Journal of diabetes science and technology
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J Diabetes Sci Technol · May 2014
Continuous glucose monitoring in newborn infants: how do errors in calibration measurements affect detected hypoglycemia?
Neonatal hypoglycemia is common and can cause serious brain injury. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing blood glucose (BG) measurements. Calibration algorithms use BG measurements to convert sensor signals into CGM data. ⋯ Similar trends were observed in the other hypoglycemia metrics. Errors in blood glucose concentration measurements used for calibration of CGM devices can have a clinically important impact on detection of hypoglycemia. If CGM devices are going to be used for assessing hypoglycemia it is important to understand of the impact of these errors on CGM data.
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J Diabetes Sci Technol · Mar 2014
ReviewBiologic Basis of Nerve Decompression Surgery for Focal Entrapments in Diabetic Peripheral Neuropathy.
The most recent (2011) National Diabetes Fact Sheet states the combined diagnosed and undiagnosed number of diabetes cases in the United States is approaching 25 million, and another 79 million are prediabetic. Of the diabetes patients, 60-70% suffer from mild to severe neuropathy. This combined loss of sensory and motor control in diabetic limbs is usually considered an irreversible, progressive process. ⋯ This review surveys current research regarding the biological basis for diabetic focal entrapment neuropathy. Metabolic dysfunction related to aldose reductase, oxidative stress, and advanced glycation end products are considered and correlated to peripheral nerve enlargement and entrapment. In addition, observational studies correlated to that biological basis are presented as well as surgical outcomes illustrating the effect of decompression on DSPN symptomatic relief, nerve function, and protection against complications.
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J Diabetes Sci Technol · Nov 2013
Complexity of continuous glucose monitoring data in critically ill patients: continuous glucose monitoring devices, sensor locations, and detrended fluctuation analysis methods.
Critically ill patients often experience high levels of insulin resistance and stress-induced hyperglycemia, which may negatively impact outcomes. However, evidence surrounding the causes of negative outcomes remains inconclusive. Continuous glucose monitoring (CGM) devices allow researchers to investigate glucose complexity, using detrended fluctuation analysis (DFA), to determine whether it is associated with negative outcomes. The aim of this study was to investigate the effects of CGM device type/calibration and CGM sensor location on results from DFA. ⋯ Monofractal DFA results are dependent on the device/calibration used to obtain CGM data, but sensor location has little impact. Future studies of glucose complexity should consider the findings presented here when designing their investigations.
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J Diabetes Sci Technol · Nov 2013
Diabetes professionals must seize the opportunity in mobile health.
The number of diabetes management mobile applications (apps) available on the market has grown exponentially since 2009; however, most patients lack the skills necessary for finding relevant health care information. Thus, clinical best practices emphasize the need for ongoing patient education. Despite the importance of education in clinical guidelines, very few of these apps include education in their top functionalities. ⋯ There has been little research on the use of diabetes management mobile apps, marginalizing the role of diabetes professionals and educators in a burgeoning market, hungry for information and an improved quality of life. Still, mobile technology holds great promise as a platform for self-management. Health care providers must not only educate patients about these resources, but take steps to ensure that mobile apps follow accepted best practices and guidelines.
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J Diabetes Sci Technol · Nov 2013
Multicenter Study Clinical TrialAccuracy of a first-generation intravenous blood glucose monitoring system in subjects with diabetes mellitus: a multicenter study.
Hyperglycemia and hypoglycemia in hospitalized patients have been associated with increased morbidity and mortality. Improvements in glucose monitoring technology may be helpful in the clinical management of critically ill patients with abnormal glucose levels. A first-generation intravenous blood glucose monitoring (IVBG) system was developed to facilitate glycemic control therapy in hospitalized patients. A nonrandomized, single-arm, multicenter study was performed to evaluate the safety and accuracy of the IVBG system in insulin-treated subjects with diabetes mellitus. ⋯ This clinical performance evaluation demonstrates that the IVBG system provides accurate and safe continuous BG measurements in healthy insulin-treated patients with diabetes.