Diabetes technology & therapeutics
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Diabetes Technol. Ther. · Jul 2012
Real-time continuous glucose monitoring in an intensive care unit: better accuracy in patients with septic shock.
This study assessed the accuracy of real-time continuous glucose monitoring system (RTCGMS) devices in an intensive care unit (ICU) to determine whether the septic status of the patient has any influence on the accuracy of the RTCGMS. ⋯ The results showed that the septic status of patients influenced the accuracy of the RTCGMS in the ICU. Accuracy was significantly better in patients with septic shock in comparison with the other patient cohorts.
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Diabetes Technol. Ther. · Jun 2012
ReviewIntensifying insulin therapy with insulin analog premixes: transitioning from basal insulin in type 2 diabetes.
Because of the progressive nature of type 2 diabetes, basal insulin alone may not be able to provide sufficient glycemic control over the long term, and thus insulin regimens will typically need to be intensified--especially for controlling postprandial glucose excursions. In patients with type 2 diabetes requiring more intensive intervention, insulin analog premix formulations can offer a simple, effective, and convenient option for tighter management of hyperglycemia in lieu of a traditional basal-bolus regimen.
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Diabetes Technol. Ther. · Jun 2012
ReviewHow to best manage glycemia and non-glycemia during the time of acute myocardial infarction.
Acute myocardial infarction (AMI) is common in patients with diabetes. Reasons for this are multifactorial, but all relate to a variety of maladaptive responses to acute hyperglycemia. Persistent hyperglycemia is associated with worse left ventricular function and higher mortality during AMI, but intervention data are far from clear. ⋯ For those with non-STEMI, initial reperfusion therapy or fibrinolysis is not routinely indicated. Overall, there have been dramatic advances for the treatment of people with AMI and diabetes. The use of continuous glucose monitoring in this population may allow better ability to safely reach glycemic targets, which it is hoped will improve glycemic control.
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Diabetes Technol. Ther. · Jun 2012
A mobile health intervention for inner city patients with poorly controlled diabetes: proof-of-concept of the TExT-MED program.
Numerous mobile health (mHealth) interventions are being developed to aid in management of complex chronic medical conditions. However, the acceptance of mHealth programs by low-income, bilingual populations has not yet been evaluated. The Trial to Examine Text-based mHealth for Emergency department patients with Diabetes (TExT-MED) program is a text message-based mHealth program designed specifically for resource-poor patients with diabetes. We conducted a prospective proof-of-concept trial to assess satisfaction and preliminary effectiveness of the TExT-MED program. ⋯ This pilot trial of the TExT-MED program demonstrated increased healthy behaviors, improved diabetes self-efficacy and medication adherence, and received excellent satisfaction scores in resource-poor, inner city patients with diabetes.
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Diabetes Technol. Ther. · Jun 2012
The glycocalyx and cardiovascular disease in diabetes: should we judge the endothelium by its cover?
Patients with diabetes mellitus are characterized by an extraordinary vascular vulnerability. Traditionally, glucose-induced damage to the vascular endothelium is believed to be one of the first steps in the development of vascular damage. However, in the healthy vessel the endothelium is protected by a matrix layer of highly glycosylated proteins that form a physical barrier between the endothelium and the blood flowing past. ⋯ In the last decade it has become clear that its full thickness actually exceeds that of the vascular endothelium. Accumulating research into the functional relevance of the endothelial glycocalyx suggests an important role for this layer in the development of cardiovascular disease in diabetes mellitus. Here we will present an overview of the biochemistry of the intact glycocalyx, current methods to assess the glycocalyx, and its possible role in the pathophysiology of cardiovascular disease in diabetes.