المؤلفون: Jessica R. Castle, Leah M. Wilson, Nichole S. Tyler, Alejandro Z. Espinoza, Clara M. Mosquera-Lopez, Taisa Kushner, Gavin M. Young, Joseph Pinsonault, Robert H. Dodier, Wade W. Hilts, Sos M. Oganessian, Deborah L. Branigan, Virginia B. Gabo, Jae H. Eom, Katrina Ramsey, Joseph El Youssef, Joseph A. Cafazzo, Kerri Winters-Stone, Peter G. Jacobs

المصدر: Diabetes technologytherapeutics. 24(12)

مصطلحات موضوعية: Adult, Blood Glucose, Glycated Hemoglobin, Medical Laboratory Technology, Endocrinology, Diabetes Mellitus, Type 1, Endocrinology, Diabetes and Metabolism, Blood Glucose Self-Monitoring, Humans, Insulin, Hypoglycemic Agents

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3aa574ae324768751367b5b76ae05447Test
https://pubmed.ncbi.nlm.nih.gov/35920839Test

المؤلفون: LEAH M. WILSON, PETER G. JACOBS, FLORIAN H. GUILLOT, NICHOLE S. TYLER, TAISA KUSHNER, ALEJANDRO Z. ESPINOZA, CLARA M. MOSQUERA-LOPEZ, JOSEPH PINSONAULT, ROBERT DODIER, SOS M. OGANESSIAN, DEBORAH BRANIGAN, VIRGINIA GABO, JAE H. EOM, JOSEPH EL YOUSSEF, KERRI WINTERS-STONE, JESSICA R. CASTLE

المصدر: Diabetes. 71

مصطلحات موضوعية: Endocrinology, Diabetes and Metabolism, Internal Medicine

الوصف: DailyDose is a smart-phone decision support system developed at Oregon Health & Science University that uses Dexcom G6 CGM and Medtonic’s InPen. The app calculates insulin doses using CGM value and trend, insulin-on-board, carbohydrate amount, and exercise information. Insulin dosing and carbohydrate intake recommendations before and after exercise are adjusted according to the 2017 consensus statement by Riddell et al. known as the PEAK Guidelines. Twenty-four adults with T1D, using multiple daily injections of insulin at baseline, completed a two-week run-in period then used the DailyDose intervention for 8 weeks. Participants completed 3 at-home exercise sessions per week, one aerobic exercise video and two other sessions of their choice. We examined the impact of the use of PEAK guidelines on glucose outcomes during exercise comparing 176 exercise sessions done during run-in and 471 sessions done during the intervention period. Glucose outcomes were assessed from start of exercise to 4 hours after the start or until either a meal was consumed, insulin dosed or new exercise session initiated. Mixed effects analysis was used to determine significance of the intervention on glucose outcomes. The nadir of the glucose was lower for the run-in compared with the intervention (120.6 vs. 130.9 mg/dL, P=.012) . Change in glucose from the start of exercise to the nadir was 58.0 for the run-in versus 46.9 for the intervention period (P=.016) . Time in hyperglycemia (>180mg/dL) during the exercise periods trended toward being lower during the intervention (43.8% run-in, 35.0% intervention, P=.059) , as did time in range of 70-180 mg/dL, (54.2% run-in, 62.2% intervention, P=.081) . There was no difference in time in hypoglycemia. Data suggest that use of PEAK within a decision support app can help prevent more severe glucose drops during and after exercise with a trend toward improving time in range. Disclosure L.M.Wilson: n/a. S.M.Oganessian: None. D.Branigan: None. V.Gabo: None. J.H.Eom: None. J.El youssef: None. K.Winters-stone: None. J.R.Castle: Advisory Panel; Insulet Corporation, Novo Nordisk, Zealand Pharma A/S, Stock/Shareholder; Pacific Diabetes Technologies. P.G.Jacobs: Other Relationship; Pacific Diabetes Technologies, Research Support; Dexcom, Inc. F.H.Guillot: Stock/Shareholder; Pacific Diabetes Technologies. N.S.Tyler: None. T.Kushner: Consultant; Tandem Diabetes Care, Inc. A.Z.Espinoza: None. C.M.Mosquera-lopez: None. J.Pinsonault: None. R.Dodier: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust (Grant 2018PG-T1D001) , OHSU Medical Research Foundation, Supplies provided by Dexcom

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::5579384b954ed6e37e114c6774f3a447Test
https://doi.org/10.2337/db22-291-orTest

المؤلفون: JESSICA R. CASTLE, ALEJANDRO Z. ESPINOZA, NICHOLE S. TYLER, LEAH M. WILSON, CLARA M. MOSQUERA-LOPEZ, JOSEPH PINSONAULT, ROBERT DODIER, SOS M. OGANESSIAN, DEBORAH BRANIGAN, VIRGINIA GABO, JAE H. EOM, JOSEPH EL YOUSSEF, KATRINA RAMSEY, TAISA KUSHNER, KERRI WINTERS-STONE, JOSEPH A. CAFAZZO, PETER G. JACOBS

المصدر: Diabetes. 71

مصطلحات موضوعية: Endocrinology, Diabetes and Metabolism, Internal Medicine

الوصف: DailyDose is a decision support system developed at Oregon Health & Science University designed for people with T1D on MDI to improve glycemic control. It connects with Dexcom G6 and Medtronic's InPen. DailyDose runs on a smartphone and calculates insulin doses using CGM value and trend, IOB, carbohydrate amount, and exercise information. The system analyzes CGM and insulin data and automatically provides weekly recommendations on insulin settings, such as basal insulin dose and carbohydrate ratios, based on a k-nearest neighbors algorithm. Twenty-four adults with T1D used DailyDose for 8 weeks. The primary outcome was change in % time in range (TIR, 70-180 mg/dL) on CGM comparing the two week run-in period before starting DailyDose vs. final two weeks of DailyDose use. A mixed effects model was used to determine the impact of the % of accepted recommendations on change in % TIR. Users who accepted and followed recommendations showed a mean week-to-week improvement in TIR of 2.0% (Figure) . The mixed effects model shows week-by-week TIR increased by 7.8% when recommendations were accepted compared with not accepted (CI, 3-12%, P=.001) . Overall, there were no significant differences between TIR or time in hypoglycemia comparing the run-in period and the final two weeks of use. Further work is needed to encourage people using decision support systems to follow recommendations. Disclosure J.R.Castle: Advisory Panel; Insulet Corporation, Novo Nordisk, Zealand Pharma A/S, Stock/Shareholder; Pacific Diabetes Technologies. V.Gabo: None. J.H.Eom: None. J.El youssef: None. K.Ramsey: None. T.Kushner: Consultant; Tandem Diabetes Care, Inc. K.Winters-stone: None. J.A.Cafazzo: None. P.G.Jacobs: Other Relationship; Pacific Diabetes Technologies, Research Support; Dexcom, Inc. A.Z.Espinoza: None. N.S.Tyler: None. L.M.Wilson: n/a. C.M.Mosquera-lopez: None. J.Pinsonault: None. R.Dodier: None. S.M.Oganessian: None. D.Branigan: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust (Grant 2018PG-T1D001) .

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::951c29326e3249a33aa497dc60dd1471Test
https://doi.org/10.2337/db22-771-pTest