scholarly journals Use of Automated Bolus Calculators for Diabetes Management

2010 ◽  
Vol 9 (2) ◽  
pp. 92 ◽  
Author(s):  
Frank L Schwartz ◽  
Cynthia R Marling ◽  
◽  
Keyword(s):  
Insulin Therapy ◽  
Glucose Control ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Smart Phone ◽  
Glycated Haemoglobin ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Numeracy Skills ◽  
Patients With Diabetes

Fewer than 30 % of patients with diabetes who are on insulin therapy achieve target glycated haemoglobin (HbA1c) levels. Automated bolus calculators (ABCs) are now almost universally used for patients on insulin pump therapy to calculate pre-meal insulin doses. Use of ABCs in glucose monitors and smart phone applications have the potential to improve glucose control in a larger population of individuals with diabetes on insulin therapy by overcoming the fear of hypoglycaemia and assisting those with low numeracy skills.

scholarly journals Use of Automated Bolus Calculators for Diabetes Management

2013 ◽  
Vol 09 (02) ◽  
pp. 124
Author(s):  
Frank L Schwartz ◽  
Cynthia R Marling ◽  
◽  
Keyword(s):  
Insulin Therapy ◽  
Glucose Control ◽  
Diabetes Management ◽  
Glycated Hemoglobin ◽  
Insulin Pump ◽  
Smart Phone ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Fear Of Hypoglycemia ◽  
Patients With Diabetes

Less than 30 % of patients with diabetes who are on insulin therapy achieve target glycated hemoglobin (HbA1C) levels. Automated bolus calculators (ABCs) are now almost universally used for patients on insulin pump therapy to calculate pre-meal insulin doses. Use of ABCs in glucose monitors and smart phone applications have the potential to improve glucose control in a larger population of individuals with diabetes on insulin therapy by overcoming the fear of hypoglycemia and assisting those with low numeracy skills.

scholarly journals Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery?

2021 ◽  
Vol 10 (15) ◽  
pp. 3399
Author(s):  
Elena Z. Golukhova ◽  
Ljubov S. Lifanova ◽  
Yaroslava V. Pugovkina ◽  
Marina V. Grigoryan ◽  
Naida I. Bulaeva
Keyword(s):  
Insulin Therapy ◽  
Postoperative Period ◽  
Glucose Control ◽  
Insulin Pump ◽  
Early Postoperative Period ◽  
Insulin Pump Therapy ◽  
Diabetic Patients ◽  
Pump Therapy ◽  
Hs Crp ◽  
Bolus Insulin

Hyperglycemia is associated with adverse outcomes after coronary artery bypass grafting (CABG). While there is a consensus that blood glucose control may benefit patients undergoing CABG, the role of biomarkers, optimal method, and duration of such monitoring are still unclear. The aim of this study is to define the efficacy of a continuous glucose monitoring system (CGMS) and link it to pro-inflammatory biomarkers while on insulin pump therapy in diabetic patients undergoing CABG. We prospectively assessed CGMS for 72 h in 105 patients including 52 diabetics undergoing isolated CABG. In diabetics, CGMS was connected to an insulin pump for precise glucose control. On top of conventional biomarkers (HbA1C, lipid profile), high sensitive C-reactive protein (hs-CRP), Regulated upon Activation Normal T cell Expressed and presumably Secreted (RANTES), and leptin levels were collected before surgery, 1 h, 12 h, 7 days, and at 1 year after CABG. Overall, CGMS revealed high glucose independently from underlying diabetes during first 48 h following CABG but was higher (р < 0.05) in diabetics. The insulin pump improved glycemic control over early follow-up (72 h) post-CABG. There were no hypoglycemic episodes in patients on insulin pump therapy and those receiving bolus insulin therapy. We revealed a lower rate of postpericardiotomy syndrome (PCTS) in patients on insulin pump therapy compared to patients prescribed bolus insulin therapy in the early postoperative period (p = 0.03). Hs-CRP and RANTES levels were lower in patients with T2DM on insulin pump therapy compared to patients prescribed bolus insulin therapy in the early postoperative period (р < 0.05). It is most likely due to the fact that insulin pump therapy decreases systemic inflammatory response. Further controlled trials should assess whether CGMS improves outcomes after cardiac surgery.

Professional and flash on the monitoring of blood glucose levels of insulin pump therapy and without it

2021 ◽  
Author(s):  
Alexander Dreval
Keyword(s):  
Insulin Therapy ◽  
Insulin Pump ◽  
Self Control ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Glucose Levels ◽  
Patients With Diabetes ◽  
Control Of Diabetes ◽  
Medical University ◽  
And Control

A new method of self-control of diabetes based on the results of continuous monitoring of glycemia (HMG) is especially relevant in patients who are on pump insulin therapy, especially since the start of pump insulin therapy is carried out with the mandatory installation of the HMG system [1,3]. Due to the novelty of these two methods (treatment of diabetes and control of glycemia) for a wide clinical practice, there is an urgent need to publish concise practical guides on this topic for doctors, both for self-study of these methods, and for advanced training courses. Based on the above and our experience of teaching at the Department of Endocrinology of the Federal Medical University of MONICA, this guide has been prepared, which will be useful, first of all, for endocrinologists, therapists working with patients with diabetes, as well as for senior students of medical institutes who are interested in new directions in practical medicine.

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 Model-Based Tool for Personalized Adjustment of Basal Insulin Supply in Patients With Intensified Conventional Insulin Therapy

2019 ◽  
Vol 13 (5) ◽  
pp. 928-934
Author(s):  
Lutz Vogt ◽  
Andreas Thomas ◽  
Gert Fritzsche ◽  
Peter Heinke ◽  
Klaus-Dieter Kohnert ◽  
...  
Keyword(s):  
Insulin Therapy ◽  
Basal Insulin ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Insulin Dosage ◽  
Treatment Team ◽  
Pump Therapy ◽  
Modeling Tool ◽  
Conventional Insulin Therapy ◽  
Model Based

Background: The decisive factor in successful intensive insulin therapy is the ability to deliver need-based-adjusted nutrition-independent insulin dosages at the closest possible approximation to the physiological insulin level. Because this basal insulin requirement is strongly influenced by the patient’s lifestyle, its subtlety is of great importance. This challenge is very different between patients with type 1 diabetes and those with insulin-dependent type 2 diabetes. Furthermore, it is more difficult to finetune a basal insulin dosage with intensified conventional insulin therapy (ICT), due to delayed insulin delivery, compared to insulin pump therapy, which provides continuous delivery of small doses of exclusively short-acting insulin. In all cases, the goal is to achieve an optimal basal delivery rate. Method: We hypothesized that this goal could be achieved with a modeling tool that determined the optimal basal insulin supply based on the patient’s anamnestic data and monitored glucose values. This type of modeling tool has been used in health insurance programs in Germany to improve insulin control in patients that receive ICT. Results: Our retrospective data analysis showed that this modeling tool provided a significant improvement in metabolic control, significant reductions in HbA1c and Q scores, and improved time-in-range values, with reduced daily insulin levels. Conclusion: The model-based basal rate test could provide additional data of the actual effect of the basal insulin adjustment in intensified insulin treated diabetes to the physician or treatment team.

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 Coordinated Basal—Bolus Infusion for Tighter Postprandial Glucose Control in Insulin Pump Therapy

2009 ◽  
Vol 3 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Jorge Bondia ◽  
Eyal Dassau ◽  
Howard Zisser ◽  
Remei Calm ◽  
Josep Vehí ◽  
...  
Keyword(s):  
Glucose Control ◽  
Insulin Pump ◽  
Postprandial Glucose ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Bolus Infusion ◽  
Basal Bolus

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.

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