, Favela-Prezas, Ruby, Boeder, Schafer, Trikudanathan, Subbulaxmi, Williams, Kristen M, Leibel, Natasha, Kirkman, M. Sue, Bergamo, Kate, Klein, Klara R, Dostou, Jean M, Machineni, Sriram, Young, Laura A, Diner, Jamie C, Bhan, Arti, Jones, J. Kimberly, Benson, Matthew, Bird, Keisha, Englert, Kimberly, Permuy, Joe, Cossen, Kristina, Felner, Eric, Salam, Maamoun, Silverstein, Julie M, Adamson, Samantha, Cedeno, Andrea, Meighan, Seema, Dauber, Andrew

المصدر: Endocrinology Articles

مصطلحات موضوعية: Adolescent, Adult, Aged, Bionics, Blood Glucose, Blood Glucose Self-Monitoring, Child, Diabetes Mellitus, Type 1, Glycated Hemoglobin A, Humans, Hypoglycemic Agents, Insulin, Insulin Aspart, Insulin Infusion Systems, Insulin Lispro, Middle Aged, Young Adult

الوصف: BACKGROUND: Currently available semiautomated insulin-delivery systems require individualized insulin regimens for the initialization of therapy and meal doses based on carbohydrate counting for routine operation. In contrast, the bionic pancreas is initialized only on the basis of body weight, makes all dose decisions and delivers insulin autonomously, and uses meal announcements without carbohydrate counting. METHODS: In this 13-week, multicenter, randomized trial, we randomly assigned in a 2:1 ratio persons at least 6 years of age with type 1 diabetes either to receive bionic pancreas treatment with insulin aspart or insulin lispro or to receive standard care (defined as any insulin-delivery method with unblinded, real-time continuous glucose monitoring). The primary outcome was the glycated hemoglobin level at 13 weeks. The key secondary outcome was the percentage of time that the glucose level as assessed by continuous glucose monitoring was below 54 mg per deciliter; the prespecified noninferiority limit for this outcome was 1 percentage point. Safety was also assessed. RESULTS: A total of 219 participants 6 to 79 years of age were assigned to the bionic-pancreas group, and 107 to the standard-care group. The glycated hemoglobin level decreased from 7.9% to 7.3% in the bionic-pancreas group and did not change (was at 7.7% at both time points) in the standard-care group (mean adjusted difference at 13 weeks, -0.5 percentage points; 95% confidence interval [CI], -0.6 to -0.3; P<0.001). The percentage of time that the glucose level as assessed by continuous glucose monitoring was below 54 mg per deciliter did not differ significantly between the two groups (13-week adjusted difference, 0.0 percentage points; 95% CI, -0.1 to 0.04; P<0.001 for noninferiority). The rate of severe hypoglycemia was 17.7 events per 100 participant-years in the bionic-pancreas group and 10.8 events per 100 participant-years in the standard-care group (P = 0.39). No episodes of diabetic ketoacidosis occurred in either group. ...

العلاقة: https://scholarlycommons.henryford.com/endocrinology_articles/129Test; https://libkey.io/36170500Test

الإتاحة: https://scholarlycommons.henryford.com/endocrinology_articles/129Test
https://libkey.io/36170500Test

المؤلفون: Englert, Kimberly, Ruedy, Katrina, Coffey, Julie, Caswell, Kimberly, Steffen, Amy, Levandoski, Lucy, Tsalikian, Eva, Tansey, Michael J., Cabbage, Joanne, Salamati, Sara, Mauras, Nelly, Fox, Larry A., Permuy, Joe, Sikes, Kaitlin, Buckingham, Bruce A., Wilson, Darrell M., Clinton, Paula, Weinzimer, Stuart A., Tamborlane, William V., Sherr, Jennifer, Weyman, Kate, Zgorski, Melinda, Tichy, Eileen, White, Neil H., Arbelaez, Ana Maria, Starnes, Angie, Beck, Roy W., Ruedy, Katrina J., Kollman, Craig, Xing, Dongyuan, Hall, Callyn, Stevens, Beth, Grave, Gilman D., Winer, Karen K., Leschek, Ellen, Becker, Dorothy M., Cleary, Patricia, Greenbaum, Carla, Moran, Antoinette, Steffes, Michael W., Bucksa, Jean M., Nowicki, Maren L., Makky, Vicky

المصدر: Journal of Diabetes Science and Technology ; volume 8, issue 4, page 745-751 ; ISSN 1932-2968 1932-2968

الوصف: Background: The purpose of this article is to describe challenges associated with successful use of continuous glucose monitoring (CGM) by young children with type 1 diabetes (T1D) and to detail the techniques and products used to improve the duration of sensor wear. Methods: The DirecNet Study Group conducted 2 studies in 169 children with T1D between the ages of 1 and 9 years who were instructed to wear a CGM device daily. Problems related to skin irritation and sensor adhesiveness in these young children presented challenges to daily use of the CGM. Study coordinators instituted a variety of techniques using commercially available products to attempt to overcome these problems. Results: Three primary factors that contributed to reduced CGM use were identified: the limited body surface area in smaller children, ambient temperature and humidity, as well as the type and duration of physical activity. Using supplemental products to minimize the impact of these factors resulted in improved adherence and reduced skin irritation. Conclusion: Achieving satisfactory adhesion of the CGM sensor and transmitter may involve finding the right supplemental product or combination of products through trial and error. Optimizing adhesion and minimizing skin irritation can significantly improve duration of use and tolerability of CGM devices by young children.

الإتاحة: https://doi.org/10.1177/1932296814529893Test