scholarly journals A Retrospective Review of the Clinical Characteristics and Blood Glucose Data from Cellnovo System Users using Data Collected from the Cellnovo Online Platform

2018 ◽  
Vol 14 (1) ◽  
pp. 30
Author(s):  
Olivia Hautier-Suply ◽  
Yasmin Friedmann ◽  
Julian Shapley
Keyword(s):  
Blood Glucose ◽  
Retrospective Review ◽  
Diabetes Management ◽  
Pump Therapy ◽  
Online Platform ◽  
Software Algorithms ◽  
Technological Advances ◽  
Using Data ◽  
Secure Server

Technological advances have led to innovative insulin delivery systems for patients with type 1 diabetes mellitus. In particular, the combination of miniature engineering and software algorithms contained in continuous subcutaneous insulin infusion (CSII) system pumps provide the user and the healthcare practitioner with an opportunity to review and adjust blood glucose (BG) levels according to system feedback, and to modify or programme their regimen according to their needs. While CSII pumps record a number of data parameters such as BG level, carbohydrate intake, activity and insulin delivered, these data are generally ‘locked in’ and can only be accessed by uploading to a cloud-based system, thus information is not contemporaneous. The Cellnovo Diabetes Management System (Cellnovo, Bridgend, UK) allows data to be transmitted securely and wirelessly in real time to a secure server, which is then retrieved by an online platform, the Cellnovo Online platform, enabling continuous access by the user and by clinicians. In this article, the authors describe a retrospective review of the patient data automatically uploaded to the Cellnovo Online platform. Baseline clinical and demographic characteristics collected at the start of pump therapy are shown for all patients, and BG data from a sub-cohort of patients who have been using the system for at least 6 months and who take and record an average of three BG level tests per day are presented to demonstrate glycaemic data over time.

Modern technologies in diabetes management - continuous glucose monitoring and insulin pump therapy

2021 ◽  
Vol 87 (1) ◽  
pp. 50-55
Author(s):  
E.Yu. Pyankova ◽  
◽  
L.A. Anshakova ◽  
I.A. Pyankov ◽  
S.V. Yegorova ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Individual ◽  
Glucose Lowering Therapy

The problems of complications of diabetes mellitus cannot be solved without constant monitoring of blood glucose levels. The evolution of additional technologies for the determination of glucose in the blood of the last decades makes it possible to more accurately predict the risks of complications, both in the individual and in the patient population as a whole. The article provides an overview of the methods used in modern diabetology, facilitating control over the variability of blood glucose levels and helping in a more accurate selection of glucose-lowering therapy. All presented methods are currently working in real clinical practice in the Khabarovsk Krai

Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait

2019 ◽  
Vol 32 (8) ◽  
pp. 843-849 ◽  
Author(s):  
Kholoud Mohamed ◽  
Dalia Al-Abdulrazzaq ◽  
Amel Fayed ◽  
Eman El Busairi ◽  
Faisal Al Shawaf ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Control Level ◽  
Insulin Pump Therapy ◽  
Insulin Regimen ◽  
Pump Therapy ◽  
Significant Difference

Abstract Background To evaluate the safety of fasting during the holy month of Ramadan among children and adolescent with type 1 diabetes (T1D). Methods A retrospective cohort study of 50 children and adolescents with T1D whose mean age was 12.7 ± 2.1 years was conducted. Twenty-seven patients (54%) were on multiple daily injections (MDI) insulin regimen and 23 (46%) were on insulin pump therapy. Before fasting for Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. Hemoglobin A1c (HbA1c), weight, number of days fasted, hypoglycemia and hyperglycemia episodes, and emergency hospital visits were collected and analyzed after completing the month. Participants were compared according to the insulin treatment regimen and their glycemic control level before Ramadan. Results The children were able to fast 20 ± 9.9 days of Ramadan, and the most common cause for breaking the fast was mild hypoglycemia (7.8% among all cases). There was no significant difference between the two insulin regimen groups in breaking fast days, frequency of hypo- or hyperglycemia, weight and HbA1c changes post Ramadan. Patients with HbA1c ≤ 8.5% were able to fast more days during Ramadan with significantly less-frequent hypoglycemic attacks as compared to patients with HbA1c > 8.5 (1.2 ± 1.5 vs. 3.3 ± 2.9 days of hypoglycemia, p = 0.01, respectively). Conclusions Fasting for children with T1D above the age of 10 years is feasible and safe in both pump and non-pump users, and well-controlled patients are less likely to develop complications. Education of the families and their children before Ramadan, along with intensive monitoring of fasting children during the month are crucial.

scholarly journals Self-Management Behaviors in Adults on Insulin Pump Therapy

2016 ◽  
Vol 11 (2) ◽  
pp. 233-239 ◽  
Author(s):  
Danielle Groat ◽  
Maria Adela Grando ◽  
Hiral Soni ◽  
Bithika Thompson ◽  
Mary Boyle ◽  
...  
Keyword(s):  
Diabetes Management ◽  
Insulin Pump ◽  
Real Life ◽  
Insulin Pump Therapy ◽  
Self Management ◽  
Pump Therapy ◽  
Adult Participants ◽  
Glycemic Outcomes ◽  
Management Behaviors

Background: Successful diabetes management requires behavioral changes. Little is known about self-management behaviors (SMB) in adults on insulin pump (IP) therapy. Objective: Analyze and characterize observed common diabetes SMB in adult participants with type 1 diabetes (T1D) using IPs and to correlate behaviors with glycemic outcomes based on participant’s individual glucose targets. Materials and Methods: One month of IP data from adults with T1D were downloaded. Computer programs were written to automatically quantify the observed frequency of expected behaviors such as: insulin bolusing, checking blood glucose (BG), and recording carbohydrate intake, and other interactions with the IP. Results: Nineteen participants were recruited and 4,249 IP interactions were analyzed to ascertain behaviors. Intersubject variability of adherence to minimally expected behaviors was observed: daily documentation of carbohydrates and BG checks in 76.6 (31.7)% and 60.0 (32.5)%, respectively, and bolusing without consulting the IPBC in 13.0 (16.9)% of delivered boluses, while daily insulin bolus delivery was consistent 96.8 (5.7)%. Higher frequency of adherence to daily behaviors correlated with a higher number of glucose readings at target. Conclusion: Results indicate variability in SMB and do not always match recommendations. Case-scenarios based on observed real-life SMB could be incorporated into interviews/surveys to elucidate ways to improve SMB.

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 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 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.

Habits and Routines during Transitions among Emerging Adults with Type 1 Diabetes

2019 ◽  
Vol 42 (6) ◽  
pp. 446-453
Author(s):  
Kathleen M. Hanna ◽  
Jed R. Hansen
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Emerging Adults ◽  
Diabetes Management ◽  
Insulin Dose ◽  
A Priori ◽  
Self Management ◽  
Typical Day ◽  
Insight Into

To provide insight into poorly understood diabetes self-management among emerging adults with type 1 diabetes (TID) experiencing transitions, this study described their diabetes self-management-related habits, routines, and disruptions as well as explored relationships among habits and routines. A qualitative study, guided by critical incidence technique, was conducted. Participants were asked to describe situations when they did and did not check blood glucose, administer insulin, eat meals, and exercise as planned. They were also asked to describe activities in a typical day and in association with diabetes self-management. Content analysis with a priori definitions of habits and routines was performed. Participants described diabetes self-management-related transitional disruption as forgetting and disorder. They described habits associated with checking a blood glucose, giving an insulin dose, eating a meal, and initiating exercise. They described routines in association with meals, exercise, and overall diabetes management. These findings provide information on variables to target in intervention research.

scholarly journals Prediction and prevention of hypoglycaemic events in type-1 diabetic patients using machine learning

2019 ◽  
Vol 26 (1) ◽  
pp. 703-718 ◽  
Author(s):  
Josep Vehí ◽  
Iván Contreras ◽  
Silvia Oviedo ◽  
Lyvia Biagi ◽  
Arthur Bertachi
Keyword(s):  
Machine Learning ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Diabetes Management ◽  
Machine Learning Algorithms ◽  
Support Vector ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Prediction And Prevention

Tight blood glucose control reduces the risk of microvascular and macrovascular complications in patients with type 1 diabetes. However, this is very difficult due to the large intra-individual variability and other factors that affect glycaemic control. The main limiting factor to achieve strict control of glucose levels in patients on intensive insulin therapy is the risk of severe hypoglycaemia. Therefore, hypoglycaemia is the main safety problem in the treatment of type 1 diabetes, negatively affecting the quality of life of patients suffering from this disease. Decision support tools based on machine learning methods have become a viable way to enhance patient safety by anticipating adverse glycaemic events. This study proposes the application of four machine learning algorithms to tackle the problem of safety in diabetes management: (1) grammatical evolution for the mid-term continuous prediction of blood glucose levels, (2) support vector machines to predict hypoglycaemic events during postprandial periods, (3) artificial neural networks to predict hypoglycaemic episodes overnight, and (4) data mining to profile diabetes management scenarios. The proposal consists of the combination of prediction and classification capabilities of the implemented approaches. The resulting system significantly reduces the number of episodes of hypoglycaemia, improving safety and providing patients with greater confidence in decision-making.

scholarly journals Assessing the efficacy, safety and utility of closed-loop insulin delivery compared with sensor-augmented pump therapy in very young children with type 1 diabetes (KidsAP02 study): an open-label, multicentre, multinational, randomised cross-over study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042790
Author(s):  
Julia Fuchs ◽  
Janet M Allen ◽  
Charlotte K Boughton ◽  
Malgorzata E Wilinska ◽  
Ajay Thankamony ◽  
...  
Keyword(s):  
Closed Loop ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Open Label ◽  
Pump Therapy ◽  
Very Young Children ◽  
Sensor Glucose ◽  
The University ◽  
Target Glucose

IntroductionDiabetes management in very young children remains challenging. Glycaemic targets are achieved at the expense of high parental diabetes management burden and frequent hypoglycaemia, impacting quality of life for the whole family. Our objective is to assess whether automated insulin delivery can improve glycaemic control and alleviate the burden of diabetes management in this particular age group.Methods and analysisThe study adopts an open-label, multinational, multicentre, randomised, crossover design and aims to randomise 72 children aged 1–7 years with type 1 diabetes on insulin pump therapy. Following screening, participants will receive training on study insulin pump and study continuous glucose monitoring devices. Participants will be randomised to 16-week use of the hybrid closed-loop system (intervention period) or to 16-week use of sensor-augmented pump therapy (control period) with 1–4 weeks washout period before crossing over to the other arm. The order of the two study periods will be random. The primary endpoint is the between-group difference in time spent in the target glucose range from 3.9 to 10.0 mmol/L based on sensor glucose readings during the 16-week study periods. Analyses will be conducted on an intention-to-treat basis. Key secondary endpoints are between group differences in time spent above and below target glucose range, glycated haemoglobin and average sensor glucose. Participants’ and caregivers’ experiences will be evaluated using questionnaires and qualitative interviews, and sleep quality will be assessed. A health economic analysis will be performed.Ethics and disseminationEthics approval has been obtained from Cambridge East Research Ethics Committee (UK), Ethics Committees of the University of Innsbruck, the University of Vienna and the University of Graz (Austria), Ethics Committee of the Medical Faculty of the University of Leipzig (Germany) and Comité National d’Ethique de Recherche (Luxembourg). The results will be disseminated by peer-reviewed publications and conference presentations.Trial registration numberNCT03784027.

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