Journal of Diabetes Science and Technology最新文献

{"title":"Workshop on Noninvasive Glucose Monitoring 2024.","authors":"Jeon Woong Kang, Mark A Arnold, Devin Steenkamp, Mark A Tapsak, Werner Mäntele, Yoonho Khang, Miyeon Jue, Peter T C So","doi":"10.1177/19322968251329371","DOIUrl":"10.1177/19322968251329371","url":null,"abstract":"<p><p>This first workshop on noninvasive glucose monitoring (NIGM) was held at the Massachusetts Institute of Technology (MIT) on October 30, 2024. Six invited speakers, representing industry, academia, and clinics, gave presentations that covered (1) an overview of the NIGM technologies, (2) the state of the art in NIGM technologies, such as near-infrared (NIR), mid-infrared (IR), photoacoustic, and Raman spectroscopies, (3) minimally invasive implantable continuous glucose monitoring (CGM) sensors, and (4) a clinician's perspective on the impact of the current CGM devices for patient care.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251329371"},"PeriodicalIF":4.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Patient Perspectives and Psychosocial Experiences With Automated Insulin Delivery in Pregnancy With Type 1 Diabetes.","authors":"Christine Field, Kartik K Venkatesh, Elizabeth O Buschur","doi":"10.1177/19322968251329288","DOIUrl":"10.1177/19322968251329288","url":null,"abstract":"<p><p>Pregnancy adds unique medical and psychosocial complexity to the management of type 1 diabetes (TID). Automated insulin delivery (AID) use in pregnancy increasingly shows promise both in improving clinical outcomes and the patient experience for individuals living with T1D. Survey and qualitative data on psychosocial correlates of AID use in pregnancy demonstrate patient benefits compared with other glucose management strategies (such as multiple daily injections, continuous subcutaneous insulin infusion, or sensor-augmented pump therapy). Benefits include improved patient well-being, flexibility, and improved collaboration with health care provider teams. However, burdens have also been identified, including technical glitches, device maintenance, device bulk/visibility, frequent alarms, and the overwhelming quantity of available data. This review describes the lived experiences and perspectives of pregnant individuals with T1D using AID systems. Ongoing education and support for both patients and providers may help to maximize the psychosocial benefits of AID use and reduce potentially negative aspects for pregnant individuals with T1D. While AID represents a significant opportunity for optimizing glucose management for individuals with T1D, both patients and providers need to have realistic expectations based on evidence of what such systems can and cannot do.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251329288"},"PeriodicalIF":4.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of AID on Glycemic Profile and Maternal/Neonatal Outcomes in Pregnancy: A Review of the Evidence From Observational Studies.","authors":"Nasim C Sobhani","doi":"10.1177/19322968251327603","DOIUrl":"10.1177/19322968251327603","url":null,"abstract":"<p><p>The mainstay of type 1 diabetes (T1D) management in pregnancy is optimization of glucose levels in a tight range. Achieving euglycemia has been revolutionized by advances in diabetes technology, including the development of automated insulin delivery (AID) systems. A small but growing population of gravidas with T1D elects to pursue off-label use of AID systems in pregnancy, and their outcomes have been described in numerous observational cohorts. This review aims to aggregate data from all available observational studies examining glycemic, maternal, and neonatal outcomes associated with antenatal AID use. A total of 243 pregnancies managed antenatally with AID were described in 24 publications, with largely reassuring outcomes data. Time in range (TIR) with commercial AID systems was generally acceptable, with many patients reaching pregnancy target TIR > 70% by the third trimester. Time in range with open-source AID systems appeared even higher, although with the potential tradeoff of worse time below range (TBR). Clinically, there do not appear to be major differences in pregnancy outcomes between AID systems and other methods of insulin delivery, although this assumption is based largely on indirect comparisons with other population-level reports rather than direct comparisons within analytic observational cohorts. Clinical outcomes appear superior with open-source AID compared with commercial AID, although this should be interpreted with caution based on the small sample size of this subpopulation (n = 16) and potential confounding. The real-world evidence generated by these observational studies provides invaluable information for patients and providers seeking to improve outcomes for gravidas with T1D.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251327603"},"PeriodicalIF":4.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Existing Knowledge Gaps in Risk Factors and Consequences of Lipohypertrophy in People Using Continuous Subcutaneous Insulin Infusion Therapy: A Systematic Review and Meta-analysis.","authors":"Julia K Mader, Riccardo Fornengo, Ahmed Hassoun, Lutz Heinemann, Bernhard Kulzer, Magdalena Monica, Trung Nguyen, Jochen Sieber, Eric Renard, Yves Reznik, Przemysław Ryś, Anita Stożek-Tutro, Emma G Wilmot","doi":"10.1177/19322968251319806","DOIUrl":"10.1177/19322968251319806","url":null,"abstract":"<p><strong>Background: </strong>Lipohypertrophy is a common skin complication in individuals with insulin-treated diabetes, but this condition in those using insulin pumps (continuous subcutaneous insulin infusion, CSII) remains poorly understood. This study aimed to identify and summarize scientific evidence regarding the risk factors and clinical consequences of lipohypertrophy in people using CSII.</p><p><strong>Methods: </strong>Medical databases (MEDLINE/PubMed, Embase, CENTRAL) were searched to identify relevant studies published in English from 1990 to March 19, 2024. If possible, extracted data were cumulated in meta-analyses. This systematic review was registered on PROSPERO (CRD42024554127).</p><p><strong>Results: </strong>Nine studies reporting risk factors for lipohypertrophy or its consequences in people treated with CSII were identified. In the included studies, only individual risk factors were reported, which in most cases prevented the conduct of a meta-analysis. Meta-analyses could be performed for two factors, that is, improper cannula site rotation and male sex. The odds of developing lipohypertrophy were higher in individuals incorrectly rotating (prevalence odds ratio, pOR = 2.59 [1.39; 4.83]), whereas gender had no impact on the prevalence of lipohypertrophy (pOR = 1.13 [0.62; 2.06]). Due to the limitations of the available data, it was not possible to draw conclusions about the clinical consequences of lipohypertrophy in people on CSII.</p><p><strong>Conclusions: </strong>This systematic review demonstrated that studies on the risk factors and clinical consequences of lipohypertrophy in CSII users are limited and that the currently published data are insufficient to draw definitive conclusions. There is a need for more comprehensive and well-designed clinical studies to better understand this issue in CSII users.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251319806"},"PeriodicalIF":4.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"py-mgipsim: An Open-Source Python Library for Simulating Type 1 Diabetes With Diverse Meals and Physical Activities.","authors":"Mate Siket, Mudassir M Rashid, Ali Cinar","doi":"10.1177/19322968251328664","DOIUrl":"10.1177/19322968251328664","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251328664"},"PeriodicalIF":4.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding Optimal Alphabet for Encoding Daily Continuous Glucose Monitoring Time Series Into Compressed Text.","authors":"Tobore Igbe, Boris Kovatchev","doi":"10.1177/19322968251323913","DOIUrl":"10.1177/19322968251323913","url":null,"abstract":"<p><strong>Background: </strong>The emergence of continuous glucose monitoring (CGM) devices has not only revolutionized diabetes management but has also opened new avenues for research. This article presents a novel approach to encoding a CGM daily profile into a CGM string and CGM text that preserves clinical metrics information but compresses the data.</p><p><strong>Methods: </strong>Eight alphabets were defined to represent glucose ranges. The Akaike information criterion (AIC) was derived from error, and the compression ratio was estimated for each alphabet to determine the optimal alphabet for encoding the CGM daily profile. The analysis was done with data from six distinct studies, with different treatment modalities, applied to individuals with type 1 diabetes (T1D) or type 2 diabetes (T2D), and without diabetes. The data set was divided into 70% for training and 30% for validation.</p><p><strong>Result: </strong>The result from the training data reveals that a 9-letter alphabet was optimal for encoding daily CGM profiles for T1D or T2D, yielding the lowest AIC score that minimizes information loss. However, in health, fewer letters were needed, and this is to be expected, given the lower variation of the data. Further testing with the Pearson correlation showed that the 9-letter alphabet approximated the coefficient of variation, with correlations between 0.945 and 0.965.</p><p><strong>Conclusion: </strong>Encoding CGM data into text could enhance the classification of CGM profiles and enable the use of well-established search engines with CGM data. Other potential applications include predictive modeling, anomaly detection, indexing, trend analysis, or future generative artificial intelligence applications for diabetes research and clinical practice.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251323913"},"PeriodicalIF":4.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for Lipohypertrophy in People With Insulin-Treated Diabetes: A Systematic Meta-Analysis.","authors":"Julia K Mader, Riccardo Fornengo, Ahmed Hassoun, Lutz Heinemann, Bernhard Kulzer, Magdalena Monica, Trung Nguyen, Jochen Sieber, Eric Renard, Yves Reznik, Przemysław Ryś, Anita Stożek-Tutro, Emma G Wilmot","doi":"10.1177/19322968251325569","DOIUrl":"10.1177/19322968251325569","url":null,"abstract":"<p><strong>Background: </strong>Lipohypertrophy is a common skin complication in people with insulin-treated diabetes. Despite its high prevalence and potential impact on diabetes management and outcomes, published data regarding the risk factors for the development of this complication are contradictory. The study aimed to determine risk factors for lipohypertrophy related to patient characteristics and insulin therapy.</p><p><strong>Method: </strong>Medical databases (MEDLINE/PubMed, Embase, CENTRAL) were searched from 1990 to August 21, 2023. All relevant studies describing potential risk factors for lipohypertrophy in people with insulin-treated diabetes (eg, sex, age, body mass index [BMI], type of diabetes, and injection technique) were included. Data enabling calculations of prevalence odds ratios (pOR) and mean differences (MD) with 95% confidence intervals [95% CI] were extracted and pooled in meta-analyses.</p><p><strong>Results: </strong>Fifty-one studies of risk factors for lipohypertrophy were identified. Performed meta-analyses indicate that the strongest contributor to lipohypertrophy was incorrect injection site rotation (pOR = 8.85 [95% CI: 5.10-15.33]), followed by needle reuse (3.20 [1.99-5.13]), duration of insulin therapy >5 years (2.62 [1.70-4.04]) and >2 daily injections per day (2.27 [1.58-3.25]). Those with type 1 diabetes and obese/overweight individuals also had significantly higher odds of developing lipohypertrophy. Sex, age, and insulin device (pen, syringes) were not significant risk factors for lipohypertrophy.</p><p><strong>Conclusions: </strong>This systematic review with meta-analysis revealed that incorrect injection site rotation and needle reuse are the most substantial factors in developing lipohypertrophy. Notably, both factors are modifiable through patient education, emphasizing the importance of teaching proper injection techniques for better diabetes management.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251325569"},"PeriodicalIF":4.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Safely Use Diluted Insulin in an Automated Insulin Delivery System in Very Young Children: An Educator Perspective.","authors":"Eilidh Nicol, Jennifer Ashford, Beatrice Prampolini, M Loredana Marcovecchio","doi":"10.1177/19322968251322183","DOIUrl":"10.1177/19322968251322183","url":null,"abstract":"<p><p>Managing type 1 diabetes in infants and very young children poses unique challenges due to their low insulin requirements, high insulin sensitivity, and rapidly changing metabolic needs. Standard insulin formulations (U100) may prove inadequate for this age group, especially when utilizing continuous subcutaneous insulin infusion or automated insulin delivery (AID) systems.This article presents our clinical experience with diluted insulin (U10) in very young children using the AID system CamAPS FX, along with a literature review, highlighting its potential benefits, such as reduced incidence of hypoglycemia and rates of technical malfunctions. We also discuss key practical considerations for implementing insulin dilution in clinical practice, including the establishment of safety protocols, caregivers and healthcare professionals training, and the importance of accurate preparation and labeling of diluted formulations to mitigate potential serious dosing errors.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251322183"},"PeriodicalIF":4.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repair, Regeneration, and Replacement, Revisited (Redux).","authors":"David G Armstrong, Bijan Najafi, Wei Gao, David C Klonoff, Charles Liu","doi":"10.1177/19322968251326906","DOIUrl":"10.1177/19322968251326906","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251326906"},"PeriodicalIF":4.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion\".","authors":"","doi":"10.1177/19322968251325907","DOIUrl":"10.1177/19322968251325907","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968251325907"},"PeriodicalIF":4.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}