Journal of Diabetes Science and Technology最新文献

{"title":"Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation.","authors":"Grazia Aleppo, Ryan Chmiel, Andrew Zurn, Ryan Bandoske, Patrick Creamer, Nicholas Neubauer, Jo Wong, Sarah B Andrade, Alexis Hauptman","doi":"10.1177/19322968231196168","DOIUrl":"10.1177/19322968231196168","url":null,"abstract":"<p><p>Managing data from continuous glucose monitoring (CGM) systems presents challenges to health care provider teams that rely on the electronic health record (EHR) during patient visits. A method of integrating CGM data with the EHR that relies on the Dexcom API was developed by Northwestern Medicine and Dexcom to address these challenges. Here, we describe the data management steps and user interface of the integrated system. Providers can access patients' historical and latest daily CGM data in the form of modal day plots and stacked columns showing time in various glucose concentration ranges. The integration facilitates the acquisition, storage, analysis, and display of CGM data within an EHR system and may be appropriate for deployment in other health care facilities.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"426-430"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10468263","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":"Glycemic and Psychosocial Correlates of Continuous Glucose Monitor Use Among Adolescents With Type 1 Diabetes.","authors":"Emma Straton, Hailey Inverso, Hailey Moore, Kashope Anifowoshe, Kendall Washington, Randi Streisand, Karishma Datye, Sarah S Jaser","doi":"10.1177/19322968231186428","DOIUrl":"10.1177/19322968231186428","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitor (CGM) use has been linked with better glycemic outcomes (HbA1c), yet many adolescents with type 1 diabetes (T1D) struggle to maintain optimal CGM use.</p><p><strong>Methods: </strong>This study examined CGM use and its association with HbA1c and psychosocial factors among adolescents with T1D experiencing at least moderate diabetes distress (N = 198). We examined mean differences in HbA1c, diabetes distress, diabetes-related family conflict, and quality of life among CGM user groups (<i>Current Users, Past Users</i>, and <i>Never Users</i>).</p><p><strong>Results: </strong><i>Current Users</i> demonstrated significantly lower HbA1c than <i>Never Users</i> and significantly lower diabetes distress than <i>Past Users</i>. CGM use was not associated with family conflict or quality of life.</p><p><strong>Conclusions: </strong>CGM use was associated with lower HbA1c and diabetes distress but not with other psychosocial outcomes. Longitudinal data may explain why many adolescents do not experience improvements in quality of life with CGM use.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"436-440"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235751","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":"Printed Copies of \"Instructions of Use\": What Nonsense!","authors":"Lutz Heinemann","doi":"10.1177/19322968241310891","DOIUrl":"10.1177/19322968241310891","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"598-599"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927297","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":"Efficacy and Safety of an Electronic Glycemic Management System for Optimizing Insulin Therapy in Noncritical Patients With Diabetes: A Randomized Trial.","authors":"Julia Mandaro Lavinas-Jones, Marcos Tadashi Kakitani Toyoshima, Laura Andrade Mesquita, Marcia Nery, Alina Coutinho Rodrigues Feitosa","doi":"10.1177/19322968241306443","DOIUrl":"10.1177/19322968241306443","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"587-589"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965142","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":"GLP-1 Receptor Agonists in Overweight and Obese Individuals With Type 1 Diabetes Using an Automated Insulin Delivery Device: A Real-World Study.","authors":"Pernille Holmager, Merete Bechmann Christensen, Kirsten Nørgaard, Signe Schmidt","doi":"10.1177/19322968241289438","DOIUrl":"10.1177/19322968241289438","url":null,"abstract":"<p><strong>Introduction: </strong>Automated insulin delivery (AID) systems have improved glycemic control in individuals with type 1 diabetes (T1D) but overweight and increased cardiovascular risk remain a challenge. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with improved cardiometabolic profile but are currently not approved for the treatment of T1D.</p><p><strong>Material and methods: </strong>Individuals with T1D at Steno Diabetes Center Copenhagen, Denmark, treated with AID and off-label GLP-1 RA for at least six months between January 2017 and May 2024 were included in a retrospective chart review study.</p><p><strong>Results: </strong>Nineteen individuals with (median [range]) age 42 (24-60) years were included. At GLP-1 RA initiation, hemoglobin A1c (HbA1c) was 7.3% (6.1%-8.7%), HbA1c 56 (43-72) mmol/mol, body weight 91.5 (78.0-115.0) kg, and body mass index 35.4 (27.0-42.0) kg/m². Time in range was 74% (29%-82%), time above range 25% (18%-71%) while time below range was 1% (0%-5%). After six months of treatment, body weight changed -11% (-22% to -3%; <i>P</i> = .001) and total daily insulin dose changed -15.1 (-32.5 to -8.2) IU (<i>P</i> = .004). There were no significant changes in HbA1c or other glucose measures. One person developed ketoacidosis caused by infusion set failure, but none reported severe hypoglycemia.</p><p><strong>Conclusion: </strong>Glucagon-like peptide-1 receptor agonist as add-on therapy for six months in individuals with obesity and AID-treated T1D led to considerable weight loss and a reduction in insulin dose.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"286-291"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466693","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":"Determinants of Liraglutide Treatment Discontinuation in Type 1 Diabetes: A Post Hoc Analysis of ADJUNCT ONE and ADJUNCT TWO Randomized Placebo-Controlled Clinical Studies.","authors":"Viral N Shah, Rikke M Agesen, Lars Bardtrum, Erik Christiansen, Jennifer Snaith, Jerry R Greenfield","doi":"10.1177/19322968241305647","DOIUrl":"10.1177/19322968241305647","url":null,"abstract":"<p><strong>Introduction: </strong>Two phase 3 randomized controlled studies (ADJUNCT ONE (Clinicaltrials.gov: NCT01836523), ADJUNCT TWO (Clinicaltrials.gov: NCT02098395)) evaluated liraglutide (1.8, 1.2 or 0.6 mg) vs placebo in participants with type 1 diabetes (T1D) as an adjunct to insulin therapy. This paper aims to improve our understanding of the potential mechanisms leading to premature discontinuation of this treatment regimen.</p><p><strong>Methods: </strong>Post hoc comparisons were conducted on baseline characteristics and adverse event (AE) rates of participants completing and not completing the ADJUNCT studies due to AEs/lack of tolerance using summary tables and variance analysis.</p><p><strong>Results: </strong>Non-completers (liraglutide and placebo combined) had lower baseline body mass index (BMI) (ADJUNCT ONE: 27.8 kg/m² vs 29.8 kg/m², <i>P</i> < .0001; ADJUNCT TWO: 26.3 kg/m² vs 29.2 kg/m², <i>P</i> < .0001), longer duration of T1D (25.8 years vs 21.0 years, <i>P</i> < .0001; 24.1 years vs 21.0 years, <i>P</i> = .04), lower daily insulin doses by continuous infusion (46.4 U vs 57.3 U, <i>P</i> = .01; 40.9 U vs 57.4 U, <i>P</i> = .12) or multiple injections (58.4 U vs 68.5 U, <i>P</i> = .006; 56.0 U vs 65.8 U, <i>P</i> =.03) and a higher proportion of participants with undetectable C-peptide (91.5% vs 81.3%; 87.0% vs 84.9%) compared to completers. When analyzed by treatment group, only duration of T1D and C-peptide differed between completers and non-completers among liraglutide (and not placebo) participants. The AE rates were higher for non-completers.</p><p><strong>Conclusion: </strong>Individuals with longer-standing T1D and low levels of C-peptide at baseline were more likely to discontinue adjunctive liraglutide treatment due to AEs/lack of tolerance than individuals with residual insulin production. Lower BMI predicted a greater likelihood of non-completion for the included participants, regardless of treatment. These new findings may be relevant for clinical practice.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"321-331"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882228","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":"Expectations and Outcomes From Glucagon-Like Peptide-1 Receptor Agonists As Adjunct Treatment for Type 1 Diabetes - Case Presentations.","authors":"Sujatha Seetharaman, Eda Cengiz","doi":"10.1177/19322968241305641","DOIUrl":"10.1177/19322968241305641","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes (T1D) is characterized by the autoimmune destruction of pancreatic beta cells, leading to lifelong insulin dependence. Despite advancements in insulin therapies and glucose monitoring, maintaining optimal blood glucose control remains challenging with common issues like weight gain and glucose variability. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), approved for type 2 diabetes and obesity, are being explored off-label for T1D.</p><p><strong>Case report: </strong>This case series investigates the effectiveness of GLP-1 RAs, mainly semaglutide and tirzepatide, as an adjunct therapy to insulin in adolescents and young adults (AYA) with T1D, in a single center, providing real-world insights and highlighting practical issues.</p><p><strong>Discussion: </strong>Most patients had obesity, consistent with typical indication for use in AYA. Common gastrointestinal side effects improved with dose titration, but careful monitoring is needed for persistent symptoms. One patient developed an eating disorder, underscoring the need for vigilance. Insurance and medication shortage issues impacted treatment continuity, highlighting the need for better support. Glycemic parameters improved in most patients, with weight reduction in several patients with obesity, and no reported diabetic ketoacidosis.</p><p><strong>Conclusions: </strong>GLP-1 RAs can be a beneficial adjunct therapy in T1D, improving glycemic control, reducing insulin needs, and supporting weight management, while potentially preventing long-term cardiovascular and renal complications.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"304-310"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872345","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":"Is Continuous Glucose Monitoring Feasible in Tribal India? Navigating the Benefits and Overcoming the Challenges.","authors":"Kritika Singh, Tapas Chakma, Aayushi Nagwanshi, Suyesh Shrivastava","doi":"10.1177/19322968241302056","DOIUrl":"10.1177/19322968241302056","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"600-601"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693024","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 Recording Interval in Continuous Glucose Monitoring on Calculating the Metrics of Glycemic Control.","authors":"Catherine L Russon, Richard M Pulsford, Michael J Allen, Emma Cockcroft, Neil Vaughan, Robert C Andrews","doi":"10.1177/19322968241310892","DOIUrl":"10.1177/19322968241310892","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"590-592"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006078","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":"Combining Glucose Monitoring and Insulin Infusion in an Integrated Device: A Narrative Review of Challenges and Proposed Solutions.","authors":"Michael Schoemaker, Anna Martensson, Julia K Mader, Kirsten Nørgaard, Guido Freckmann, Pierre-Yves Benhamou, Peter Diem, Lutz Heinemann","doi":"10.1177/19322968231203237","DOIUrl":"10.1177/19322968231203237","url":null,"abstract":"<p><p>The introduction of automated insulin delivery (AID) systems has enabled increasing numbers of individuals with type 1 diabetes (T1D) to improve their glycemic control largely. However, use of AID systems is limited due to their complexity and costs associated. The user must wear both a continuously monitoring glucose system and an insulin infusion pump. The glucose sensor and the insulin catheter must be inserted at two different body sites using different insertion devices. In addition, the user must pair and manage the different systems. These communicate with the AID software implemented on the pump or on a third device such as a dedicated display device or smart phone application. These components might be developed and commercialized by different manufacturers, which in turn can cause difficulties for patients seeking technical support. A possible solution to these challenges would be to integrate the glucose sensor and insulin catheter into a single device. This would allow the glucose sensor and insulin catheter to be inserted simultaneously, eliminating the need for pairing, and simplifying system management. In recent years, different technologies have been developed and evaluated in clinical investigations that combine the glucose sensor and the insulin catheter in one platform. The consistent finding of all these studies is that integration has no adverse effect on insulin infusion and glucose measurements provided that certain conditions are met. In this review, we discuss the perceived challenges of such an approach and discuss possible solutions that have been proposed.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"441-451"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41126726","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}