OBJECTIVE: To use continuous glucose monitoring (CGM) to characterize diurnal glucose patterns produced by a novel formulation of exenatide consisting of biodegradable polymeric microspheres that entrap exenatide and provide extended release enabling once-weekly administration. METHODS: We performed a subgroup analysis of patients with type 2 diabetes who participated in a ...

AIMS: To determine whether continuous glucose information provided through use of either the GlucoWatch G2 Biographer or the MiniMed continuous glucose monitoring system (CGMS) results in improved glycated haemoglobin (HbA(1c)) for insulin-treated adults with diabetes mellitus, relative to an attention control and standard care group. METHODS: Four hundred and four ...

Data mining is the process of selecting, exploring, and modeling large amounts of data to discover unknown patterns or relationships useful to the data analyst. This article describes applications of data mining for the analysis of blood glucose and diabetes mellitus data. The diabetes management context is particularly well suited ...

To prevent complications in diabetes, the proper management of blood glucose levels is essential. Since conventional glucose meters require pricking fingers or other areas of the skin, a noninvasive method for monitoring blood glucose levels is desired. Using a lightweight cymbal transducer array, this study was conducted to noninvasively determine ...

Patient-health care practitioner (HCP) interaction via a Web-based diabetes management system may increase patient monitoring of their blood glucose (BG) levels. A three-center, nonrandomized, prospective feasibility study of 109 Native Americans with poorly controlled type 1 diabetes mellitus and type 2 diabetes mellitus were recruited from Alabama, Idaho, and Arizona. ...

BACKGROUND: In diabetes, strict glycemic control reduces risk of complications. One mode of therapy is continuous intraperitoneal insulin infusion (CIPII). With CIPII, like all intensified treatment strategies, frequent assessment of glucose levels is mandatory. Real-time (RT)-continuous glucose monitoring (CGM) gives RT information without the need for multiple invasive measurements. In ...

OBJECTIVE: Diabetic ketoacidosis (DKA) is associated with significant morbidity and mortality. Self-monitoring of ketone bodies by diabetes patients can be done using blood or urine. We compared the two self-monitoring methods and summarized recent developments in the epidemiology and management of DKA. METHODS: MEDLINE and EMBASE were searched for relevant ...

BACKGROUND: The proportion of diabetic patients undergoing haemodialysis is rapidly increasing. Glucose control among such patients is difficult to assess. We aimed to evaluate the clinical performance of a continuous glucose monitoring system (CGMS) in type 2 diabetic patients on chronic haemodialysis. METHODS: We used a 4-day CGMS to monitor ...

CONTEXT: Real-time continuous glucose monitoring (CGM) has been available for type 1 diabetes for several years. This paper is a status report on our early experiences with this next technology. EVIDENCE ACQUISITION: The two major sources of data acquisition included PubMed search strategies and personal experience of the author from ...

Recent trials have provided differing estimates of the benefits of self-monitoring of blood glucose (SMBG) for non-insulin treated patients with type 2 diabetes. Designing and conducting randomised trials to demonstrate the efficacy of complex interventions is challenging. Variations in the components of the intervention delivered, target population selected, and reporting ...

Model-based control systems are better fitted to glycaemic control in intensive care than ad-hoc protocols, but depend on predictive accuracy and facilitation of clinical routines. A general method to customize and visualize modelbased blood glucose predictions is presented. Customization is based on admission type and diabetic status of patients. Blood ...

OBJECTIVE: To evaluate the impact of circulatory shock requiring norepinephrine therapy on the accuracy and reliability of a subcutaneous continuous glucose monitoring system (CGMS) in critically ill patients. DESIGN AND SETTING: A prospective, validation study of a medical intensive care unit at a university hospital was carried out. METHODS: Continuous ...

This paper presents a novel blood glucose regulation for type I (insulin-dependent) diabetes mellitus patients using biologically inspired TSK0-FCMAC, a fuzzy cerebellar model articulation controller (CMAC) based on the zero-ordered Takagi-Sugeno-Kang (TSK) fuzzy inference scheme. TSK0 -FCMAC is capable of performing localized online training with an effective fuzzy inference scheme ...

OBJECTIVE: To determine which of two simplified blood glucose monitoring schemes promotes better metabolic control in type 1 diabetic patients during 12 months of participation in educational groups. METHODS: A crossover clinical trial involving 21 patients divided into two groups was conducted. They were submitted to a two monitoring schemes: ...

OBJECTIVES: To compare (1) blood glucose and glycosylated hemoglobin (A1C) laboratory results and (2) longitudinal trends in blood glucose levels among veterans switched from one second-generation antipsychotic (SGA) to another. DESIGN: Retrospective, naturalistic, nonequivalent control group. SETTING: United States between April 1, 2003, and September 30, 2003. PATIENTS: 1,776 U.S. ...

BACKGROUND: The main concern in noninvasive (NI) glucose measurement is achieving high accuracy readings, although no blood (or other fluid) is involved in the process. Using methods based on different physical properties of a measured object can ensure the independence of each of the readings and therefore improve the validity ...

Continuous glucose monitoring (CGM) is a new technology that allows patients to measure glucose levels continuously over several days. It has several advantages over traditional glucose meters in that it does not involve repeated finger sticks and can measure trends and track changes in glucose levels over time. The Clinical ...

BACKGROUND: The latest Paradigm 722 insulin pump, Medtronic MiniMed, USA, enables daily reading of 288 interstitial fluid glucose concentrations determined by a sensor inserted into subcutaneous tissue; the sensor signals are transmitted into the insulin pump, enabling the patient to see real-time glucose concentration on the display and adapt further ...

BACKGROUND: Continuous glucose monitoring (CGM) has the potential to provide useful data for behavioral interventions targeting non-insulin-using, sedentary individuals with type 2 diabetes mellitus (T2DM). The aims of this study were to describe CGM in terms of (1) feasibility and acceptability and (2) dietary- and exercise-teaching events. METHODS: Cross-sectional data ...

BACKGROUND: The objective of the analysis was to compare detection of hypoglycemic episodes (glucose <70 mg/dL lasting >15 min) with the FreeStyle Navigator Continuous Glucose Monitoring System (FSN-CGM) (Abbott Diabetes Care, Alameda, CA) alarms to detection with traditional finger stick testing at an average frequency of eight tests per day. ...

AIM: To verify whether, with thorough practical and theoretical training, well-controlled, non-complicated diabetic patients can safely go diving underwater with no additional medical or metabolic risks. METHODS: Twelve diabetic patients participated in the study after undergoing training focused on their diabetic status. Two dives per day were scheduled during two ...

BACKGROUND: The complications of diabetes are preventable by exact glycemic control, which can be provided by an accurate self-monitoring blood glucose system to promote self-care in the management of diabetes. METHODS: We evaluated the accuracy and reliability of the EasyPlus mini R2N blood glucose self-monitoring system and compare glucose measurements ...

AIMS: To review the recent literature relating to the role of self-monitoring of blood glucose (SMBG) and glycemic control. METHODS: Medline and EMBASE databases were searched between 1996 and June 2008 using terms that included diabetes mellitus, self-care, and blood glucose self monitoring. Both experimental and nonexperimental studies with HbA(1c) ...

BACKGROUND: This study evaluated the use of an accelerometer-based device in helping to manage blood glucose levels (BGLs) in people with diabetes mellitus. METHODS: Five people with diabetes were given a triaxial accelerometer-based device (Energy Monitor) that measured energy levels associated with activities of daily living. For 3 months, they ...

OBJECTIVE: This study evaluated the accuracy and safety of two continuous glucose monitoring (CGM) systems, the SEVEN (DexCom, San Diego, CA) and the Navigator (Abbott Diabetes Care, Alameda, CA), with the YSI laboratory measurements of blood glucose (blood glucose meter manufactured by YSI, Yellow Springs, OH), when worn concurrently in ...

BACKGROUND: Continuous glucose-monitoring system (CGMS) is a tool for assessment of glycemic excursions. Glucose variability is a risk factor independent of glycosylated hemoglobin (HbA1c) for diabetic complications; hence CGMS may be a better method for management of diabetes. AIM: To evaluate the extent of glycemic excursions in well-controlled type 2 ...

OBJECTIVES: To determine whether self-monitoring of blood glucose (SMBG), either alone or with additional instruction in incorporating the results into self-care, is more effective than usual care in improving glycaemic control in non-insulin-treated diabetes. DESIGN: An open, parallel group randomised controlled trial. SETTING: 24 general practices in Oxfordshire and 24 ...

BACKGROUND: Cell phone text messaging, via the Short Messaging Service (SMS), offers the promise of a highly portable, well-accepted, and inexpensive modality for engaging youth and young adults in the management of their diabetes. This pilot and feasibility study compared two-way SMS cell phone messaging with e-mail reminders that were ...

The control of diabetes is an interdisciplinary endeavor, which includes a significant biomedical engineering component, with traditions of success beginning in the early 1960s. It began with modeling of the insulin-glucose system, and progressed to large-scale in silico experiments, and automated closed-loop control (artificial pancreas). Here, we follow these engineering ...

BACKGROUND: This study was designed to assess the accuracy, reliability, and contribution to clinical decision-making of two commercially available continuous glucose monitoring (CGM) devices using a novel analytical approach. STUDY DESIGN: Eleven individuals with type 1 diabetes and five with type 2 diabetes wore a Guardian RT (GRT) (Medtronic Minimed, ...

INTRODUCTION: Patient outcomes, such as morbidity and mortality, depend on accurate laboratory test results. Computer simulation of the effects of test performance parameters on outcome measures may represent a valuable approach to defining the quality of assay performance that is needed to provide optimal outcomes. METHODS: We carried out computer ...

BACKGROUND: Our objective was to evaluate the accuracy and safety of a real-time (RT) continuous glucose monitoring system (CGMS) in patients before and after cardiothoracic surgery and to investigate whether activation of the alarm function of the RT-CGMS had an effect on glucose control. METHODS: Patients scheduled for elective cardiothoracic ...

In the resource-poor areas of the tropics, diabetic patients requiring insulin are often treated with once-daily injections of intermediate-acting insulin. Glycaemic control on this regime is usually poor. We trialled a simple change to twice-daily insulin (same total daily dose, two-thirds given in morning, and one-third in evening) in a ...

Self-monitoring of blood glucose is an integral part of diabetes care which may be extended to other biometrics. Cellular and short range communication technologies will be important for the routine usage of these systems. However, the issues of follow-up and patient compliance with these emerging systems have not been yet ...

Blood glucose regulation is of a great concern for insulin-dependant patients with excessive glucose in blood (hyperglycaemia), or low glucose profile (hypoglycaemia) due to excess insulin delivery. Both conditions can cause dangerous complications for diabetic patients, and hence glucose regulation in blood is of prime importance. Insulin pumps are used ...

Good blood glucose control is important to people with type 1 diabetes to prevent diabetes-related complications. Too much blood glucose (hyperglycaemia) causes long-term micro-vascular complications, while a severe drop in blood glucose (hypoglycaemia) can cause life-threatening coma. Finding the right balance between quantity and type of food intake, physical activity ...

Arguably, a minimally invasive system using subcutaneous (s.c.) continuous glucose monitoring (CGM) and s.c. insulin delivery via insulin pump would be a most feasible step to closed-loop control in type 1 diabetes mellitus (T1DM). Consequently, diabetes technology is focusing on developing an artificial pancreas using control algorithms to link CGM ...

BACKGROUND: A 16-week, two-site study evaluated outcomes for a new device (the Paradigm 722 System, Medtronic MiniMed, Northridge, CA) that combines a "smart" continuous subcutaneous insulin infusion (CSII) pump with real-time (RT) continuous glucose monitoring (CGM) and CareLinktrade mark data management software (DMS). METHODS: CSII-naive adults with type 1 diabetes ...

Imagine a diabetes patient receiving a text message on his mobile phone warning him that his blood glucose level is too low or a patient's mobile phone calling an emergency number when the patient goes into diabetic shock.Both scenarios depend on automatic, continuous monitoring of blood glucose levels and transmission ...

Little attention has been given and few studies have been published focusing on how to optimize self-monitoring of blood glucose (SMBG) use to monitor daily therapy for persons with type 1 diabetes mellitus. This study was designed to evaluate the effect on glycated hemoglobin (A1C) of a structured intervention focused ...

Insulin sensitivity (SI) estimation has numerous uses in medical and clinical situations. However, highresolution tests that are useful for clinical diagnosis and monitoring are often too intensive, long and costly for regular use. Simpler tests that mitigate these issues are not accurate enough for many clinical diagnostic or monitoring scenarios. ...

Current clinical guidelines for diabetes care encourage self-monitoring of blood glucose (SMBG) to improve glycemic control. Specific protocols remain variable, however, particularly among non-insulin-using patients. This is due in part to efficacy studies that neglect to consider (1) the performance of monitoring equipment under real-world conditions, (2) whether or how ...

BACKGROUND: Glycostator is a diabetes management software package consisting of 3 indicators-"time-averaged glucose (TAG)," "virtual A1c (VA1c)," and "lability index"-all devised for statistical manipulation of capillary glucose data and assessment of overall glycemic control. The TAG approximates the average value of the function of blood glucose versus time, adding the ...

OBJECTIVE: The purpose of this pilot study was to evaluate the feasibility of 10-day use of a transcutaneous, real-time, continuous glucose-monitoring (CGM) system. All previous reports using different CGM systems were for 3-, 5-, or 7-day use. RESEARCH DESIGN AND METHODS: On day 1, subjects received the CGM device (SEVEN ...

The utility and efficacy of self-monitoring of blood glucose (SMBG), using single capillary glucose determinations, in the management of non-insulin treated type 2 diabetes has been called into question. The use of continuous sub-cutaneous glucose monitoring (CGM) systems provides an answer for at least some of the inadequacies attributed to ...

Self-monitoring of blood glucose (SMBG) in type 2 diabetic patients was compared across 14 countries. There was an unexpectedly high SMBG-use in non-insulin-treated patients. Reimbursement polices differed by country, region, insurance status, and patient income. More rigorous and systematic data collection is needed to ensure evidence-based SMBG-use.

THE dysglycemia of diabetes includes two components: (1) sustained chronic hyperglycemia that exerts its effects through both excessive protein glycation and activation of oxidative stress and (2) acute glucose fluctuations. Glycemic variability seems to have more deleterious effects than sustained hyperglycemia in the development of diabetic complications as both upward ...

BACKGROUND: Glycemic variability is an important parameter used to resolve potential clinical problems in diabetic patients. It is known that glycemic variability generates oxidative stress and potentially contributes to the development of macro- and microvascular complications in diabetes. By controlling glycemic variability, it is possible to reduce these complications and ...

The Coalition for Clinical Research-Self-Monitoring of Blood Glucose Scientific Board, a group of nine academic clinicians and scientists from the United States and Europe, convened in San Francisco, California, on June 11-12, 2008, to discuss the appropriate uses of self-monitoring of blood glucose (SMBG) and the measures necessary to accurately ...

BACKGROUND: Recent data show that blood glucose (BG) variability is an HbA1c-independent risk factor for diabetic complications. This study investigated the characteristics of BG variability in type 2 diabetic patients and the effect of intensive treatment. MATERIAL/METHODS: Forty-eight subjects with normal glucose regulation and 69 patients with newly diagnosed type ...