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Estimating Breakfast Characteristics Using Continuous Glucose Monitoring and Machine Learning in Adults With or at Risk of Type 2 Diabetes. 利用连续血糖监测和机器学习估算 2 型糖尿病患者或高危人群的早餐特征。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-23 DOI: 10.1177/19322968241274800
Ryan Pai, Souptik Barua, Bo Sung Kim, Maya McDonald, Raven A Wierzchowska-McNew, Amruta Pai, Nicolaas E P Deutz, David Kerr, Ashutosh Sabharwal

Background: Continuous glucose monitoring (CGM) systems allow detailed assessment of postprandial glucose responses (PPGR), offering new insights into food choices' impact on dysglycemia. However, current approaches to analyze PPGR using a CGM require manual meal logging, limiting the scalability of CGM-driven applications like personalized nutrition and at-home diabetes risk assessment.

Objective: We propose a machine learning (ML) framework to automatically identify and characterize breakfast-related PPGRs from CGM profiles in adults at risk of or living with noninsulin-treated type 2 diabetes (T2D).

Methods: Our PPGR estimation framework uses a random forest ML algorithm trained on 15 adults without diabetes who wore a CGM for up to four weeks. The algorithm performance was evaluated on a held-out subset of the participants' CGM data as well as on an external validation data set of 36 individuals at risk for or with noninsulin-treated T2D.

Results: Our algorithm's estimations of breakfast PPGRs displayed no statistically significant differences to annotated PPGRs, in terms of incremental area under the curve and glucose rise (P > .05 for both data sets), while a small difference in prebreakfast glucose was found in the nondiabetes data set (P = .005) but not in the validation T2D data set (P = .18).

Conclusions: We designed an ML framework to automatically estimate the timing of meal events from CGM data in individuals without diabetes and in individuals at risk or with T2D. This could provide a more scalable approach for analyzing postprandial glycemia, increasing the feasibility of CGM-based precision nutrition and diabetes risk assessment applications.

背景:连续血糖监测(CGM)系统可对餐后血糖反应(PPGR)进行详细评估,为了解食物选择对血糖异常的影响提供了新的视角。然而,目前使用 CGM 分析 PPGR 的方法需要手动记录膳食,这限制了 CGM 驱动的应用(如个性化营养和居家糖尿病风险评估)的可扩展性:我们提出了一个机器学习(ML)框架,用于从 CGM 资料中自动识别和描述与早餐有关的 PPGR,对象是有糖尿病风险或正在接受非胰岛素治疗的 2 型糖尿病(T2D)成人:我们的 PPGR 估算框架采用随机森林 ML 算法,该算法是在 15 名佩戴 CGM 长达四周的非糖尿病成人身上训练出来的。我们在参与者的 CGM 数据中保留了一个子集,并在 36 名有 T2D 风险或未经胰岛素治疗的 T2D 患者的外部验证数据集上评估了该算法的性能:我们的算法对早餐PPGR的估计在曲线下增量面积和血糖上升方面与注释的PPGR没有统计学意义上的显著差异(两个数据集的P > .05),而在非糖尿病数据集(P = .005)中发现了早餐前血糖的微小差异,但在验证的T2D数据集(P = .18)中没有发现这种差异:我们设计了一个 ML 框架,用于从 CGM 数据中自动估计非糖尿病患者、高危患者或 T2D 患者的进餐时间。这为分析餐后血糖提供了一种更具扩展性的方法,提高了基于 CGM 的精准营养和糖尿病风险评估应用的可行性。
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引用次数: 0
HIT4HYPOS Continuous Glucose Monitoring Data Analysis: The Effects of High-Intensity Interval Training on Hypoglycemia in People With Type 1 Diabetes and Impaired Awareness of Hypoglycemia. HIT4HYPOS 连续血糖监测数据分析:高强度间歇训练对 1 型糖尿病患者和低血糖意识受损者低血糖的影响。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-23 DOI: 10.1177/19322968241273845
Catriona M Farrell, Giacomo Cappon, Daniel J West, Andrea Facchinetti, Rory J McCrimmon

Aims: To assess the impact of high-intensity interval training (HIIT) on hypoglycemia frequency and duration in people with type 1 diabetes (T1D) with impaired awareness of hypoglycemia (IAH).

Methods: Post hoc analysis of four weeks of continuous glucose monitoring (CGM) data from HIT4HYPOS; a parallel-group study comparing HIIT + CGM versus no exercise + CGM in 18 participants with T1D and IAH.

Results: When compared with those participating individuals not exercising, HIIT did not increase total hypoglycemia frequency, THypo(L1) 1.44 [1.00-2.77]% versus 2.53 [1.46-4.23]%; P = .335, THypo(L2) 0.25 [0.09-0.37]% versus 0.45 [0.20-0.78]%; P = .146, HIIT + CGM versus CGM, respectively, rate (EventPerWeekHypo 5.30 [3.35-8.27] #/week vs 7.45 [3.54-10.81] #/week, P = .340) or duration (DurationHypo 33.33 [27.60-39.10] minutes vs 39.56 [31.00-48.38] minutes; P = .219, HIIT + CGM vs CGM, respectively). There was a reduction in nocturnal hypoglycemia in those who carried out HIIT, THypo(L1) 0.50 [0.13-0.97]% versus 2.45 [0.77-4.74]%; P = .076; THypo(L2) 0.00 [0.00-0.03]% versus 0.49 [0.13-0.74]%; P = .006, HIIT + CGM versus CGM, respectively.

Conclusions/interpretation: Based on CGM data collected from a real-world study of four weeks of HIIT versus no exercise in individuals with T1D and IAH, we conclude that HIIT does not increase hypoglycemia, and in fact reduces exposure to nocturnal hypoglycemia.

目的:评估高强度间歇训练(HIIT)对伴有低血糖意识受损(IAH)的1型糖尿病(T1D)患者低血糖发生频率和持续时间的影响:方法:对 HIT4HYPOS 四周连续血糖监测(CGM)数据进行事后分析;这是一项平行分组研究,比较了 HIIT + CGM 与不运动 + CGM 对 18 名患有 T1D 和 IAH 的参与者的影响:结果:与不运动的参与者相比,HIIT没有增加低血糖的总频率,THypo(L1) 1.44 [1.00-2.77]% 对 2.53 [1.46-4.23]%; P = .335, THypo(L2) 0.25 [0.09-0.37]% 对 0.45 [0.20-0.78]%; P = .在这两项研究中,患者的夜间睡眠时间(HIIT + CGM vs CGM,分别为 0.25 [0.09-0.37]% 对 0.45 [0.20-0.78]%; P = .146)、发生率(EventPerWeekHypo 5.30 [3.35-8.27] #/week vs 7.45 [3.54-10.81] #/week,P = .340)或持续时间(DurationHypo 33.33 [27.60-39.10] minutes vs 39.56 [31.00-48.38] minutes; P = .219,HIIT + CGM vs CGM,分别为 0.25 [0.09-0.37]% 对 0.45 [0.20-0.78]%; P = .HIIT + CGM 与 CGM 相比,进行 HIIT 的患者夜间低血糖发生率有所下降,THypo(L1) 0.50 [0.13-0.97]% 与 2.45 [0.77-4.74]% 相比;P = .076;THypo(L2) 0.00 [0.00-0.03]% 与 0.49 [0.13-0.74]% 相比;P = .006:根据对 T1D 和 IAH 患者进行的一项为期四周的 HIIT 与不运动对比的真实世界研究中收集的 CGM 数据,我们得出结论:HIIT 不会增加低血糖,事实上还能减少夜间低血糖的发生。
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引用次数: 0
Prediction of People With Type 2 Diabetes Not Achieving HbA1c Target After Initiation of Fast-Acting Insulin Therapy: Using Machine Learning Framework on Clinical Trial Data. 预测 2 型糖尿病患者在接受速效胰岛素治疗后 HbA1c 达不到目标值的情况:在临床试验数据中使用机器学习框架。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-20 DOI: 10.1177/19322968241280096
Carsten Wridt Stoltenberg, Stine Hangaard, Ole Hejlesen, Thomas Kronborg, Peter Vestergaard, Morten Hasselstrøm Jensen

Background and aims: Glycemic control is crucial for people with type 2 diabetes. However, only about half achieve the advocated HbA1c target of ≤7%. Identifying those who will probably struggle to reach this target may be valuable as they require additional support. Thus, the aim of this study was to develop a model to predict people with type 2 diabetes not achieving HbA1c target after initiating fast-acting insulin.

Methods: Data from a randomized controlled trial (NCT01819129) of participants with type 2 diabetes initiating fast-acting insulin were used. Data included demographics, clinical laboratory values, self-monitored blood glucose (SMBG), health-related quality of life (SF-36), and body measurements. A logistic regression was developed to predict HbA1c target nonachievers. A potential of 196 features was input for a forward feature selection. To assess the performance, a 20-repeated stratified 5-fold cross-validation with area under the receiver operating characteristics curve (AUROC) was used.

Results: Out of the 467 included participants, 98 (21%) did not achieve HbA1c target of ≤7%. The forward selection identified 7 features: baseline HbA1c (%), mean postprandial SMBG at all meals 3 consecutive days before baseline (mmol/L), sex, no ketones in urine, baseline albumin (g/dL), baseline low-density lipoprotein cholesterol (mmol/L), and traces of protein in urine. The model had an AUROC of 0.745 [95% CI = 0.734, 0.756].

Conclusions: The model was able to predict those who did not achieve HbA1c target with promising performance, potentially enabling early identification of people with type 2 diabetes who require additional support to reach glycemic control.

背景和目的:血糖控制对 2 型糖尿病患者至关重要。然而,只有大约一半的患者能达到 HbA1c≤7% 的目标。找出那些可能难以达到这一目标的患者可能很有价值,因为他们需要额外的支持。因此,本研究的目的是建立一个模型来预测那些在使用速效胰岛素后无法达到 HbA1c 目标值的 2 型糖尿病患者:研究使用了一项随机对照试验(NCT01819129)中的数据,该试验的参与者均为开始使用速效胰岛素的 2 型糖尿病患者。数据包括人口统计学、临床实验室值、自我监测血糖(SMBG)、健康相关生活质量(SF-36)和身体测量。为预测未达标者的 HbA1c 目标,我们开发了一种逻辑回归方法。前向特征选择输入了 196 个潜在特征。为了评估性能,采用了 20 次分层 5 倍交叉验证和接收者操作特征曲线下面积(AUROC):结果:在纳入的 467 名参与者中,有 98 人(21%)未达到 HbA1c ≤7% 的目标值。前向选择确定了 7 个特征:基线 HbA1c(%)、基线前连续 3 天所有餐次的餐后 SMBG 平均值(mmol/L)、性别、尿液中无酮体、基线白蛋白(g/dL)、基线低密度脂蛋白胆固醇(mmol/L)和尿液中的微量蛋白。该模型的AUROC为0.745 [95% CI = 0.734, 0.756]:该模型能够预测未达到 HbA1c 目标值的患者,效果良好,有可能及早识别出需要额外支持以达到血糖控制的 2 型糖尿病患者。
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引用次数: 0
Diabetic Peripheral Neuropathy: Emerging Treatments of Neuropathic Pain and Novel Diagnostic Methods. 糖尿病周围神经病变:新出现的神经病理性疼痛治疗方法和新型诊断方法。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-16 DOI: 10.1177/19322968241279553
Johan Røikjer, Mette Krabsmark Borbjerg, Trine Andresen, Rocco Giordano, Claus Vinter Bødker Hviid, Carsten Dahl Mørch, Pall Karlsson, David C Klonoff, Lars Arendt-Nielsen, Niels Ejskjaer

Background: Diabetic peripheral neuropathy (DPN) is a prevalent and debilitating complication of diabetes, often leading to severe neuropathic pain. Although other diabetes-related complications have witnessed a surge of emerging treatments in recent years, DPN has seen minimal progression. This stagnation stems from various factors, including insensitive diagnostic methods and inadequate treatment options for neuropathic pain.

Methods: In this comprehensive review, we highlight promising novel diagnostic techniques for assessing DPN, elucidating their development, strengths, and limitations, and assessing their potential as future reliable clinical biomarkers and endpoints. In addition, we delve into the most promising emerging pharmacological and mechanistic treatments for managing neuropathic pain, an area currently characterized by inadequate pain relief and a notable burden of side effects.

Results: Skin biopsies, corneal confocal microscopy, transcutaneous electrical stimulation, blood-derived biomarkers, and multi-omics emerge as some of the most promising new techniques, while low-dose naltrexone, selective sodium-channel blockers, calcitonin gene-related peptide antibodies, and angiotensin type 2 receptor antagonists emerge as some of the most promising new drug candidates.

Conclusion: Our review concludes that although several promising diagnostic modalities and emerging treatments exist, an ongoing need persists for the further development of sensitive diagnostic tools and mechanism-based, personalized treatment approaches.

背景:糖尿病周围神经病变(DPN)是一种普遍存在且使人衰弱的糖尿病并发症,通常会导致严重的神经性疼痛。尽管近年来其他糖尿病相关并发症的治疗方法层出不穷,但 DPN 的治疗进展却微乎其微。这种停滞不前源于多种因素,包括诊断方法不敏感和神经病理性疼痛的治疗方案不足:在这篇综合综述中,我们重点介绍了用于评估 DPN 的前景看好的新型诊断技术,阐明了这些技术的发展、优势和局限性,并评估了它们作为未来可靠的临床生物标记物和终点的潜力。此外,我们还深入研究了治疗神经病理性疼痛最有前景的新兴药理学和机理疗法,该领域目前的特点是疼痛缓解不充分和副作用显著:结果:皮肤活检、角膜共聚焦显微镜、经皮电刺激、血源性生物标记物和多组学成为最有前景的新技术,而小剂量纳曲酮、选择性钠通道阻滞剂、降钙素基因相关肽抗体和血管紧张素 2 型受体拮抗剂成为最有前景的候选新药:我们的综述得出的结论是,尽管存在几种有前景的诊断方式和新兴治疗方法,但仍需要进一步开发敏感的诊断工具和基于机制的个性化治疗方法。
{"title":"Diabetic Peripheral Neuropathy: Emerging Treatments of Neuropathic Pain and Novel Diagnostic Methods.","authors":"Johan Røikjer, Mette Krabsmark Borbjerg, Trine Andresen, Rocco Giordano, Claus Vinter Bødker Hviid, Carsten Dahl Mørch, Pall Karlsson, David C Klonoff, Lars Arendt-Nielsen, Niels Ejskjaer","doi":"10.1177/19322968241279553","DOIUrl":"10.1177/19322968241279553","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a prevalent and debilitating complication of diabetes, often leading to severe neuropathic pain. Although other diabetes-related complications have witnessed a surge of emerging treatments in recent years, DPN has seen minimal progression. This stagnation stems from various factors, including insensitive diagnostic methods and inadequate treatment options for neuropathic pain.</p><p><strong>Methods: </strong>In this comprehensive review, we highlight promising novel diagnostic techniques for assessing DPN, elucidating their development, strengths, and limitations, and assessing their potential as future reliable clinical biomarkers and endpoints. In addition, we delve into the most promising emerging pharmacological and mechanistic treatments for managing neuropathic pain, an area currently characterized by inadequate pain relief and a notable burden of side effects.</p><p><strong>Results: </strong>Skin biopsies, corneal confocal microscopy, transcutaneous electrical stimulation, blood-derived biomarkers, and multi-omics emerge as some of the most promising new techniques, while low-dose naltrexone, selective sodium-channel blockers, calcitonin gene-related peptide antibodies, and angiotensin type 2 receptor antagonists emerge as some of the most promising new drug candidates.</p><p><strong>Conclusion: </strong>Our review concludes that although several promising diagnostic modalities and emerging treatments exist, an ongoing need persists for the further development of sensitive diagnostic tools and mechanism-based, personalized treatment approaches.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968241279553"},"PeriodicalIF":4.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288366","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}
引用次数: 0
Batteries Within Diabetes Devices: A Narrative Review on Recycling, Environmental, and Sustainability Perspective. 糖尿病设备中的电池:从回收、环境和可持续性角度的叙述性评论。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-10 DOI: 10.1177/19322968241278374
Parizad Avari, Yi Cai, Vivek Verma, Monika Reddy, Madhavi Srinivasan, Nick Oliver

The adoption of diabetes technology for the management of type 1 and insulin-treated type 2 diabetes has greatly increased. The annual volume of discarded continuous glucose monitoring (CGM) devices, considering only Dexcom and Freestyle Libre brands, totals more than 153 million units and Omnipod® contributes an additional estimated 43.8 million units.Although these technologies are clinically effective, their environmental impact is unknown. Batteries are a pivotal, yet often overlooked, component in diabetes technologies and can exert a detrimental impact on the environment.In this commentary article, we explore the environmental impact of batteries used in diabetes devices. Furthermore, we highlight various strategies, including recycling of used batteries and alternative design approaches, that may reduce the environmental burden, as they become the ubiquitous standard of care for people with diabetes.

采用糖尿病技术管理 1 型糖尿病和胰岛素治疗的 2 型糖尿病的人数大幅增加。仅就 Dexcom 和 Freestyle Libre 品牌而言,每年废弃的连续血糖监测(CGM)设备总量就超过 1.53 亿台,而 Omnipod® 估计还贡献了 4380 万台。在这篇评论文章中,我们将探讨糖尿病设备中使用的电池对环境的影响。在这篇评论文章中,我们探讨了糖尿病设备中使用的电池对环境的影响。此外,我们还强调了各种策略,包括废旧电池的回收利用和替代设计方法,这些策略可能会减轻环境负担,因为电池已成为糖尿病患者无处不在的护理标准。
{"title":"Batteries Within Diabetes Devices: A Narrative Review on Recycling, Environmental, and Sustainability Perspective.","authors":"Parizad Avari, Yi Cai, Vivek Verma, Monika Reddy, Madhavi Srinivasan, Nick Oliver","doi":"10.1177/19322968241278374","DOIUrl":"10.1177/19322968241278374","url":null,"abstract":"<p><p>The adoption of diabetes technology for the management of type 1 and insulin-treated type 2 diabetes has greatly increased. The annual volume of discarded continuous glucose monitoring (CGM) devices, considering only Dexcom and Freestyle Libre brands, totals more than 153 million units and Omnipod<sup>®</sup> contributes an additional estimated 43.8 million units.Although these technologies are clinically effective, their environmental impact is unknown. Batteries are a pivotal, yet often overlooked, component in diabetes technologies and can exert a detrimental impact on the environment.In this commentary article, we explore the environmental impact of batteries used in diabetes devices. Furthermore, we highlight various strategies, including recycling of used batteries and alternative design approaches, that may reduce the environmental burden, as they become the ubiquitous standard of care for people with diabetes.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968241278374"},"PeriodicalIF":4.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288365","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}
引用次数: 0
Electronic Health Record Alert With Heart Failure Risk and Sodium Glucose Cotransporter 2 Inhibitor Prescriptions in Diabetes: A Randomized Clinical Trial. 糖尿病患者心衰风险和葡萄糖钠转运体 2 抑制剂处方的电子健康记录提示:随机临床试验。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-10 DOI: 10.1177/19322968241264747
Matthew W Segar, Kershaw V Patel, Neil Keshvani, Vaishnavi Kannan, Duwayne Willett, David C Klonoff, Ambarish Pandey

Background: Sodium glucose cotransporter 2 inhibitors (SGLT2i) prevent heart failure (HF) in patients with type 2 diabetes mellitus (T2DM) but prescription rates are low. The effect of an electronic health record (EHR) alert notifying providers of patients' estimated risk of developing HF on SGTL2i prescriptions is unknown.

Methods: This was a pragmatic, randomized clinical trial that compared an EHR alert and usual care among patients with T2DM and no history of HF or SGLT2i use at a single center. The EHR alert notified providers of their patient's HF risk and recommended HF prevention strategies. Randomization was performed at the provider level across general and subspecialty internal medicine as well as family medicine outpatient clinics. The primary outcome was proportion of SGLT2i prescriptions within 30 days. Proportion of natriuretic peptide (NP) tests within 90 days was also assessed.

Results: A total of 1524 patients (median age 75 years, 45% women, 23% Black) were enrolled between September 28, 2021, and April 29, 2022 from 189 outpatient clinics. SGLT2i were prescribed to 1.2% (9/780) of patients in the EHR alert group and 0% (0/744) of those in the usual care group (P value = 0.009). Natriuretic peptide testing was performed within 90 days among 10.8% (84/780) of patients in the EHR alert group and 7.3% (54/744) of patients in the usual care group (P value = 0.02).

Conclusions: In a single-center trial with low overall SGLT2i use, an EHR alert incorporating HF risk information significantly increased SGLT2i prescriptions and NP testing although the absolute rates were low.

背景:钠葡萄糖共转运体 2 抑制剂(SGLT2i)可预防 2 型糖尿病患者的心力衰竭(HF),但处方率很低。电子健康记录 (EHR) 提醒医疗服务提供者患者罹患高血压的估计风险对 SGTL2i 处方的影响尚不清楚:这是一项务实的随机临床试验,在单个中心的 T2DM 患者中比较了电子病历警报和常规护理,前者无高血压病史,也未使用过 SGLT2i。电子病历警报通知医疗服务提供者患者的高血压风险,并推荐高血压预防策略。随机化在普通内科、亚专科内科以及家庭医学门诊的医疗服务提供者层面进行。主要结果是 30 天内开具 SGLT2i 处方的比例。此外,还评估了 90 天内进行钠尿肽 (NP) 检测的比例:2021 年 9 月 28 日至 2022 年 4 月 29 日期间,189 家门诊诊所共招募了 1524 名患者(中位年龄 75 岁,45% 为女性,23% 为黑人)。在 EHR 提醒组中,1.2%(9/780)的患者使用了 SGLT2i,而在常规护理组中,0%(0/744)的患者使用了 SGLT2i(P 值 = 0.009)。在 90 天内进行钠尿肽检测的患者中,电子病历预警组为 10.8%(84/780),常规护理组为 7.3%(54/744)(P 值 = 0.02):结论:在一项SGLT2i总体使用率较低的单中心试验中,包含高血压风险信息的电子病历提示显著增加了SGLT2i处方和NP检测,尽管绝对值较低。
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引用次数: 0
FDA Interoperability Designation-Creating Options for People With Diabetes and Pump Companies: Regulatory, Technological, and Commercial Perspectives. FDA 互操作性指定--为糖尿病患者和泵公司创造选择:监管、技术和商业视角。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-10 DOI: 10.1177/19322968241271304
David C Klonoff, Cindy N Ho, Alessandra Ayers, Aiman Abdel-Malek
{"title":"FDA Interoperability Designation-Creating Options for People With Diabetes and Pump Companies: Regulatory, Technological, and Commercial Perspectives.","authors":"David C Klonoff, Cindy N Ho, Alessandra Ayers, Aiman Abdel-Malek","doi":"10.1177/19322968241271304","DOIUrl":"10.1177/19322968241271304","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968241271304"},"PeriodicalIF":4.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288369","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}
引用次数: 0
All Children Deserve to Be Safe, Mothers Too: Evidence and Rationale Supporting Continuous Glucose Monitoring Use in Gestational Diabetes Within the Medicaid Population. 所有儿童和母亲都应享有安全:支持在医疗补助人群中使用 CGM 治疗妊娠糖尿病的证据和理由。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-01 Epub Date: 2023-03-15 DOI: 10.1177/19322968231161317
Carol J Levy, Rodolfo J Galindo, Christopher G Parkin, Jacob Gillis, Nicholas B Argento

Gestational diabetes mellitus (GDM) is a common metabolic disease of pregnancy that threatens the health of several million women and their offspring. The highest prevalence of GDM is seen in women of low socioeconomic status. Women with GDM are at increased risk of adverse maternal outcomes, including increased rates of Cesarean section delivery, preeclampsia, perineal tears, and postpartum hemorrhage. However, of even greater concern is the increased risk to the fetus and long-term health of the child due to elevated glycemia during pregnancy. Although the use of continuous glucose monitoring (CGM) has been shown to reduce the incidence of maternal and fetal complications in pregnant women with type 1 diabetes and type 2 diabetes, most state Medicaid programs do not cover CGM for women with GDM. This article reviews current statistics relevant to the incidence and costs of GDM among Medicaid beneficiaries, summarizes key findings from pregnancy studies using CGM, and presents a rationale for expanding and standardizing CGM coverage for GDM within state Medicaid populations.

妊娠糖尿病(GDM)是一种常见的妊娠代谢疾病,威胁着数百万妇女及其后代的健康。社会经济地位低下的妇女罹患 GDM 的比例最高。患有 GDM 的妇女发生不良孕产后果的风险增加,包括剖宫产率增加、子痫前期、会阴撕裂和产后出血。然而,更令人担忧的是,妊娠期血糖升高会增加胎儿和婴儿长期健康的风险。尽管使用连续血糖监测(CGM)已被证明可降低 1 型糖尿病和 2 型糖尿病孕妇的母体和胎儿并发症的发生率,但大多数州的医疗补助计划并不涵盖 GDM 妇女的 CGM。本文回顾了目前与医疗补助受益人中 GDM 发病率和费用相关的统计数据,总结了使用 CGM 进行妊娠研究的主要发现,并提出了扩大和规范各州医疗补助人群中 GDM 的 CGM 覆盖范围的理由。
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引用次数: 0
Regarding Singh et al, "Effects, Safety, and Treatment Experience of Advanced Hybrid Closed-Loop Systems in Clinical Practice Among Adults Living With Type 1 Diabetes". 关于 Singh 等人,"先进的混合闭环系统在 1 型糖尿病成人临床实践中的效果、安全性和治疗经验"。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI: 10.1177/19322968241257003
Laurel H Messer, John B Welsh, Steph Habif, Jordan E Pinsker, Tomas C Walker
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引用次数: 0
Concept and Implementation of a Novel Continuous Glucose Monitoring Solution With Glucose Predictions on Board. 带有葡萄糖预测功能的新型连续葡萄糖监测解决方案的概念与实施。
IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-01 Epub Date: 2024-08-19 DOI: 10.1177/19322968241269927
Timor Glatzer, Christian Ringemann, Daniel Militz, Wiebke Mueller-Hoffmann

The recently CE-marked continuous real-time glucose monitoring (rtCGM) solution Accu-Chek® (AC) SmartGuide Solution was developed to enable people with diabetes mellitus (DM) to proactively control their glucose levels using predictive technologies. The comprehensive solution consists of three components that harmonize well with each other. The CGM device is composed of a sensor applicator and a glucose sensor patch whose data are transferred to the connected smartphone by Bluetooth® Low Energy. The user interface of the CGM solution is powered by the AC SmartGuide app delivering current and past glucose metrics, and the AC SmartGuide Predict app providing a glucose prediction suite enabled by artificial intelligence (AI). This article describes the innovative CGM solution.

最近获得 CE 认证的连续实时血糖监测(rtCGM)解决方案 Accu-Chek® (AC) SmartGuide Solution 是为糖尿病(DM)患者利用预测技术主动控制血糖水平而开发的。该综合解决方案由三个相互协调的组件组成。CGM 设备由传感器涂抹器和葡萄糖传感器贴片组成,其数据通过蓝牙® 低能耗传输到连接的智能手机。CGM 解决方案的用户界面由 AC SmartGuide 应用程序和 AC SmartGuide Predict 应用程序提供支持,前者提供当前和过去的血糖指标,后者提供人工智能(AI)支持的血糖预测套件。本文介绍了创新型 CGM 解决方案。
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引用次数: 0
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Journal of Diabetes Science and Technology
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