Diabetes technology & therapeutics最新文献

{"title":"GLP-1 Receptor Agonist Therapy in Cystic Fibrosis-Related Diabetes: A Case Report.","authors":"Gida Ayada, Sagit Zolotov, Raya Cohen, Tal Lavi, Muhammad Abdul-Ghani, Naim Shehadeh, Afif Nakhleh","doi":"10.1089/dia.2024.0367","DOIUrl":"10.1089/dia.2024.0367","url":null,"abstract":"","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"144-146"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Insulin Delivery Effects During Driving Among Older Adults with Type 1 Diabetes in a Randomized Trial.","authors":"Steven Trawley, Hye Jin Kwon, Sara Vogrin, Peter G Colman, Spiros Fourlanos, Melissa H Lee, Richard J MacIsaac, David N O'Neal, Niamh A O'Regan, Vijaya Sundararajan, Glenn M Ward, Sybil A McAuley","doi":"10.1089/dia.2024.0303","DOIUrl":"10.1089/dia.2024.0303","url":null,"abstract":"<p><p>Dysglycemia among drivers with type 1 diabetes (T1D) is associated with impaired driving performance, and glucose levels \"above 5 to drive\" are often recommended for insulin-treated drivers. Evidence for diabetes treatments that support euglycemia while driving is minimal, particularly for older drivers. In this randomized, crossover trial involving adults aged ≥60 years with T1D, we used continuous glucose monitoring (CGM) during driving to compare the first-generation closed-loop automated insulin delivery (AID) versus a sensor-augmented pump therapy. There were 1894 trips undertaken by 8 drivers (median age 68 years [IQR: 64-70]). During AID versus sensor-augmented pump, time in range >5.0-10.0 mmol/L was greater (100% [0-100] vs. 81% [0-100]; <i>P</i> = 0.033) and fewer trips had any CGM >16.7 mmol/L (3.5% vs. 6.4%; <i>P</i> = 0.006). Three percent of all trips included CGM <3.9 mmol/L, with no between-stage difference (3.0% vs. 3.5%; <i>P</i> = 0.52). System alerts occurred in 10% of all trips, with no between-stage difference (9% vs. 11%; <i>P</i> = 0.078). First-generation AID reduces hyperglycemic driving among older drivers with T1D, without increasing hypoglycemia. Developing dedicated \"driving-mode\" settings could prioritize safety while minimizing distraction. Trial Registration: ACTRN12619000515190.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"134-138"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Pump Use and Diabetic Ketoacidosis Risk in Type 1 Diabetes: Secular Trends over Four Decades.","authors":"Dalton R Budhram, Priya Bapat, Abdulmohsen Bakhsh, Mohammad I Abuabat, Natasha J Verhoeff, Doug Mumford, Wajeeha Cheema, Andrej Orszag, Akshay Jain, David Z I Cherney, Michael Fralick, Bader N Alamri, Alanna Weisman, Leif Erik Lovblom, Bruce A Perkins","doi":"10.1089/dia.2024.0272","DOIUrl":"10.1089/dia.2024.0272","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Continuous subcutaneous insulin infusion (CSII) in type 1 diabetes has been regarded as a major diabetic ketoacidosis (DKA) risk factor. We aimed to determine secular trends in risk since CSII implementation in the 1980s. <b><i>Research Design and Methods:</i></b> We assessed the relationship between time-varying CSII use and DKA events from 1983 to 2017 and by each decade in the 1441 Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study participants using crude and adjusted Cox proportional hazards models. <b><i>Results:</i></b> Time-varying CSII exposure was associated with significantly higher DKA risk in the 1980s (adjusted hazard ratio [HR] 5.81; 95% confidence interval [CI] 3.28-10.29; <i>P</i> < 0.001), but in the 2010s, this risk was not significantly elevated (adjusted HR 1.24; 95% CI 0.73-2.12; <i>P</i> = 0.43). <b><i>Conclusions:</i></b> DKA risk associated with CSII in type 1 diabetes has declined substantially since the 1980s such that the remaining risk in the past decade appears to be of low magnitude.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"139-143"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an Automated Priming Bolus for Improving Prandial Glucose Control in Full Closed Loop Delivery.","authors":"Marcela Moscoso-Vasquez, Patricio Colmegna, Charlotte Barnett, Morgan Fuller, Chaitanya L K Koravi, Sue A Brown, Mark D DeBoer, Marc D Breton","doi":"10.1089/dia.2024.0315","DOIUrl":"10.1089/dia.2024.0315","url":null,"abstract":"<p><p><b><i>Background:</i></b> Automated insulin delivery (AID) is widely available to people with type 1 diabetes (T1D), providing superior glycemic control versus traditional methods. The next generation of AID devices focus on minimizing user/device interactions, especially around meals (\"full closed loop,\" [FCL]). Our goal was to assess the postprandial glycemic impact of the bolus priming system (BPS), an algorithm delivering fixed insulin doses based on the likelihood of a meal having occurred, in conjunction with UVA's latest AID. <b><i>Method:</i></b> Eleven adults with T1D participated in a supervised randomized-crossover trial assessing glycemic control during two 24-h sessions with identical meals and activity-with and without BPS. On the day in-between study sessions, participants underwent food and activity challenges to test BPS safety and robustness. Continuous glucose monitor (CGM) outcomes and total insulin doses were assessed overall and following meals with potential for BPS to dose additional insulin (CGM >90 mg/dL for 1 h prior). <b><i>Results:</i></b> Daytime CGM outcomes were similar with and without BPS: time-in-range (TIR) 70-180 mg/dL 70.6% [62.2-76.5] versus 65.7% [58.6%-80.6%]; time-below-range <70 mg/dL 0% [0-2.1] versus 0% [0-1.3]; respectively. Insulin delivery during 3 h postprandial was indistinguishable 33.5 U [26.4-47.0] versus 35.7 U [28.7-44.9]. Among 43 out of 66 meals with potential to trigger BPS (24/19 BPS/no-BPS), postprandial incremental area-under-the-curve (iAUC) was lower for BPS versus no-BPS (2530 ± 1934 versus 3228 ± 2029, <i>P</i> = 0.047), but CGM outcomes were inconclusive: 4-h-TIR 51.2% [19.8-83.3] versus 40.2% [20.8-56.3] (<i>P</i> = 0.24). There were no severe adverse events. <b><i>Conclusion:</i></b> While there was no difference in TIR, when BPS was active an improved postprandial AUC in FCL was obtained via earlier insulin injection.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"93-100"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Accuracy and Safety of the 365-Day Implantable Eversense Continuous Glucose Monitoring System: The ENHANCE Study.","authors":"Timothy S Bailey, David R Liljenquist, Douglas S Denham, Ronald L Brazg, Sorin Ioacara, James Masciotti, Samanwoy Ghosh-Dastidar, Katherine S Tweden, Francine R Kaufman","doi":"10.1089/dia.2024.0592","DOIUrl":"https://doi.org/10.1089/dia.2024.0592","url":null,"abstract":"<p><p>The implanted Eversense Continuous Glucose Monitoring (CGM) System transitioned from 90- to 180- to 365-day durations marketed today. This report summarizes the 365-day clinical study. ENHANCE was a prospective, multicenter study evaluating the accuracy and safety of the Eversense 365 CGM system through 1 year in adults with diabetes. Accuracy and adverse events (AEs) were assessed during 14 in-clinic visits comparing CGM and Yellow Springs Instrument reference glucose measurements, including during hyperglycemia and hypoglycemia challenges. In total, 110 participants were implanted with the Eversense 365 CGM System. The overall mean absolute relative difference was 8.8% with primarily one calibration per week. The confirmed alert detection rate at 70 mg/dL was 96.6%, and at 180 mg/dL, it was 97.9%. Ninety percent of the sensors survived 365 days. Interoperable CGM special controls were met. No related serious AEs were reported. The Eversense 365 CGM was shown to be safe and accurate through 1 year with primarily one calibration per week.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EValuating Glucose ContrOL Using a Next-GeneraTION Automated Insulin Delivery Algorithm in Patients with Type 1 and Type 2 Diabetes: The EVOLUTION Study.","authors":"Tom Wilkinson, Renee Meier, Niranjala Hewapathirana, Claire Lever, Solita Donnelly, Rachael Sampson, Jonathan Williman, Mert Sevil, Saeed Salavati, Sam Carl, Bonnie Dumais, Trang T Ly, Martin de Bock","doi":"10.1089/dia.2024.0463","DOIUrl":"https://doi.org/10.1089/dia.2024.0463","url":null,"abstract":"<p><p>This study evaluated a next-generation automated insulin delivery (AID) algorithm for Omnipod in type 1 and type 2 diabetes across multiple phases: 14-day run-in with usual therapy, 48-h AID use in a hotel setting (type 1 only), and up to 6 weeks of outpatient AID use. Participants did, or did not, deliver manual boluses at alternating periods. Twelve adults with type 1 diabetes completed the hotel phase; 9 of those 12 plus 8 adults with type 2 diabetes completed the subsequent outpatient phase. Outpatient % continuous glucose monitor readings >250 mg/dL decreased from 33.5% at baseline to 9.4% with, and 14.3% without, manual boluses in type 1 diabetes and from 20.8% to 7.7% with, and 10.5% without, manual boluses in type 2 diabetes. Time below 70 mg/dL remained <4% during all phases. No adverse events occurred. In conclusion, a next-generation AID algorithm demonstrated feasibility in people with diabetes.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Improvements in Glycemia and User-Reported Outcomes Associated with Open-Source Automated Insulin Delivery Systems in Adults with Type 1 Diabetes in the United Kingdom: A Real-World Observational Study.","authors":"Alexandros L Liarakos, Thomas S J Crabtree, Sufyan Hussain, Rachel Patel, Anastasios Gazis, Buddhike Mendis, Roselle Herring, Adele Kennedy, Neil Black, Robert E J Ryder, Emma G Wilmot","doi":"10.1089/dia.2024.0556","DOIUrl":"https://doi.org/10.1089/dia.2024.0556","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate real-world outcomes in adults with type 1 diabetes initiating open-source automated insulin delivery systems (OS-AID). <b><i>Methods:</i></b> Adults with type 1 diabetes who commenced OS-AID, between May 2016 and April 2021, across 12 centers in the United Kingdom were included. Anonymized clinical data, collected during routine clinical care between December 2019 and November 2023, were submitted to a secure web-based tool within the National Health Service network. Outcomes included change in hemoglobin A1c (HbA1c), sensor glucometrics, diabetes distress score, Gold score (hypoglycemia awareness), user opinion of OS-AID, and event rates (hospital admissions, paramedic callouts, severe hypoglycemia, and adverse events) between baseline and follow-up. <b><i>Results:</i></b> In total, 81 OS-AID users were included (51.9% male; 90.1% White British; mean age 41.4 years; median diabetes duration 25 years [IQR 17-32]). Over a mean follow-up of 1.7 years, HbA1c reduced by 0.8% (9 mmol/mol) (7.3 ± 1.1% vs. 6.5 ± 0.7%; <i>P</i> < 0.001), and the percentage of individuals achieving HbA1c ≤ 7.0% (53 mmol/mol) increased from 48.6% to 75.7% (<i>P</i> < 0.001). Diabetes-related distress score reduced by 0.9 (95% confidence interval [CI] -0.3, -1.5; <i>P</i> = 0.006), and Gold score reduced by 0.7 (95% CI -0.1, -1.3; <i>P</i> = 0.022). The percentage of individuals with impaired hypoglycemia awareness (Gold score ≥4) reduced (27.8% at baseline vs. 8.3% at follow-up; <i>P</i> = 0.039). Of those asked, all participants stated that OS-AID had a positive impact on quality of life. The number of hospital admissions was low. <b><i>Conclusions:</i></b> The use of OS-AID is associated with long-term improvements in HbA1c, hypoglycemia awareness, and diabetes-related distress in type 1 diabetes. These benefits were achieved without increased rates of hospital admissions, diabetic ketoacidosis, or severe hypoglycemia.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ranting in 2025: It's Not the Same Rant.","authors":"Irl B Hirsch","doi":"10.1089/dia.2025.0005","DOIUrl":"https://doi.org/10.1089/dia.2025.0005","url":null,"abstract":"","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Control Across the Menstrual Cycle in Women with Type 1 Diabetes Using the MiniMed 780G Advanced Hybrid Closed-Loop System: The 780MENS Prospective Study.","authors":"Gabriela Monroy, María José Picón-César, Jorge García-Alemán, Francisco J Tinahones, José Ignacio Martínez-Montoro","doi":"10.1089/dia.2024.0522","DOIUrl":"https://doi.org/10.1089/dia.2024.0522","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate whether the MiniMed™ 780G advanced hybrid closed-loop (AHCL) system maintains similar glycemic control across two different phases of the menstrual cycle in women with type 1 diabetes (T1D) and to analyze the system's performance in these situations. <b><i>Methods:</i></b> Continuous glucose monitoring (CGM) and insulin delivery metrics from 12 participants with T1D using the MiniMed™ 780G AHCL were analyzed throughout 3 prospectively recorded, consecutive menstrual cycles (36 cycles in total). Mixed models were used to compare the different variables between the early follicular phase and late luteal phase. <b><i>Results:</i></b> A higher average glucose was found throughout the late luteal phase compared with the early follicular phase (139.5 [133.5, 145.2] vs. 131.5 [126.8, 140.2] mg/dl, respectively, <i>P</i> = 0.002), together with an increase in total daily insulin dose (37.2 ± 11.9 vs. 33.6 ± 12.2 IU, <i>P</i> < 0.001). However, similar values between phases were observed for most of the remaining CGM metrics, including time in range (83.0 [76.0, 87.5] vs. 85.0 [79.8, 89.0] %, <i>P</i> = 0.101). <b><i>Conclusion:</i></b> Our results suggest that differences in glycemic control may be found across the menstrual cycle in women with T1D using the MiniMed™ 780G AHCL. Although higher average glucose levels may be expected in the late luteal phase, the deterioration of glycemic control during this phase may be mild with the MiniMed™ 780G AHCL, given the similarities for most of the CGM metrics with respect to the early follicular phase.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Continuous Glucose Monitoring in Adults with Type 1 Diabetes Admitted to Hospital: A Real-World Multicenter Observational Study.","authors":"Ray Wang, Mervyn Kyi, Brintha Krishnamoorthi, Jason Tjahyadi, Ailie Connell, Cherie Chiang, Debra Renouf, Rahul Barmanray, Spiros Fourlanos","doi":"10.1089/dia.2024.0604","DOIUrl":"https://doi.org/10.1089/dia.2024.0604","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Continuous glucose monitoring (CGM) use in people with type 1 diabetes (T1D) is revolutionizing management. Use of CGM in hospital is poised to transform care, however routine use is not currently recommended due to lack of accuracy validation in acute care, including in people with T1D. We aimed to determine real-world CGM accuracy in hospitalized adults with T1D. <b><i>Materials and Methods:</i></b> In this multicenter retrospective observational study, we compared CGM interstitial fluid glucose with reference blood glucose (capillary/whole-blood point-of-care [POC], blood gas [GAS]) in adults with T1D requiring multiday admissions during 2020-2023 across three health services in Australia. Patients requiring dialysis or admitted under pediatric/obstetric/palliative care/psychiatry units were excluded. CGM accuracy was assessed by comparison with time-matched (±5 min) reference glucose measures, utilizing median absolute relative difference (ARD), mean ARD (MARD), and consensus error grid (CEG) analysis. <b><i>Results:</i></b> In total, 2,199 CGM-reference glucose pairs from 214 admissions (146 patients) were assessed. Overall, mean (SD) ARD was 12.8% (13.1) and median (IQR) ARD was 9.4% (3.7-17.7). MARD for CGM-POC pairs was 12.3%; MARD for CGM-GAS pairs was 14.3%. In CEG analysis, 99.3% of glucose pairs were within zones A/B. Accuracy was lower in critical care compared with noncritical care wards (MARD 16.1% vs. 12.0%, <i>P</i> < 0.001). <b><i>Conclusions:</i></b> In this real-world multicenter study, CGM glucose agreed well with reference blood glucose, suggesting modern CGM devices could be safely and effectively used in hospitalized adults with T1D. Further prospective studies of CGM accuracy with newer generation devices across different scenarios will further elucidate inpatient CGM accuracy and safety.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}