Diabetes technology & therapeutics
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Diabetes Technol. Ther. · Dec 2012
ReviewMorbidity and mortality of diabetic ketoacidosis with and without insulin pump care.
Diabetic ketoacidosis (DKA) is one of the most common, costly, and dangerous acute complications in people with type 1 diabetes (T1D). Although DKA has been reported to occur with less frequency than severe hypoglycemia, it is associated with a higher mortality rate and is the leading cause of diabetes-related deaths in children and adolescents. The most common risk factor for DKA is lack of adherence to insulin treatment. ⋯ Expert care within a T1D specialty clinic may help reduce the risk of DKA mortality. Further advances are needed in developing new technologies and methods to improve glycemic control in intensively treated patients without increasing the risk of acute complications. The purpose of this review is to discuss DKA morbidity and mortality in youth with T1D, particularly in relation to insulin pump use.
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Diabetes Technol. Ther. · Nov 2012
Comparative StudyComparison of insulin infusion protocols targeting 110-140 mg/dL in patients after cardiac surgery.
Continuous intravenous insulin infusion (CII) following coronary artery bypass graft (CABG) surgery reduces postoperative complications and hospitalization duration. Because of limited data evaluating outcomes of CII with revised glycemic targets (110-140 mg/dL) in cardiac surgery, this study compared efficacy and safety of two different CII protocols having revised targets. ⋯ CII protocols targeting 110-140 mg/dL were effective in achieving revised targets with low hypoglycemia. Despite differences in mean BG level and time to target, each hospital continued using its existing protocols and identified areas for improvement.
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Diabetes Technol. Ther. · Oct 2012
Impact of retrospective calibration algorithms on hypoglycemia detection in newborn infants using continuous glucose monitoring.
Neonatal hypoglycemia is common and may cause serious brain injury. Diagnosis is by blood glucose (BG) measurements, often taken several hours apart. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing the number of BG measurements. Calibration algorithms convert sensor signals into CGM output. Thus, these algorithms directly affect measures used to quantify hypoglycemia. This study was designed to quantify the effects of recalibration and filtering of CGM data on measures of hypoglycemia (BG <2.6 mmol/L) in neonates. ⋯ Hypoglycemia metrics, especially counting events, are heavily dependent on CGM calibration BG error, and the calibration algorithm. CGM devices tended to read high at lower levels, so when high accuracy calibration measurements are available it may be more appropriate to recalibrate the data.
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Diabetes Technol. Ther. · Aug 2012
Efficacy and safety of glucose control with Space GlucoseControl in the medical intensive care unit--an open clinical investigation.
We aimed to investigate the performance of the Space GlucoseControl system (SGC) (B. Braun, Melsungen, Germany) in medical critically ill patients. The SGC is a nurse-driven, computer-assisted device for glycemic control combining infusion pumps with the enhanced Model Predictive Control algorithm. ⋯ SGC is a safe and efficient method to control blood glucose in critically ill patients in the medical intensive care unit.
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Diabetes Technol. Ther. · Jul 2012
Influence of time point of calibration on accuracy of continuous glucose monitoring in individuals with type 1 diabetes.
Data on the influence of calibration on accuracy of continuous glucose monitoring (CGM) are scarce. The aim of the present study was to investigate whether the time point of calibration has an influence on sensor accuracy and whether this effect differs according to glycemic level. ⋯ Sensor calibration predominantly based on preprandial glucose resulted in a significantly higher overall sensor accuracy compared with a predominantly postprandial calibration. The difference was most pronounced in the hypo- and euglycemic reference range, whereas both calibration patterns were comparable in the hyperglycemic range.