Assessment of use of specific features of subcutaneous insulin infusion systems and their relationship to metabolic control in patients with type 1 diabetes

Quirós, Carmen; Patrascioiu, Ioana; Giménez, Marga; Vinagre, Irene; Vidal, Mercè; Jansà, M.; Conget, Ignacio

doi:10.1016/j.endoen.2014.06.003

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Remote monitoring includes the ability to see glucose meter data, CGM data as trends or daily patterns, and insulin pump downloads. Regarding CGM remote monitoring, some companies have software specifically for their products, such as CareLink and CareLink Pro for Medtronic products [54][55][56][57][58][59] and Studio, Share, and Clarity for Dexcom products. 60,61 Other programs can download multiple devices and view data in one system, such as Glooko, [61][62][63] Tidepool Blip, 61,64 and Diasend.…”

Section: Remote Monitoring In Pregnancymentioning

confidence: 99%

“…61,65 Software and online programs have been used in remote or retrospective monitoring of glucose data in nonpregnant populations. [55][56][57][58][59][66][67][68] One CGM system was evaluated with concurrent remote monitoring at children's diabetes camps. On control nights of CGM use, subjects (n = 57) could hear hypoglycemia alarms, but on intervention nights, only medical personnel received alarms through remote monitoring.…”

Section: Remote Monitoring In Pregnancymentioning

confidence: 99%

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CGM, Pregnancy, and Remote Monitoring

Polsky

Garcetti

2017

Diabetes Technology & Therapeutics

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The glycemic goals of pregnancy are very narrow to reduce excess risks for numerous maternal and fetal complications. Continuous glucose monitors (CGMs) may help women achieve glucose goals and reduce hypoglycemia. CGM use has been found to be safe and effective in pregnancies associated with diabetes. CGM use can accurately identify glycemic patterns among women with and without diabetes in pregnancy. The data on the effects of CGM use on maternal and fetal outcomes are conflicting. Using CGMs in conjunction with continuous subcutaneous insulin infusion therapy in pregnancies complicated by diabetes may improve outcomes. There are limitations of CGM use that affect patients in and outside of pregnancy, as well as specific barriers that only affect pregnant women. Of importance, CGM use does not replace standard clinical care, but may be used an adjunctive tool in pregnancy. CGM remote monitoring in pregnancy is an understudied field. In this study, we review the studies on CGM use in pregnancy.

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Section: Remote Monitoring In Pregnancymentioning

confidence: 99%

Section: Remote Monitoring In Pregnancymentioning

confidence: 99%

CGM, Pregnancy, and Remote Monitoring

Polsky

Garcetti

2017

Diabetes Technology & Therapeutics

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“…En la mejoría del control metabólico asociado al uso de ICSI, el número de bolos diarios y el uso del asistente de bolos son factores importantes en el éxito de esta terapia [4][5][6] . Tras la configuración inicial del ICSI, debe existir continuamente ajustes en los diferentes parámetros que permiten la entrega de insulina basal y prandial, según los patrones glicémicos individualizados en el tiempo.…”

Section: Icsiunclassified

De la bomba de insulina y el monitoreo continuo de glucosa al páncreas artificial

2017

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, época en que se utilizó por primera vez un infusor continuo subcutáneo de insulina (ICSI), también conocido como bomba de insulina. En la siguiente década surgió el monitoreo continuo de glucosa (MCG), que permite medir glicemia intersticial en forma continua. Inicialmente el MCG era usado sólo como examen solicitado por el médico y analizado en forma retrospectiva; posteriormente fueron desarrollados equipos que informan niveles de glicemia en tiempo real (MCG-TR).Hace una década que ICSI y MCG fueron unidos en un sólo dispositivo que tiene la capacidad de infundir insulina y también medir glicemia intersticial, dando paso a lo que se conoce como Sensor-Augmented Pump Therapy (SAPT). Estos equipos inicialmente no tenían un programa que permitiera suspender el aporte de insulina ante hipoglicemia, pero actualmente existen modelos de SAPT que interrumpen automáticamente la infusión de insulina frente a la predicción de hipoglicemia, tecnología conocida como integrada.Durante la última década las investigaciones en nuevas tecnologías se han centrado en el desarrollo del páncreas artificial, en que existe un programa computacional que permite aumentar o disminuir el aporte de insulina según los valores de glicemia obtenidos en el MCG.Este artículo tiene como objetivo describir el estado actual de las tecnologías disponibles y en desarrollo para los pacientes con diabetes, así como aquéllas en vías de comercialización, como es el caso del primer sistema híbrido aprobado para uso clínico.

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“…Although current BCs do not account for additional variables such as accuracy of CHO counting, exercise, and meal composition, multiple studies have shown a positive effect of pump use in lowering both hemoglobin A1c and frequency of hypoglycemia when BCs are used consistently. [3][4][5][6][7] The parameters entered by users and incorporated into BC formulas include an insulin-to-carbohydrate ratio (ICR), target BG, insulin sensitivity factor (ISF), and active insulin time (AIT). Using these same parameters, BCs from various manufacturers have different formulas for calculating dose recommendations.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Insulin Pump Bolus Calculators Reveals Wide Variation in Dose Recommendations

Buchanan

Zabinsky

Ferrara-Cook

et al. 2020

J Diabetes Sci Technol

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Background: The introduction of insulin pumps with bolus calculators (BCs) has improved glycemic outcomes and quality of life for those with type 1 diabetes. Despite the increased reliance on BCs, the formulas used to derive recommended boluses are not standardized. Our objective was to examine whether recommendations from different pump BCs vary significantly for identical clinical scenarios. Methods: Three commercially available insulin pump BCs were programmed with identical settings and then presented with combinations of blood glucose (BG) and carbohydrates (CHOs) to generate a 4-unit bolus. At one- and two-hour time points, while there was insulin-on-board (IOB) present, we simulated various BG and CHO scenarios in order to compare BC-recommended doses. Results: Differences in suggested doses were noted between BCs, as well as within the same brand. The greatest variation was apparent when BG was below target. Doses suggested by one BC varied depending on whether the IOB resulted from a previous dose given for BG or CHO, while the other two BCs adjusted for total IOB regardless of the source. Conclusions: In this simulation study, there were large differences in recommended doses between BCs due to the unique way each manufacturer incorporates IOB into their formulas as well as the pharmacokinetics used to derive the IOB amount. Providers should be aware that identical pump settings will result in a different dose recommendation for each pump brand and advise patients accordingly.

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Assessment of use of specific features of subcutaneous insulin infusion systems and their relationship to metabolic control in patients with type 1 diabetes

Cited by 5 publications

References 10 publications

CGM, Pregnancy, and Remote Monitoring

CGM, Pregnancy, and Remote Monitoring

De la bomba de insulina y el monitoreo continuo de glucosa al páncreas artificial

Comparison of Insulin Pump Bolus Calculators Reveals Wide Variation in Dose Recommendations

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