Diabetes technology & therapeutics
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Diabetes Technol. Ther. · Apr 2006
Case Reports Clinical TrialA novel, model-based insulin and nutrition delivery controller for glycemic regulation in critically ill patients.
Critically ill patients are often hyperglycemic and insulin resistant, as well as highly dynamic. Tight glucose control has been shown to significantly reduce mortality in critical care. A physiological model of the glucose-insulin regulatory system is improved and used to develop an adaptive control protocol utilizing both nutritional and insulin inputs to control hyperglycemia. The approach is clinically verified in a critical care patient cohort. ⋯ Tight, targeted stepwise regulation was exhibited in all trials. Overall, tight glycemic regulation is achieved in a broad critical care cohort with optimized insulin and nutrition delivery, effectively managing glycemia even with high effective insulin resistance.
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Diabetes Technol. Ther. · Dec 2005
Randomized Controlled Trial Multicenter Study Comparative StudyGlycated hemoglobin assessment in clinical practice: comparison of the A1cNow point-of-care device with central laboratory testing (GOAL A1C Study).
The Glycemic Optimization with Algorithms and Labs At Po1nt of Care (GOAL A1C) Study assessed the effect of titration monitoring strategies and methods of A1C testing on glycemic control in patients with type 2 diabetes failing oral therapy and beginning basal insulin glargine. The availability of both point-of-care (POC) and central laboratory A1C values provided an opportunity to evaluate correlation and statistical agreement between these methods of testing. This analysis forms the basis of the current report. ⋯ POC testing of A1C in predominantly primary care settings using the A1cNow device was correlated with central laboratory results. The correlation was less than expected based on each method's reproducibility data. Although there was agreement between the average POC A1C values and the corresponding central laboratory values, the dispersion of individual POC A1C values was large. Thus, we conclude that these two methods of A1C testing should not be used interchangeably.
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Diabetes Technol. Ther. · Oct 2004
Comparative StudyEvaluation of SET--a new device for the measurement of pain perception in comparison to standard measures of diabetic neuropathy.
Early detection of sensory impairment and loss of protective pain sensation is of major importance for the prevention of neuropathic foot ulceration. The aim of our study was to evaluate a new handheld device (SET, a prototype developed by Dr. W. Henniges, Zülpich, Germany) for measurement of pain perception, in comparison with established methods for diagnosis of diabetic neuropathy. ⋯ Measurement of pain perception threshold using the SET device is an easy and reliable method for identifying patients with impaired small nerve fiber function.