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

scholarly journals The Promise and Perils of Wearable Physiological Sensors for Diabetes Management

2018 ◽  
Vol 12 (3) ◽  
pp. 587-591 ◽  
Author(s):  
Frank L. Schwartz ◽  
Cynthia R. Marling ◽  
Razvan C. Bunescu
Keyword(s):  
Diabetes Management ◽  
Contact Lenses ◽  
Insulin Pump ◽  
Improve Patient Safety ◽  
Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Current Status ◽  
Pump Therapy ◽  
Glucose Levels ◽  
The Impact

Development of truly useful wearable physiologic monitoring devices for use in diabetes management is still in its infancy. From wearable activity monitors such as fitness trackers and smart watches to contact lenses measuring glucose levels in tears, we are just at the threshold of their coming use in medicine. Ultimately, such devices could help to improve the performance of sense-and-respond insulin pumps, illuminate the impact of physical activity on blood glucose levels, and improve patient safety. This is a summary of our experience attempting to use such devices to enhance continuous glucose monitoring–augmented insulin pump therapy. We discuss the current status and present difficulties with available devices, and review the potential for future use.

scholarly journals A Novel Adaptive Basal Therapy Based on the Value and Rate of Change of Blood Glucose

2009 ◽  
Vol 3 (5) ◽  
pp. 1099-1108 ◽  
Author(s):  
Youqing Wang ◽  
Matthew W. Percival ◽  
Eyal Dassau ◽  
Howard C. Zisser ◽  
Lois Jovanovič ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Insulin Sensitivity ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Rate Of Change ◽  
Activity Level ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Diurnal Variability ◽  
Glucose Levels

Background: Modern insulin pump therapy for type 1 diabetes mellitus offers the freedom to program several basal profiles that may accommodate diurnal variability in insulin sensitivity and activity level. However, these basal profiles do not change even if a pending hypoglycemic or hyperglycemic event is foreseen. New insulin pumps could receive a direct feed of glucose values from a continuous glucose monitoring (CGM) system and could enable dynamic basal adaptation to improve glycemic control. Method: The proposed method is a two-step procedure. After the design of an initial basal profile, an adaptation of the basal rate is suggested as a gain multiplier based on the current CGM glucose value and its rate of change (ROC). Taking the glucose value and its ROC as axes, a two-dimensional plane is divided into a nine-zone mosaic, where each zone is given a predefined basal multiplier; for example, a basal multiplier of zero indicates a recommendation to shut off the pump. Results: The proposed therapy was evaluated on 20 in silico subjects (ten adults and ten adolescents) in the Food and Drug Administration-approved UVa/Padova simulator. Compared with conventional basal therapy, the proposed basal adjustment improved the percentage of glucose levels that stayed in the range of 60–180 mg/dl for all 20 subjects. In addition, the adaptive basal therapy reduced the average blood glucose index values. Conclusions: The proposed therapy provides the flexibility to account for insulin sensitivity variations that may result from stress and/or physical activities. Because of its simplicity, the proposed method could be embedded in a chip in a future artificial pancreatic β cell or used in a “smart” insulin pump.

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 A Review of Non-Invasive Optical Systems for Continuous Blood Glucose Monitoring

Sensors ◽  
2021 ◽  
Vol 21 (20) ◽  
pp. 6820
Author(s):  
Bushra Alsunaidi ◽  
Murad Althobaiti ◽  
Mahbubunnabi Tamal ◽  
Waleed Albaker ◽  
Ibraheem Al-Naib
Keyword(s):  
Blood Glucose ◽  
Glucose Monitoring ◽  
Daily Basis ◽  
Glucose Sensing ◽  
Blood Glucose Monitoring ◽  
Optical Systems ◽  
Glucose Levels ◽  
Non Invasive ◽  
Blood Glucose Levels ◽  
Continuous Blood Glucose Monitoring

The prevalence of diabetes is increasing globally. More than 690 million cases of diabetes are expected worldwide by 2045. Continuous blood glucose monitoring is essential to control the disease and avoid long-term complications. Diabetics suffer on a daily basis with the traditional glucose monitors currently in use, which are invasive, painful, and cost-intensive. Therefore, the demand for non-invasive, painless, economical, and reliable approaches to monitor glucose levels is increasing. Since the last decades, many glucose sensing technologies have been developed. Researchers and scientists have been working on the enhancement of these technologies to achieve better results. This paper provides an updated review of some of the pioneering non-invasive optical techniques for monitoring blood glucose levels that have been proposed in the last six years, including a summary of state-of-the-art error analysis and validation techniques.

Online Prediction of Blood Glucose Levels using Genetic Algorithm

2014 ◽  
pp. 299-310
Author(s):  
Khaled Eskaf ◽  
Tim Ritchings ◽  
Osama Bedawy
Keyword(s):  
Blood Glucose ◽  
Glucose Monitoring ◽  
Simulation Software ◽  
Machine Learning Techniques ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Learning Techniques ◽  
Preliminary Study ◽  
Online Prediction

Diabetes mellitus is one of the most common chronic diseases. The number of cases of diabetes in the world is likely to increase more than two fold in the next 30 years: from 115 million in 2000 to 284 million in 2030. This chapter is concerned with helping diabetic patients to manage themselves by developing a computer system that predicts their Blood Glucose Level (BGL) after 30 minutes on the basis of their current levels, so that they can administer insulin. This will enable the diabetic patient to continue living a normal daily life, as much as is possible. The prediction of BGLs based on the current levels BGLs become feasible through the advent of Continuous Glucose Monitoring (CGM) systems, which are able to sample patients' BGLs, typically 5 minutes, and computer systems that can process and analyse these samples. The approach taken in this chapter uses machine-learning techniques, specifically Genetic Algorithms (GA), to learn BGL patterns over an hour and the resulting value 30 minutes later, without questioning the patients about their food intake and activities. The GAs were invested using the raw BGLs as input and metadata derived from a Diabetic Dynamic Model of BGLs supplemented by the changes in patients' BGLs over the previous hour. The results obtained in a preliminary study including 4 virtual patients taken from the AIDA diabetes simulation software and 3 volunteers using the DexCom SEVEN system, show that the metadata approach gives more accurate predictions. Online learning, whereby new BGL patterns were incorporated into the prediction system as they were encountered, improved the results further.

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.

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