scholarly journals G479(P) Adherence to blood glucose monitoring in children and young people with type 1 diabetes on insulin pump therapy in a teaching hospital:

2015 ◽  
Vol 100 (Suppl 3) ◽  
pp. A204.2-A205
Author(s):  
S Punniyakodi ◽  
PCB Sundaram ◽  
JE Greening ◽  
V Tziaferi
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Young People ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Children And Young People

The advantages of insulin pump therapy and real time glucose monitoring systems as the tools for reducing the frequency of hypoglycemic episodes in the children and adolescents with type 1 diabetes mellitus

2014 ◽  
Vol 60 (2) ◽  
pp. 24-30 ◽  
Author(s):  
D N Laptev
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Type 1 Diabetes Mellitus ◽  
Real Time ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Pump Therapy

The primary objective of the present study was to analyse the advantages of insulin pump therapy and real time glucose monitoring systems as the tools for reducing the frequency of hypoglycemic episodes. The study included 190 children and adolescents at the age varying from 1 to 18 years suffering from type 1 diabetes mellitus. All the patients were hospitalized at the Endocrinological Research Centre for the treatment the disease using different modalities of insulin therapy, such as multiple injections of insulin (MII) and its continuous subcutaneous infusion (CSII). The blood glucose level was monitored during 72 hours making use of the continuous blind and real time monitoring protocols (blind-CGM and RT-CGM respectively). All the patients were divided into 4 groups depending on the therapeutic modality and the mode of blood glucose monitoring. Group 1 was comprised of the patients given multiple insulin injections in combination with blind glucose monitoring ("blind-CGM + MII"), group 2 included the patients undergoing blind glucose monitoring in conjunction with continuous insulin infusion ("blind-CGM + CSII"), group 3 contained the patients treated by multiple insulin injections followed by real-time blood glucose monitoring ("RT-CGM + MII"), and group 4 was composed of the patients undergoing continuous subcutaneous infusion of insulin combined with real-time blood glucose monitoring ("RT-CGM + CSII"). In all the cases, the blood glucose levels were measured and the occurrence of hypoglycemia during the period of monitoring time was evaluated. It was shown that the highest frequency of hypoglycemia during 72 hours was recorded in the "blind-CGM" group and the lowest one in the RT-CGM groups. Despite adequate self-control, almost half of the patients in the "blind-CGM + MII" group reported at least one hypoglycemic episode either at the daytime or at night ; the duration of such episode was more than 1 hour on the average. In the "blind-CGM" group, CSII resulted in the decrease of the number of hypoglycemic episodes both at night and daytime (p<0.05). In the "RT-CGM + CSII" group, continuous insulin infusion reduced the mean duration of nocturnal hypoglycemic episodes (p<0.05) whereas this parameter was not significantly different between the other groups. It is concluded that hypoglycemia especially nocturnal one is rather a common problem facing children and adolescents suffering from type 1 diabetes mellitus. The use of insulin pump therapy and real time glucose monitoring systems (RT-CGM) makes it possible to substantially decrease the frequency and duration of hypoglycemic episodes in this population group.

scholarly journals Pharmacotherapy of type1 diabetes in children and adolescents: more than insulin?

2018 ◽  
Vol 9 (5) ◽  
pp. 157-166 ◽  
Author(s):  
Torben Biester ◽  
Olga Kordonouri ◽  
Thomas Danne
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Real Life ◽  
Glucose Monitoring ◽  
Insulin Analogues ◽  
Insulin Pump Therapy ◽  
Daily Injection ◽  
Great Success ◽  
Pump Therapy

For paediatric patients with type 1 diabetes, intensified insulin therapy with either multiple daily injection or insulin pump therapy is currently the only method of treatment. To optimize this therapy, insulin analogues are fixed parts of all therapy regimens. New ultra-rapid insulins seem to be beneficial not only in adults but also in this age group. New developments in long-acting analogues have demonstrated safety and will be regular in paediatrics, we hope, soon. Furthermore, the psychosocial approach for consideration of real-life aspects becomes more the focus of therapeutic regimens and is implemented into international guidelines. Technical improvements, such as continuous glucose monitoring, particularly in combination with pump therapy, support the great success of rapid-acting analogues by reducing hypoglycaemias. Non-insulin agents such as SGLT2-inhibitors show beneficial aspects in people with type 1 diabetes. For outpatient care with these currently off-label-used drugs, special training for measurement of ketones should be imperative.

scholarly journals Temporal Trends and Contemporary Use of Insulin Pump Therapy and Glucose Monitoring Among Children, Adolescents, and Adults With Type 1 Diabetes Between 1995 and 2017

Diabetes Care ◽  
2019 ◽  
Vol 42 (11) ◽  
pp. 2050-2056 ◽  
Author(s):  
Louisa van den Boom ◽  
Beate Karges ◽  
Marie Auzanneau ◽  
Birgit Rami-Merhar ◽  
Eggert Lilienthal ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Temporal Trends ◽  
Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Adolescents And Adults

scholarly journals Characterization of Exercise and Alcohol Self-Management Behaviors of Type 1 Diabetes Patients on Insulin Pump Therapy

2016 ◽  
Vol 11 (2) ◽  
pp. 240-246 ◽  
Author(s):  
Maria Adela Grando ◽  
Danielle Groat ◽  
Hiral Soni ◽  
Mary Boyle ◽  
Marilyn Bailey ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Insulin Pump ◽  
Blood Glucose Control ◽  
Real Life ◽  
Insulin Pump Therapy ◽  
Insulin Pumps ◽  
Pump Therapy ◽  
Diabetes Patients

Background: There is a lack of systematic ways to analyze how diabetes patients use their insulin pumps to self-manage blood glucose to compensate for alcohol ingestion and exercise. The objective was to analyze “real-life” insulin dosing decisions occurring in conjunction with alcohol intake and exercise among patients using insulin pumps. Methods: We recruited adult type 1 diabetes (T1D) patients on insulin pump therapy. Participants were asked to maintain their daily routines, including those related to exercising and consuming alcohol, and keep a 30-day journal on exercise performed and alcohol consumed. Thirty days of insulin pump data were downloaded. Participants’ actual insulin dosing behaviors were compared against their self-reported behaviors in the setting of exercise and alcohol. Results: Nineteen T1D patients were recruited and over 4000 interactions with the insulin pump were analyzed. The analysis exposed variability in how subjects perceived the effects of exercise/alcohol on their blood glucose, inconsistencies between self-reported and observed behaviors, and higher rates of blood glucose control behaviors for exercise versus alcohol. Conclusion: Compensation techniques and perceptions on how exercise and alcohol affect their blood glucose levels vary between patients. Improved individualized educational techniques that take into consideration a patient’s unique life style are needed to help patients effectively apply alcohol and exercise compensation techniques.

scholarly journals Six-months of hybrid closed-loop versus manual insulin delivery with finger-prick blood glucose monitoring in adults with type 1 diabetes: a randomized, controlled trial

2020 ◽  
Author(s):  
Sybil A McAuley ◽  
Melissa H Lee ◽  
Barbora Paldus ◽  
Sara Vogrin ◽  
Martin I de Bock ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Closed Loop ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Diabetes Distress ◽  
Current Therapy ◽  
Control Group

OBJECTIVE <p>To investigate glycemic and psychosocial outcomes with hybrid closed loop (HCL) versus user-determined insulin dosing with multiple daily injections (MDI) or insulin pump i.e. standard therapy for most adults with type 1 diabetes.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Adults with type 1 diabetes using MDI or insulin pump without continuous glucose monitoring (CGM) were randomized to 26-weeks HCL (Medtronic 670G) or continuation of current therapy. The primary outcome was masked-CGM time-in-range (TIR; 70–180mg/dL) during the final 3 weeks. </p> <p>RESULTS</p> <p>Participants were randomized to HCL (<i>n</i>=61) or control (<i>n</i>=59). Baseline mean (SD) age 44.2(11.7)years; HbA<sub>1c</sub> 7.4(0.9)%, 57(10)mmol/mol; 53% were women and 51% used MDI. HCL TIR increased from (baseline) 55% (13%) to (26 weeks) 70% (10%) with the control group unchanged: (baseline) 55% (12%) and (26 weeks) 55% (13%) (difference 15%; 95% CI 11, 19%; <i>p</i><0.0001). For HCL, HbA<sub>1c</sub> was lower (median [95% CI] difference −0.4% [−0.6, −0.2]; −4mmol/mol [−7, −2]; <i>p</i><0.0001) and diabetes-specific positive well-being higher (difference 1.2, 95% CI 0.4, 1.9; <i>p</i><0.0048) without a deterioration in diabetes distress, perceived sleep quality or cognition. Seventeen (nine device-related) vs. thirteen serious adverse events occurred in the HCL and control groups respectively.</p> <p>CONCLUSIONS</p> <p>In adults with type 1 diabetes 26 weeks of HCL improved TIR, HbA<sub>1c</sub> and their sense of satisfaction from managing their diabetes than those continuing with user-determined insulin dosing and self-monitoring blood glucose. For most people living with type 1 diabetes globally, this trial demonstrates that HCL is feasible, acceptable and advantageous.</p>

scholarly journals Six-months of hybrid closed-loop versus manual insulin delivery with finger-prick blood glucose monitoring in adults with type 1 diabetes: a randomized, controlled trial

2020 ◽  
Author(s):  
Sybil A McAuley ◽  
Melissa H Lee ◽  
Barbora Paldus ◽  
Sara Vogrin ◽  
Martin I de Bock ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Closed Loop ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Diabetes Distress ◽  
Current Therapy ◽  
Control Group

OBJECTIVE <p>To investigate glycemic and psychosocial outcomes with hybrid closed loop (HCL) versus user-determined insulin dosing with multiple daily injections (MDI) or insulin pump i.e. standard therapy for most adults with type 1 diabetes.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Adults with type 1 diabetes using MDI or insulin pump without continuous glucose monitoring (CGM) were randomized to 26-weeks HCL (Medtronic 670G) or continuation of current therapy. The primary outcome was masked-CGM time-in-range (TIR; 70–180mg/dL) during the final 3 weeks. </p> <p>RESULTS</p> <p>Participants were randomized to HCL (<i>n</i>=61) or control (<i>n</i>=59). Baseline mean (SD) age 44.2(11.7)years; HbA<sub>1c</sub> 7.4(0.9)%, 57(10)mmol/mol; 53% were women and 51% used MDI. HCL TIR increased from (baseline) 55% (13%) to (26 weeks) 70% (10%) with the control group unchanged: (baseline) 55% (12%) and (26 weeks) 55% (13%) (difference 15%; 95% CI 11, 19%; <i>p</i><0.0001). For HCL, HbA<sub>1c</sub> was lower (median [95% CI] difference −0.4% [−0.6, −0.2]; −4mmol/mol [−7, −2]; <i>p</i><0.0001) and diabetes-specific positive well-being higher (difference 1.2, 95% CI 0.4, 1.9; <i>p</i><0.0048) without a deterioration in diabetes distress, perceived sleep quality or cognition. Seventeen (nine device-related) vs. thirteen serious adverse events occurred in the HCL and control groups respectively.</p> <p>CONCLUSIONS</p> <p>In adults with type 1 diabetes 26 weeks of HCL improved TIR, HbA<sub>1c</sub> and their sense of satisfaction from managing their diabetes than those continuing with user-determined insulin dosing and self-monitoring blood glucose. For most people living with type 1 diabetes globally, this trial demonstrates that HCL is feasible, acceptable and advantageous.</p>

scholarly journals Self-Reported Compensation Techniques for Carbohydrate, Exercise, and Alcohol Behaviors in Patients With Type 1 Diabetes on Insulin Pump Therapy

2017 ◽  
Vol 12 (2) ◽  
pp. 412-414 ◽  
Author(s):  
Danielle Groat ◽  
Hiral Soni ◽  
Maria Adela Grando ◽  
Bithika Thompson ◽  
Curtiss B. Cook
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Self Management ◽  
Pump Therapy ◽  
Electronic Survey ◽  
Alcohol Behaviors ◽  
Management Behaviors

Studies have found variability in self-care behaviors in patients with type 1 diabetes, particularly when incorporating exercise and alcohol consumption. The objective of this study was to provide results from a survey to understand (1) insulin pump behaviors, (2) reported self-management behaviors for exercise and alcohol, and (3) perceptions of the effects of exercise and alcohol on blood glucose (BG) control. Fourteen participants from an outpatient endocrinology practice were recruited and administered an electronic survey. Compensation techniques for exercise and alcohol, along with reasons for employing the techniques were identified. Also identified were factors that participants said affected BG control with regard to exercise and alcohol. These results confirm the considerable inconsistency patients have about incorporating exercise and alcohol into decisions about self-management behaviors.

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