scholarly journals Glycemic Control and Hypoglycemia in Patients Treated with Insulin Pump Therapy: An Observational Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Guillermo Guzmán ◽  
Veline Martínez ◽  
Julián David Yara ◽  
Miguel Angel Mina ◽  
Juan Sebastian Solarte ◽  
...  
Keyword(s):  
Insulin Pump ◽  
Glycosylated Hemoglobin ◽  
Clinical Status ◽  
Life Quality ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
University Hospital ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Clinically Significant

Introduction. Diabetes mellitus (DM) is a highly prevalent disease worldwide. It has been associated with an important morbimortality due to its complications and sometimes as a result of adverse events related to treatment. Insulin pump therapy (IPT) is one of the options used to control this disease and reduces one of the most frequent complication associated with treatment: hypoglycemia, which has also a great impact on life quality and clinical status of patients. Materials and Methods. A descriptive and retrospective study was performed including patients treated and followed by the department of endocrinology from a high-complexity university hospital in Cali, Colombia, between 2012 and 2017. Patients were on IPT and continuous glucose monitoring (CGM): MiniMed Paradigm® Veo™ Insulin Pump (Medtronic®) and MiniMed 640G Insulin Pump-Enlite™ Sensor (Medtronic®). Presentation of hypoglycemia and variables associated with its development were evaluated. Results. 51 patients were included. The main indication for IPT initiation was the report of hypoglycemic episodes and inappropriate metabolic control. Initiation of IPT was related with a decrease in glycosylated hemoglobin (HbA1c) and also a decrease in severe hypoglycemic events and hospitalization due to hypoglycemia. The risk factors linked with clinically significant hypoglycemia were male gender, and standard deviation of glucose measures calculated by CGM. A diminished glomerular filtration rate (GFR) (<60 mL/min/1.73 m2) was correlated with higher risk of severe hypoglycemia. Conclusion. IPT with CGM is a useful strategy in the management of patients with DM; it is associated with a reduction of adverse hypoglycemic events and hospitalizations due to hypoglycemia.

scholarly journals Sustained impact of real-time continuous glucose monitoring in adults with type 1 diabetes on insulin pump therapy: Results after 24 months RESCUE study

2020 ◽  
Author(s):  
Sara Charleer ◽  
Christophe De Block ◽  
Frank Nobels ◽  
Régis P. Radermecker ◽  
Ine Lowyck ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Real Time ◽  
Continuous Glucose Monitoring ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Acute Hypoglycemia

<b>Objective:</b> In recent years, a growing number of people with type 1 diabetes have access to real-time continuous glucose monitoring (rtCGM). Long-term benefits of rtCGM are unclear due to lack of large studies of long duration. We evaluated whether real-world rtCGM-use up to 24 months offered benefits, in particular to those living with impaired awareness of hypoglycemia (IAH). <p><b>Research Design and Methods:</b> This 24-month, prospective, observational, cohort study followed 441<b> </b>adults with insulin pumps receiving full reimbursement for rtCGM. Forty-two percent had IAH. Primary endpoint was evolution of HbA<sub>1c</sub>, with secondary endpoints change in acute hypoglycemia complications, diabetes-related work absenteeism, and quality of life (QOL) scores. Additionally, we evaluated if people could achieve glycemic consensus targets during follow-up.</p> <p><b>Results:</b> After 24 months, HbA<sub>1c</sub> remained significantly lower compared to baseline (7.64% [60 mmol/mol] vs 7.37% [57 mmol/mol], p<0.0001). Sustained benefits were also observed for the score on the hypoglycemia fear survey and hypoglycemia-related acute complications irrespective of hypoglycemia awareness level. People with IAH had the strongest improvement, especially for severe hypoglycemia (862 events year before vs 119 events per 100 patient-years in second year, p<0.0001). Over 24 months, more people were able to meet hypoglycemia consensus targets at the expense of slightly less people achieving hyperglycemia consensus targets. Furthermore, the number of people with HbA<sub>1c</sub> <7% (<53 mmol/mol) without severe hypoglycemia events more than doubled (11.0% vs 25.4%, p<0.0001).</p> <p><b>Conclusion:</b> Use of rtCGM led to sustained improvements in hypoglycemia-related glucose control over 24 months. Lower fear of hypoglycemia, less acute hypoglycemia-related events and diabetes-related days off work were observed, particularly in those with IAH.</p>

scholarly journals Sustained impact of real-time continuous glucose monitoring in adults with type 1 diabetes on insulin pump therapy: Results after 24 months RESCUE study

2020 ◽  
Author(s):  
Sara Charleer ◽  
Christophe De Block ◽  
Frank Nobels ◽  
Régis P. Radermecker ◽  
Ine Lowyck ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Real Time ◽  
Continuous Glucose Monitoring ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Acute Hypoglycemia

<b>Objective:</b> In recent years, a growing number of people with type 1 diabetes have access to real-time continuous glucose monitoring (rtCGM). Long-term benefits of rtCGM are unclear due to lack of large studies of long duration. We evaluated whether real-world rtCGM-use up to 24 months offered benefits, in particular to those living with impaired awareness of hypoglycemia (IAH). <p><b>Research Design and Methods:</b> This 24-month, prospective, observational, cohort study followed 441<b> </b>adults with insulin pumps receiving full reimbursement for rtCGM. Forty-two percent had IAH. Primary endpoint was evolution of HbA<sub>1c</sub>, with secondary endpoints change in acute hypoglycemia complications, diabetes-related work absenteeism, and quality of life (QOL) scores. Additionally, we evaluated if people could achieve glycemic consensus targets during follow-up.</p> <p><b>Results:</b> After 24 months, HbA<sub>1c</sub> remained significantly lower compared to baseline (7.64% [60 mmol/mol] vs 7.37% [57 mmol/mol], p<0.0001). Sustained benefits were also observed for the score on the hypoglycemia fear survey and hypoglycemia-related acute complications irrespective of hypoglycemia awareness level. People with IAH had the strongest improvement, especially for severe hypoglycemia (862 events year before vs 119 events per 100 patient-years in second year, p<0.0001). Over 24 months, more people were able to meet hypoglycemia consensus targets at the expense of slightly less people achieving hyperglycemia consensus targets. Furthermore, the number of people with HbA<sub>1c</sub> <7% (<53 mmol/mol) without severe hypoglycemia events more than doubled (11.0% vs 25.4%, p<0.0001).</p> <p><b>Conclusion:</b> Use of rtCGM led to sustained improvements in hypoglycemia-related glucose control over 24 months. Lower fear of hypoglycemia, less acute hypoglycemia-related events and diabetes-related days off work were observed, particularly in those with IAH.</p>

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 Integrated insulin pump therapy with continuous glucose monitoring for improved adherence: technology update

2015 ◽  
pp. 1263 ◽  
Author(s):  
Andrea Tumminia ◽  
Laura Sciacca ◽  
Lucia Frittitta ◽  
Sebastiano Squatrito ◽  
Riccardo Vigneri ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Pump Therapy

scholarly journals Active Subjects with Autoimmune Type 1 Diabetes have Better Metabolic Profiles than Sedentary Controls

2017 ◽  
Vol 26 (1) ◽  
pp. 23-32 ◽  
Author(s):  
M. Adamo ◽  
R. Codella ◽  
F. Casiraghi ◽  
A. Ferrulli ◽  
C. Macrì ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Glycosylated Hemoglobin ◽  
High Volume ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Glucose Levels ◽  
Nonobese Diabetic Mice

Previous studies in humans with type 1 diabetes mellitus (T1D) and in nonobese diabetic mice have investigated the beneficial immunomodulatory potential of aerobic physical activity. Performing high volume of aerobic exercise may favorably regulate autoimmunity in diabetes. We tested whether increased physical activity is a self-sufficient positive factor in T1D subjects. During a 3-month observational period, active (six males; 40.5 ± 6.1 years; BMI: 24.5 ± 2.1) and sedentary (four males, three females; 35.9 ± 8.9 years; BMI: 25.7 ± 3.8) T1D individuals on insulin pump therapy were studied for metabolic, inflammatory, and autoimmune parameters. At baseline and at the end of a 3-month period, glycosylated hemoglobin (HbA1c), autoantibodies (anti-GAD, anti-ZnT8, anti-IA2, and ICA) and proinflammatory cytokines (IL-6 and TNF-α) were evaluated. During the third month of the period, physically active T1D patients showed a significant reduction in the average glucose levels (-9%, p = 0.025, by CGM) compared to the first month values, and even their hyperglycemic episodes (>180 mg/dl) diminished significantly (-24.2%, p = 0.032 vs. first month). Moreover, active T1D subjects exhibited an improved body composition with respect to sedentary controls. No significant changes were detected as to the autoimmune and inflammatory profiles. This study confirms the beneficial role of physical exercise associated with insulin pump therapy in order to improve metabolic control in individuals with T1D. These preliminary positive observations need to be challenged in a prolonged interventional follow-up.

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