scholarly journals Insulin pump therapy and continuous glucose monitoring in adults with type 2 diabetes: where are we now?

2020 ◽  
Vol 1 (5) ◽  
pp. 314-330
Author(s):  
Erika Pedone ◽  
Andrea Laurenzi ◽  
Agnese Allora ◽  
Andrea Mario Bolla ◽  
Amelia Caretto
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Continuous Glucose Monitoring ◽  
New Technologies ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Blood Glucose Control ◽  
Glucose Monitoring ◽  
Insulin Pump Therapy

Technology in diabetes is rapidly evolving, with the aim of helping affected people to safely optimize their blood glucose control. New technologies are now considered as an essential tool for managing glycemia predominantly in people with type 1 diabetes, and clinical trials have demonstrated that in these subjects the use of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) systems are associated with improved glycemic control along with a better quality of life. Literature regarding technologies and type 2 diabetes is relatively lacking, but innovations may have an important role also in the management of these patients. Some studies in adults with type 2 diabetes have shown benefits with the use of CGM in terms of glycemic variability and improved therapeutic adjustments. Clinical trials about CSII and CGM use in type 2 diabetes may have some pitfalls and future studies are needed to assess how these advanced systems could improve clinical outcomes and also ensure cost-effectiveness in this population. In this narrative review, we aim to highlight the most relevant studies on this topic and to focus on the potential role of new technological devices in type 2 diabetes management.

scholarly journals Rapid Changes in Serum Testosterone in Men with Newly Diagnosed Type 2 Diabetes With Intensive Insulin and Metformin

2021 ◽  
Author(s):  
Yun Hu ◽  
Bo Ding ◽  
Yun Shen ◽  
Reng-Na Yan ◽  
Feng-Fei Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Pump ◽  
Blood Glucose Control ◽  
Serum Testosterone ◽  
Insulin Pump Therapy ◽  
Newly Diagnosed ◽  
Pump Therapy ◽  
Testosterone Levels ◽  
Metformin Group

Objective: To investigate the effect of metformin on testosterone levels in men with type 2 diabetes mellitus (T2DM). <p>Methods: Seventy men with newly diagnosed drug naïve T2DM, HbA<sub>1c</sub> >9.0% (75mmol/mol) were treated with intensive insulin pump therapy for 5 days to achieve glucose normalization. They were randomized to control (continued on intensive insulin only) and metformin (plus metformin) groups (1:1) for one month. Testosterone was measured at baseline, randomization, and after one-month treatment. </p> <p>Results: Total, free and bioavailable testosterone increased significantly within 5 days (all <i>p</i><0.001). After one month, compared to controls, the metformin group had lower total (12.7 vs 15.3 nmol/L), free (0.20 vs 0.24 nmol/L), and bioavailable (4.56 vs 5.31 nmol/L) testosterone (<i>p</i> all <0.05).</p> <p>Conclusions: In men with T2DM, one-month oral metformin may decrease serum testosterone levels independent of blood glucose control. The effects of long-term metformin on testosterone in men need further study.</p>

scholarly journals Association of Body Fat Percentage With Time in Range Generated by Continuous Glucose Monitoring During Intensive Insulin Pump Therapy in Type 2 Diabetes

2021 ◽  
Author(s):  
Yuting Ruan ◽  
Jiana Zhong ◽  
Rongping Chen ◽  
Zhen Zhang ◽  
Dixing Liu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Fat ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Body Fat Percentage ◽  
Fat Percentage ◽  
Pump Therapy ◽  
Time In Range

Abstract BackgroundObesity is a crucial risk factor associated with type 2 diabetes mellitus (T2DM). Excessive accumulation of body fat may affect the glycemia control in T2DM. This study investigated the relationship between body fat percentage and time in range (TIR) assessed by continuous glucose monitoring (CGM) during short-term intensive insulin pump therapy in T2DM patients.MethodA total of 85 T2DM patients were recruited in this cross-sectional study. All participants underwent 72-h CGM period during intensive insulin pump therapy. TIR was defined as the percentage of time spent within the target glucose range of 3.9-10.0 mmol/L. Body composition was measured using bioelectrical impedance analysis (BIA) and overfat was defined as an amount of body fat of at least 25% of total body mass for men or at least 30% for women. Multiple linear regression models were used to evaluate the independent association of body fat percentage with TIR after adjusting for confounding factors.ResultsCompared with normal fat T2DM patients, individual with a higher body fat percentage exhibited lower levels of TIR (P=0.004) and higher 72h mean blood glucose (72h-MBG) (P=0.001) during intensive insulin pump therapy. The presence of overfat inversely correlated with TIR in T2DM populations (r = -0.306; P=0.004). Multiple linear regression analysis indicated that body fat percentage was significantly associated with TIR independent of HbA1c, insulin dosage and glycemic variability metrics (All P for trend <0.05). Further adjustment of other body composition parameters, including waist circumference, visceral fat area and muscle quantity, the link between body fat percentage and TIR remained significant (All P＜0.05).ConclusionsBody fat percentage was significantly associated with TIR in T2DM during intensive insulin pump therapy. Reduction of body fat may be an important therapeutic target to improve glycemic control in obese T2DM patients.

scholarly journals Insulin Pump Therapy for Patients With Type 2 Diabetes Mellitus: Evidence, Current Barriers, and New Technologies

2020 ◽  
pp. 193229682092810
Author(s):  
Guido Freckmann ◽  
Sina Buck ◽  
Delia Waldenmaier ◽  
Bernhard Kulzer ◽  
Oliver Schnell ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
New Technologies ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy

scholarly journals Rapid Changes in Serum Testosterone in Men with Newly Diagnosed Type 2 Diabetes With Intensive Insulin and Metformin

2021 ◽  
Author(s):  
Yun Hu ◽  
Bo Ding ◽  
Yun Shen ◽  
Reng-Na Yan ◽  
Feng-Fei Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Pump ◽  
Blood Glucose Control ◽  
Serum Testosterone ◽  
Insulin Pump Therapy ◽  
Newly Diagnosed ◽  
Pump Therapy ◽  
Testosterone Levels ◽  
Metformin Group

Objective: To investigate the effect of metformin on testosterone levels in men with type 2 diabetes mellitus (T2DM). <p>Methods: Seventy men with newly diagnosed drug naïve T2DM, HbA<sub>1c</sub> >9.0% (75mmol/mol) were treated with intensive insulin pump therapy for 5 days to achieve glucose normalization. They were randomized to control (continued on intensive insulin only) and metformin (plus metformin) groups (1:1) for one month. Testosterone was measured at baseline, randomization, and after one-month treatment. </p> <p>Results: Total, free and bioavailable testosterone increased significantly within 5 days (all <i>p</i><0.001). After one month, compared to controls, the metformin group had lower total (12.7 vs 15.3 nmol/L), free (0.20 vs 0.24 nmol/L), and bioavailable (4.56 vs 5.31 nmol/L) testosterone (<i>p</i> all <0.05).</p> <p>Conclusions: In men with T2DM, one-month oral metformin may decrease serum testosterone levels independent of blood glucose control. The effects of long-term metformin on testosterone in men need further study.</p>

scholarly journals Type 2 Diabetes Management in Primary Care: The Role of Retrospective, Professional Continuous Glucose Monitoring

2018 ◽  
Vol 31 (3) ◽  
pp. 279-287 ◽  
Author(s):  
Maneesh Shrivastav ◽  
William Gibson ◽  
Rajendra Shrivastav ◽  
Katie Elzea ◽  
Cyrus Khambatta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Glucose Monitoring
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