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Research papers on Diabetes management technology

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  1. Diagnosis and Classification of Diabetes Mellitus

    American Diabetes Association · 2010 · Diabetes Care · 14,030 citations

    OF DIABETES MELLITUS -Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of differentorgans, especially the eyes, kidneys, nerves, heart, and blood vessels.

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  2. Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes

    The ADVANCE Collaborative Group · 2008 · New England Journal of Medicine · 7,461 citations

    BACKGROUND: In patients with type 2 diabetes, the effects of intensive glucose control on vascular outcomes remain uncertain. METHODS: We randomly assigned 11,140 patients with type 2 diabetes to undergo either standard glucose control or intensive glucose control, defined as the use of gliclazide (modified release) plus other drugs as required to achieve a glycated hemoglobin value of 6.5% or less. Primary end points were composites of major macrovascular events (death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke) and major microvascular events (new or worsening nephropathy or retinopathy), assessed both jointly and separately. RESULTS: After a median of 5

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  3. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range

    Tadej Battelino, Thomas Danne, Richard M. Bergenstal, et al. · 2019 · Diabetes Care · 3,978 citations

    Improvements in sensor accuracy, greater convenience and ease of use, and expanding reimbursement have led to growing adoption of continuous glucose monitoring (CGM). However, successful utilization of CGM technology in routine clinical practice remains relatively low. This may be due in part to the lack of clear and agreed-upon glycemic targets that both diabetes teams and people with diabetes can work toward. Although unified recommendations for use of key CGM metrics have been established in three separate peer-reviewed articles, formal adoption by diabetes professional organizations and guidance in the practical application of these metrics in clinical practice have been lacking. In Febr

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  4. Continuous Glucose Monitoring and Intensive Treatment of Type 1 Diabetes

    The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group · 2008 · New England Journal of Medicine · 2,677 citations

    BACKGROUND: The value of continuous glucose monitoring in the management of type 1 diabetes mellitus has not been determined. METHODS: In a multicenter clinical trial, we randomly assigned 322 adults and children who were already receiving intensive therapy for type 1 diabetes to a group with continuous glucose monitoring or to a control group performing home monitoring with a blood glucose meter. All the patients were stratified into three groups according to age and had a glycated hemoglobin level of 7.0 to 10.0%. The primary outcome was the change in the glycated hemoglobin level at 26 weeks. RESULTS: The changes in glycated hemoglobin levels in the two study groups varied markedly accord

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  5. International Consensus on Use of Continuous Glucose Monitoring

    Thomas Danne, Revital Nimri, Tadej Battelino, et al. · 2017 · Diabetes Care · 2,069 citations

    Measurement of glycated hemoglobin (HbA1c) has been the traditional method for assessing glycemic control. However, it does not reflect intra- and interday glycemic excursions that may lead to acute events (such as hypoglycemia) or postprandial hyperglycemia, which have been linked to both microvascular and macrovascular complications. Continuous glucose monitoring (CGM), either from real-time use (rtCGM) or intermittently viewed (iCGM), addresses many of the limitations inherent in HbA1c testing and self-monitoring of blood glucose. Although both provide the means to move beyond the HbA1c measurement as the sole marker of glycemic control, standardized metrics for analyzing CGM data are lac

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  6. Continuous Glucose Monitoring Sensors for Diabetes Management: A Review of Technologies and Applications

    Giacomo Cappon, Martina Vettoretti, Giovanni Sparacino, et al. · 2019 · Diabetes & Metabolism Journal · 485 citations

    By providing blood glucose (BG) concentration measurements in an almost continuous-time fashion for several consecutive days, wearable minimally-invasive continuous glucose monitoring (CGM) sensors are revolutionizing diabetes management, and are becoming an increasingly adopted technology especially for diabetic individuals requiring insulin administrations. Indeed, by providing glucose real-time insights of BG dynamics and trend, and being equipped with visual and acoustic alarms for hypo- and hyperglycemia, CGM devices have been proved to improve safety and effectiveness of diabetes therapy, reduce hypoglycemia incidence and duration, and decrease glycemic variability. Furthermore, the re

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  7. Impact of Fat, Protein, and Glycemic Index on Postprandial Glucose Control in Type 1 Diabetes: Implications for Intensive Diabetes Management in the Continuous Glucose Monitoring Era

    Kirstine J. Bell, Carmel E. Smart, Garry M. Steil, et al. · 2015 · Diabetes Care · 385 citations

    BACKGROUND: Continuous glucose monitoring highlights the complexity of postprandial glucose patterns present in type 1 diabetes and points to the limitations of current approaches to mealtime insulin dosing based primarily on carbohydrate counting. METHODS: A systematic review of all relevant biomedical databases, including MEDLINE, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials, was conducted to identify research on the effects of dietary fat, protein, and glycemic index (GI) on acute postprandial glucose control in type 1 diabetes and prandial insulin dosing strategies for these dietary factors. RESULTS: All studies examining the effect of fat (n = 7), protein (n =

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  8. The Effect of Continuous Glucose Monitoring in Well-Controlled Type 1 Diabetes

    · 2009 · Diabetes Care · 352 citations

    OBJECTIVE The potential benefits of continuous glucose monitoring (CGM) in the management of adults and children with well-controlled type 1 diabetes have not been examined. RESEARCH DESIGN AND METHODS A total of 129 adults and children with intensively treated type 1 diabetes (age range 8–69 years) and A1C <7.0% were randomly assigned to either continuous or standard glucose monitoring for 26 weeks. The main study outcomes were time with glucose level ≤70 mg/dl, A1C level, and severe hypoglycemic events. RESULTS A

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  9. Effectiveness of Continuous Glucose Monitoring in a Clinical Care Environment

    · 2010 · Diabetes Care · 295 citations

    OBJECTIVE To determine whether continuous glucose monitoring (CGM) is effective in the management of type 1 diabetes when implemented in a manner that more closely approximates clinical practice. RESEARCH DESIGN AND METHODS After completion of a 6-month randomized controlled trial (RCT) evaluating CGM in children, adolescents, and adults with type 1 diabetes, CGM was initiated in the trial's control group with less intensive training and follow-up than was included in the RCT. Subjects had an outpatient training session, two follow-up phone calls, and outpatient visits at 1, 4, 13, and 26

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  10. Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring

    Michael Yapanis, Steven James, Maria E. Craig, et al. · 2022 · The Journal of Clinical Endocrinology & Metabolism · 293 citations

    CONTEXT: Although glycated hemoglobin A1c is currently the best parameter used clinically to assess risk for the development of diabetes complications, it does not provide insight into short-term fluctuations in glucose levels. This review summarizes the relationship between continuous glucose monitoring (CGM)-derived metrics of glycemic variability and diabetes-related complications. EVIDENCE ACQUISITION: PubMed and Embase databases were searched from January 1, 2010 to August 22, 2020, using the terms type 1 diabetes, type 2 diabetes, diabetes-related microvascular and macrovascular complications, and measures of glycaemic variability. Exclusion criteria were studies that did not use CGM a

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  11. Factors Predictive of Use and of Benefit From Continuous Glucose Monitoring in Type 1 Diabetes

    · 2009 · Diabetes Care · 220 citations

    OBJECTIVE To evaluate factors associated with successful use of continuous glucose monitoring (CGM) among participants with intensively treated type 1 diabetes in the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Randomized Clinical Trial. RESEARCH DESIGN AND METHODS The 232 participants randomly assigned to the CGM group (165 with baseline A1C ≥7.0% and 67 with A1C <7.0%) were asked to use CGM on a daily basis. The associations of baseline factors and early CGM use with CGM use ≥6 days/week in the 6th month and with change in A1C from baseline to 6 months wer

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  12. Patients’ and caregivers’ experiences of using continuous glucose monitoring to support diabetes self-management: qualitative study

    Julia Lawton, Maxine Blackburn, Jody L. Allen, et al. · 2018 · BMC Endocrine Disorders · 185 citations

    BACKGROUND: Continuous glucose monitoring (CGM) enables users to view real-time interstitial glucose readings and provides information on the direction and rate of change of blood glucose levels. Users can also access historical data to inform treatment decisions. While the clinical and psychological benefits of CGM are well established, little is known about how individuals use CGM to inform diabetes self-management. We explored participants' experiences of using CGM in order to provide recommendations for supporting individuals to make optimal use of this technology. METHODS: In-depth interviews (n = 24) with adults, adolescents and parents who had used CGM for ≥4 weeks; data were analysed

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  13. Advanced Diabetes Management Using Artificial Intelligence and Continuous Glucose Monitoring Sensors

    Martina Vettoretti, Giacomo Cappon, Andrea Facchinetti, et al. · 2020 · Sensors · 176 citations

    Wearable continuous glucose monitoring (CGM) sensors are revolutionizing the treatment of type 1 diabetes (T1D). These sensors provide in real-time, every 1-5 min, the current blood glucose concentration and its rate-of-change, two key pieces of information for improving the determination of exogenous insulin administration and the prediction of forthcoming adverse events, such as hypo-/hyper-glycemia. The current research in diabetes technology is putting considerable effort into developing decision support systems for patient use, which automatically analyze the patient's data collected by CGM sensors and other portable devices, as well as providing personalized recommendations about thera

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  14. Prolonged Nocturnal Hypoglycemia Is Common During 12 Months of Continuous Glucose Monitoring in Children and Adults With Type 1 Diabetes

    · 2010 · Diabetes Care · 154 citations

    OBJECTIVE To characterize the amount of nocturnal hypoglycemia and evaluate factors associated with nocturnal hypoglycemia assessed with continuous glucose monitoring (CGM) in adults and children with type 1 diabetes who participated in the Juvenile Diabetes Research Foundation CGM randomized clinical trial. RESEARCH DESIGN AND METHODS The analysis included 36,467 nights with ≥4 h of CGM glucose readings between 12 midnight and 6:00 a.m. from 176 subjects assigned to the CGM group of the trial. The percentage of nights in which hypoglycemia occurred (two consecutive CGM readings ≤60 mg/dl

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  16. Variation of Interstitial Glucose Measurements Assessed by Continuous Glucose Monitors in Healthy, Nondiabetic Individuals

    · 2010 · Diabetes Care · 118 citations

    OBJECTIVE To characterize glucose levels during daily living using continuous glucose monitors (CGMs) in nondiabetic individuals. RESEARCH DESIGN AND METHODS Seventy-four healthy children, adolescents, and adults aged 9–65 years with normal glucose tolerance used a blinded CGM device for 3 to 7 days. RESULTS Sensor glucose concentrations were 71–120 mg/dl for 91% of the day. Sensor values were ≤60 or >140 mg/dl for only 0.2% and 0.4% of the day, respectively. Sensor glucose concentrations were slightly higher in ch

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  17. Sustained Benefit of Continuous Glucose Monitoring on A1C, Glucose Profiles, and Hypoglycemia in Adults With Type 1 Diabetes

    · 2009 · Diabetes Care · 104 citations

    OBJECTIVE To evaluate long-term effects of continuous glucose monitoring (CGM) in intensively treated adults with type 1 diabetes. RESEARCH DESIGN AND METHODS We studied 83 of 86 individuals ≥25 years of age with type 1 diabetes who used CGM as part of a 6-month randomized clinical trial in a subsequent 6-month extension study. RESULTS After 12 months, median CGM use was 6.8 days per week. Mean change in A1C level from baseline to 12 months was −0.4 ± 0.6% (P < 0.001) in subjects with baseline A1C ≥7.0%. A1C remain

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  18. Flash Continuous Glucose Monitoring: Implications for Use of Continuous Data in Daily Diabetes Management

    Irl B. Hirsch, Elizabeth Nardacci, Carol A. Verderese · 2019 · Diabetes Spectrum · 11 citations

    Full realization of the benefits of continuous glucose monitoring (CGM) depends on addressing barriers such as cost, accuracy, burdens of daily use, and uncertainty about applying the data. Lack of systematic education has also hampered widespread adoption among patients and health care professionals. This article describes the practical application of an affordable and intuitive category of CGM called “flash” that requires users to scan the sensor with a handheld reader for on-demand access to continuous data. The data may be used for in-the-moment therapy adjustment, retrospective review of glucose patterns, and observation of glucose trending in response to behavior. Higher rates of flash

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  21. Short-Term Use of Continuous Glucose Monitoring Devices in the Multidisciplinary Active Diabetes Clinic

    Gagandeep Gill · 2022 · Diabetes & Obesity International Journal

    The MemorialCare Medical Foundation ACTIVE Diabetes program aims to engage poorly controlled diabetic patients in the management of their chronic disease in order to reduce their risk of macrovascular and microvascular complications. This is done through a combination of medication management and lifestyle coaching. Newer technologies such as continuous glucose monitoring (CGM) devices have become commonly used in order to support patient engagement in diabetes management. In our practice, short term use of CGM devices have been shown to increase patients’ awareness of blood sugar trends which leads to improvements in lifestyle changes and medication adherence. Our team first observed this b

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