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AP@home: The Artificial Pancreas Is Now at Home
In the past years the development of an artificial pancreas (AP) has made great progress and many activities are ongoing in this area of research. The major step forward made in the last years was moving the evaluation of AP systems from highly controlled experimental conditions to daily life conditions at the home of patients with diabetes; this was also the aim of the European Union–funded AP@home project. Over a time period of 5 years a series of clinical studies were performed that culminated in 2 "final studies" during which an AP system was used by patients in their home environment for 2 or 3 months without su...
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Heinemann, L., Benesch, C., DeVries, J. H., on Behalf of the AP at home Consortium Tags: Review Articles Source Type: research

Requirements for Successful Adoption of a Glucose Measurement System Into a Hospital POC Program
Widespread and successful implementation of any glucose measurement system in a hospital point-of-care (POC) program requires a number of features in addition to accurate and reliable analytical performance. Such features include, but are not limited to, a system’s glucose-hematocrit dependence, durability, information technology capabilities, and battery capacity and battery life. While the study of Ottiger et al in this issue supports the analytical accuracy and reliability of Bayer’s CONTOUR XT® blood glucose monitoring system, the suitability of other features of this system for a hospital POC program r...
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Füzery, A. K., Cembrowski, G. S. Tags: Technology Reports Source Type: research

Performance of a Blood Glucose Monitoring System in a Point-of-Care Setting
This study assesses and demonstrates that CONTOUR® XT-BGMS (CXT-BGMS) complies with the requirements of the German (RiliBÄK) and Swiss (QUALAB) quality control guidelines for point-of-care testing (POCT) and fulfills the ISO15197:2013 accuracy limits criteria under the routine conditions of a hospital point-of care setting. This single-center study was conducted in Switzerland using 105 venous blood samples from hospitalized patients. Each sample was tested in comparison to the hexokinase reference method. Compliance with POCT guidelines was assessed by daily BGMS measurements using control solutions. Accuracy ...
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Ottiger, C., Gygli, N., Huber, A. R., Fernandez-Tresguerres, B., Pardo, S., Petruschke, T. Tags: Technology Reports Source Type: research

Transition From Intravenous to Subcutaneous Insulin in Critically Ill Adults
Conclusions: This retrospective study suggests critically ill adults may be safely transitioned to 50-59% of their 24-hour IV insulin requirements. A dosing protocol will be implemented to transition to 50-70% subcutaneous insulin. Follow-up data will be reviewed to assess the protocol’s safety and efficacy. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Doolin, M. K., Walroth, T. A., Harris, S. A., Whitten, J. A., Fritschle-Hilliard, A. C. Tags: Original Articles Source Type: research

Attributes Influencing Insulin Pen Preference Among Caregivers and Patients With Diabetes Who Require Greater Than 20 Units of Mealtime Insulin
Conclusions: Based on these key attributes, the IL 200 pen was significantly preferred over the IL 100 pen by patients with diabetes who require >20 daily mealtime insulin units or diabetes caregivers and may improve the injection experience for these patients. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Wang, T., Conrad, K. A., van Brunt, K., Rees, T. M. Tags: Original Articles Source Type: research

Injection Technique and Pen Needle Design Affect Leakage From Skin After Subcutaneous Injections
Conclusions: Leakage will be minimized using a thin needle, using 90° needle insertion in the abdomen, injecting maximum 800 µL at a time, and waiting at least 3 seconds after the injection until the needle is withdrawn from the skin. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Praestmark, K. A., Stallknecht, B., Jensen, M. L., Sparre, T., Madsen, N. B., Kildegaard, J. Tags: Original Articles Source Type: research

The Potential Cost Implications of Averting Severe Hypoglycemic Events Requiring Hospitalization in High-Risk Adults With Type 1 Diabetes Using Real-Time Continuous Glucose Monitoring
Conclusion: This article presents a cost calculation based on available data from multiple sources showing that RT-CGM has the potential to reduce short-term health care costs by averting severe hypoglycemic events requiring hospitalization in a select high-risk population. Prospective, randomized studies that are adequately powered and specifically enroll patients at high risk for severe hypoglycemia are needed to confirm that RT-CGM significantly reduces the incidence of these costly events. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Bronstone, A., Graham, C. Tags: Original Articles Source Type: research

The Cost-Effectiveness of Real-Time Continuous Glucose Monitoring (RT-CGM) in Type 2 Diabetes
Conclusions: RT-CGM, as a self-care tool, is a cost-effective disease management option in the US for people with type 2 diabetes not on prandial insulin. Repeated use of RT-CGM may result in additional cost-effectiveness. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Fonda, S. J., Graham, C., Munakata, J., Powers, J. M., Price, D., Vigersky, R. A. Tags: Original Articles Source Type: research

The Impact of Real-Time Continuous Glucose Monitoring in Patients 65 Years and Older
Conclusions: These data suggest that RT-CGM use in seniors is associated with reductions in episodes of severe hypoglycemia and improved QOL, suggesting that restrictive access to RT-CGM in the Medicare age population may have deleterious health, economic, and QOL consequences. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Polonsky, W. H., Peters, A. L., Hessler, D. Tags: Original Articles Source Type: research

Glucose Variability: Comparison of Different Indices During Continuous Glucose Monitoring in Diabetic Patients
Conclusions: Indices and ratios provide complementary pieces of information associated with high and low glucose values, respectively. The pairs MAG+MAG/m and GFI+GCF appear to be the most reliable markers of glucose variability in diabetic patients. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Le Floch, J.-P., Kessler, L. Tags: Original Articles Source Type: research

Assessing the Accuracy of Continuous Glucose Monitoring (CGM) Calibrated With Capillary Values Using Capillary or Venous Glucose Levels as a Reference
Conclusion: Using capillary glucose concentrations as reference to evaluate the accuracy of CGM calibrated with capillary samples is associated with a lower MARD than using venous glucose as the reference. Capillary glucose concentrations were significantly higher than venous in all glycemic ranges. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Andelin, M., Kropff, J., Matuleviciene, V., Joseph, J. I., Attvall, S., Theodorsson, E., Hirsch, I. B., Imberg, H., Dahlqvist, S., Klonoff, D., Haraldsson, B., DeVries, J. H., Lind, M. Tags: Original Articles Source Type: research

Fundamental Importance of Reference Glucose Analyzer Accuracy for Evaluating the Performance of Blood Glucose Monitoring Systems (BGMSs)
Conclusions: These findings suggest that the ability to demonstrate that a BGMS meets accuracy guidelines is influenced by reference instrument accuracy. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Bailey, T. S., Klaff, L. J., Wallace, J. F., Greene, C., Pardo, S., Harrison, B., Simmons, D. A. Tags: Original Articles Source Type: research

A New Method to Assess Asymmetry in Fingerprints Could Be Used as an Early Indicator of Type 2 Diabetes Mellitus
Conclusions: A diagnostic tool based on FA in the fingerprints of finger pair IV, measured using a wavelet analysis could be developed for predicting risk prior to associated health problems for both T2DM and T1DM. In addition, given that that the prints for fingers IV and V develop during the 14-17 weeks of gestation, we predict that interventions during this time period of pregnancy will be most successful. (Source: Journal of Diabetes Science and Technology)
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Morris, M. R., Ludwar, B. C., Swingle, E., Mamo, M. N., Shubrook, J. H. Tags: Original Articles Source Type: research

Psychosocial Aspects of Continuous Glucose Monitoring: Connecting to the Patients Experience
Continuous glucose monitoring (CGM) systems provide people with diabetes with valuable real-time information on glucose trajectories and trends, thus offering opportunities for improving diabetes self-management. Ample evidence from clinical trials underscores CGM effectiveness for biomedical outcomes including HbA1C and hypoglycemia. However, interindividual variability in CGM uptake seems to be substantial: Neither do all individuals with diabetes adopt CGM readily in their diabetes self-management, nor do all of them benefit from CGM. In this article, we focus on CGM effects on quality of life and the potential role of ...
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Kubiak, T., Mann, C. G., Barnard, K. C., Heinemann, L. Tags: Guest Editors: Katherine Barnard, Jill Weissberg-Benchell, Michael Harris, and Kimberly Driscoll Source Type: research

Diabetes Technology: Uptake, Outcomes, Barriers, and the Intersection With Distress
Patients managing type 1 diabetes have access to new technologies to assist in management. This manuscript has two aims: 1) to briefly review the literature on diabetes technology use and how this relates to psychological factors and 2) to present an example of human factors research using our data to examine psychological factors associated with technology use. Device/technology uptake and use has increased over the years and at present day is a common clinical practice. There are mixed results in terms of health and psychosocial outcomes, with specific subgroups doing better than others with technology. Our data demonstr...
Source: Journal of Diabetes Science and Technology - June 27, 2016 Category: Endocrinology Authors: Naranjo, D., Tanenbaum, M. L., Iturralde, E., Hood, K. K. Tags: Guest Editors: Katherine Barnard, Jill Weissberg-Benchell, Michael Harris, and Kimberly Driscoll Source Type: research