Diabetes technology & therapeutics
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Diabetes Technol. Ther. · Oct 2014
Comparative StudyAccuracy evaluation of a new real-time continuous glucose monitoring algorithm in hypoglycemia.
The purpose of this study was to evaluate the performance of a new continuous glucose monitoring (CGM) calibration algorithm and to compare it with the Guardian(®) REAL-Time (RT) (Medtronic Diabetes, Northridge, CA) calibration algorithm in hypoglycemia. ⋯ The results suggest that the new algorithm may reduce the inaccuracy of Guardian RT CGM system within the hypoglycemic range; however, data from a larger number of patients are required to compare the clinical reliability of the two algorithms.
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Diabetes Technol. Ther. · Sep 2014
Multicenter Study Observational StudyCarotid artery ultrasonographic assessment in patients from the Fremantle Diabetes Study Phase II with carotid bruits detected by electronic auscultation.
Electronic auscultation appears superior to acoustic auscultation for identifying hemodynamic abnormalities. The aim of this study was to determine whether carotid bruits detected by electronic stethoscope in patients with diabetes are associated with stenoses and increased carotid intima-medial thickness (CIMT). ⋯ Electronic recording of carotid sounds for later interpretation is convenient and reliable. Most patients with stenoses had an overlying bruit. Most bruits were false positives, but ultrasonography is justified to document extent of disease; CIMT measurement will identify increased vascular risk in most of these patients. The absence of a bruit was rarely a false-negative finding, suggesting that these patients can usually be reassured that they do not have hemodynamically important stenosis.
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Diabetes Technol. Ther. · Jul 2014
Comparative StudyThe university of Virginia/Padova type 1 diabetes simulator matches the glucose traces of a clinical trial.
In 2008, the Food and Drug Administration (FDA) accepted our type 1 diabetes mellitus (T1DM) simulator (S2008), equipped with 100 in silico adults, 100 adolescents, and 100 children, as a substitute for preclinical trials for certain insulin treatments, including closed-loop algorithms. Hypoglycemia was well described in the simulator, but recent closed-loop trials showed a much larger frequency of hypoglycemia events in patients compared with the in silico ones. In order to better describe the distribution of glucose concentration observed in clinical trials, the simulator has recently been updated, and modifications have been accepted by the FDA (S2013). The aim of this study is to assess the validity of the S2013 simulator against clinical data and compare its performance with that of the S2008. ⋯ We demonstrated that the virtual subjects of the S2013 are representative of the T1DM population observed in a clinical trial. We conclude that the S2013 is a valid tool usable to test the robustness of closed-loop control algorithms for artificial pancreas.
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Diabetes Technol. Ther. · Apr 2014
Target attainment through algorithm design during intravenous insulin infusion.
Algorithms were designed under a single model, to attain differing designated glycemic targets during intravenous insulin infusion, and evaluated in order to justify computerization of the model. The approximate maintenance rate (MR) of insulin infusion is discovered according to rate of change of blood glucose (BG) and previous insulin infusion rate (IR). During treatment, re-assignment of IR depends on MR and BG. For each MR, a roughly sigmoidal relationship between BG and IR is specified, such that the inflection point falls approximately at a true target BG. ⋯ The pilot series suggests that once target range BG is attained, maintenance of control within each of three distinct BG target ranges is achievable, according to choice of algorithm.