scholarly journals Comparison of Insulin Pump Bolus Calculators Reveals Wide Variation in Dose Recommendations

2020 ◽  
pp. 193229682095185 ◽  
Author(s):  
Jeanne Buchanan ◽  
Jennifer A. Zabinsky ◽  
Christine Ferrara-Cook ◽  
Saleh Adi ◽  
Jenise C. Wong
Keyword(s):  
Quality Of Life ◽  
Insulin Pump ◽  
The Other ◽  
Dose Recommendation ◽  
Time Points ◽  
Clinical Scenarios ◽  
Glycemic Outcomes ◽  
Dose Recommendations

Background: The introduction of insulin pumps with bolus calculators (BCs) has improved glycemic outcomes and quality of life for those with type 1 diabetes. Despite the increased reliance on BCs, the formulas used to derive recommended boluses are not standardized. Our objective was to examine whether recommendations from different pump BCs vary significantly for identical clinical scenarios. Methods: Three commercially available insulin pump BCs were programmed with identical settings and then presented with combinations of blood glucose (BG) and carbohydrates (CHOs) to generate a 4-unit bolus. At one- and two-hour time points, while there was insulin-on-board (IOB) present, we simulated various BG and CHO scenarios in order to compare BC-recommended doses. Results: Differences in suggested doses were noted between BCs, as well as within the same brand. The greatest variation was apparent when BG was below target. Doses suggested by one BC varied depending on whether the IOB resulted from a previous dose given for BG or CHO, while the other two BCs adjusted for total IOB regardless of the source. Conclusions: In this simulation study, there were large differences in recommended doses between BCs due to the unique way each manufacturer incorporates IOB into their formulas as well as the pharmacokinetics used to derive the IOB amount. Providers should be aware that identical pump settings will result in a different dose recommendation for each pump brand and advise patients accordingly.

Insulin Management for Type 1 Diabetic Patients During Social Alcohol Consumption: The SPRITZ Study

2020 ◽  
Vol 16 (6) ◽  
pp. 619-627
Author(s):  
Elisa Cipponeri ◽  
Cesare Blini ◽  
Christian Lamera ◽  
Valentina De Mori ◽  
Giovanni Veronesi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Glycemic Control ◽  
Educational Program ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Adult Type ◽  
Time To Peak

Background : There is no data available on the best insulin treatment to counteract the effects of glucose excursions due to a moderate alcohol intake associated with portions of slight fat and protein-containing food, as often the case during social happenings or “happy hours”. Introduction: This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips). Introduction : This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips). Methods: Patients consumed Spritz aperitif twice: using their habitual bolus, based on carbohydrates (CHO) counting (V1), or with a personalized, advanced bolus (V2) calculated from insulin/Kcal derived from Fats and Proteins (FPU). Post-prandial glucose was continuously monitored; glucose incremental areas (iAUC), glucose peak and time to peak, and estimated change from V1 to V2 from repeated- measures models were computed. Each patient fulfilled validated questionnaires on quality of life, knowledge about diabetes and CHO counting. Results : After the educational program, a reduced iAUC (0-80 min: -306, p=ns; 40-80 min: -400, p=0.07) due to greater (p=0.03) and prolonged double-wave insulin boluses was observed. Blood glucose peak and time to peak were also reduced. Moreover, improvements in the psycho-affective dimension, as well as in the alimentary knowledge were detected. Conclusion: Therefore, a personalized educational program on CHO + FPU counting together with insulin bolus management can improve glycemic control during social consumption of alcohol, with positive reflections on the psycho-affective dimension. Further studies are mandatory to confirm such preliminary results.

Technological Developments and Quality of Life in Type 1 Diabetes Mellitus Patients: A Review of the Modern Insulin Analogues, Continuous Glucose Monitoring and Insulin Pump Therapy

2021 ◽  
Vol 18 ◽  
Author(s):  
Emmanouil Benioudakis ◽  
Eleni Karlafti ◽  
Argyroula Kalaitzaki ◽  
Georgia Kaiafa ◽  
Christos Savopoulos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Insulin Pump ◽  
Glycosylated Hemoglobin ◽  
Glucose Monitoring ◽  
Insulin Analogues

Background: Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease, which is characterized by an increased prevalence worldwide, which, in fact, tends to take extensive dimensions. The recent rapid development of science and technology has significantly contributed to the improvement of the management of type 1 diabetes mellitus, both in achieving the required euglycaemic regulation and reducing the psychological burden associated with the disease, consequently improving the quality of life of the patients with type 1 diabetes mellitus. Methods: A literature review from 2010, related to the contribution of the modern insulin analogues, continuous glucose monitoring and the insulin pump, was performed using Scopus, ScienceDirect and PubMed databases. Results: Studies included in the review support a direct and indirect association of technological innovations with the quality of life. The use of type 1 diabetes mellitus technology was negatively associated with the frequency of the hypoglycaemias and the value of the glycosylated hemoglobin, while at the same time, the development and use of the related technology were highly associated with an improvement in the quality of life. Conclusion: Patients’ quality of life is an indicator of the management of type 1 diabetes mellitus, and it is just as important as glycaemic regulation. Through this review, it was concluded that a better quality of life of T1DM patients was associated with the improvement of glycosylated hemoglobin and hypoglycemic episodes.

scholarly journals Generic and disease-specific quality of life in adolescents with type 1 diabetes: comparison to age-matched healthy peers

2016 ◽  
Vol 29 (7) ◽  
Author(s):  
Andrea Lukács ◽  
Péter Sasvári ◽  
András Török ◽  
László Barkai
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Regular Exercise ◽  
Pump Therapy

AbstractThis study aimed to evaluate the health-related quality of life (HRQoL) of adolescents with type 1 diabetes (T1DM) on the basis of the pediatric quality of life inventory™ (PedsQL™) generic and diabetes-specific modules, and to compare it to that of healthy peers.This retrospective case-control study involved 650 participants between ages of 13 and 19 years including 296 adolescents with T1DM from four diabetes centers and 354 healthy peers matched for age and gender from three different cities of the country. Participants completed the validated PedsQL™ for assessing the HRQoL. The analysis included an independent t-test to compare the means of the total and subscales of the PedsQL™ between boys and girls as well as between a healthy group and a group with T1DM. Gender differences in exercise, insulin therapy modalities were evaluated with the Pearson χAdolescents with T1DM have similar HRQoL in all domains when compared to their healthy counterparts. Females report worse HRQoL regardless of the presence of the disease. Insulin pump therapy facilitates better glycemic control and HRQoL. Regular exercise positively correlates with the generic HRQoL in both groups; however, it has no relationship with glycemic control.Optimal metabolic control and improved HRQoL are the eventual goals of diabetes management. Despite the difficulties, adolescents with diabetes can manage their disease well and live normal lives, similar to their healthy peers. Although diabetes-related problems exist, it seems that regular exercise and staying physically active, as well as promoting insulin pump therapy where it is applicable are related to favorable HRQoL.

scholarly journals Use of telemedicine improves glycemic control and quality of life in type 1 diabetes children on insulin pump therapy

2018 ◽  
Vol 20 (6) ◽  
pp. 420-426 ◽  
Author(s):  
Dmitry N. Laptev ◽  
Valentina A. Peterkova
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Insulin Pump ◽  
Insulin Pump Therapy

Rationale: Healthcare access plays a significant role in the improvement and maintaining of glycemic control and quality of life in type 1 diabetes mellitus (T1DM) patients on continuous subcutaneous insulin infusion (CSII). Aims: The aim of the study was to evaluate the feasibility of remote support in children and adolescents with type 1 diabetes mellitus (T1DM) and its effect on glycemic control and quality of life. Materials and methods: In 40 children and adolescents (132,7 years, 18/22 m/f) on CSII with inadequately controlled T1DM (HbA1c7,5%) we evaluated the effectiveness of telemedical support (TS), as compared with conventional support (CS). Parameters of glycemic control (HbA1c, average glycemia, SD, etc.) and quality of a life were obtained on follow-up visits. Patients and their parents in ТМ group twice a month sent their insulin pump data using to CSII center and diabetologists sent back their advice via e-mail, phone or Skype. The primary end point was the change from the baseline HbA1c level and the proportion of patients achieving HbA1c of less than 7.5%. Results: At 24 weeks, the baseline mean HbA1c (8.7% in the two study groups) had decreased to 7.7% in the TS group, as compared with 8.4% in the CS group (P0,05). The proportion of patients who reached the HbA1c target (7,5%) was greater in the TS group (50%) than in the CS group (20%, p0,05). A number of quality of life indicators for both parents and children with T1DM at the end of the study compared to baseline significantly increased in the TS group compared with the TC group (p0.05). During the study period rate of severe hypoglycemia and DKA in TS group (0 and 10 cases per 100 person-years) did not differ significantly from that in CS group (0 and 20 cases per 100 person-years, P0,05). Conclusion: In children with inadequately controlled T1DM, telemedical support proved to be feasible and resulted in significant improvement in glucose control (HbA1c, glucose variability) and quality of life without the increase in the incidence of DKA and severe glycemia.

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