Improved Glycemic Control in Intensively Treated Type 1 Diabetic Patients Using Blood Glucose Meters With Storage Capability and Computer-Assisted Analyses

Strowig, Suzanne M.; Raskin, Philip

doi:10.2337/diacare.21.10.1694

Cited by 69 publications

(37 citation statements)

References 18 publications

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“…Research has shown that increased SMBG is associated with improved glycemic control. 23 This is possible as adjustments in pharmacotherapy can be done based on blood glucose levels so as to achieve adequate glycemic control. Hence, it is important that patients be made aware about the importance of SMBG and encouraged to follow it as recommended.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Adherence to Therapy In Patients of Type 2 Diabetes Mellitus

Sontakke¹,

Jadhav²,

Pimpalkhute³

et al. 2015

J YOUNG PHARM

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Objective: To evaluate adherence to therapy and study factors associated with non-adherence in patients of type 2 diabetes mellitus (DM). Methods: A prospective, cross-sectional, questionnaire based study was conducted in a tertiary care teaching hospital. 150 patients suffering from type 2 DM since six months or more were interviewed using self-designed, semistructured questionnaire to get information about adherence to medication, diet/exercise schedule and self-monitoring of blood glucose. Morisky medication adherence questionnaire was used to calculate overall adherence. Results: Average number of medicines taken by each patient daily was 4.75 ± 1.73 (mean + SD). 70% patients reported non-adherence to medication schedule. Not buying all medicines (58.66%), not taking prescribed dose of medicines (34%), taking additional non-prescribed medicines (30%) and not taking medicines for required duration (25.33%) were common types of nonadherence. Unawareness about need of each medicine (55.66%), forgetfulness (50.66%) and high cost (43.33%) were the common causes of non-adherence. In Morisky medication adherence questionnaire high, medium and low adherence was reported by 0%, 26% and 74% of patients, respectively. Moderately positive correlation was observed between poor adherence and number of concurrent illnesses, number of medicines taken and female gender. Regular monitoring of blood glucose and diet schedule was followed by 46% and 68% patients respectively. Conclusion: Since, not buying all medicines, which was mostly due to high cost was the commonest type of non-adherence, measures to provide free medicines to non-affording patients need to be implemented. Majority of patients were not aware about need of taking each medicine, hence, creating awareness about the same is essential for improving adherence to therapy.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Adherence to Therapy In Patients of Type 2 Diabetes Mellitus

Sontakke¹,

Jadhav²,

Pimpalkhute³

et al. 2015

J YOUNG PHARM

View full text Add to dashboard Cite

show abstract

“…24 Automatic recording systems can be helpful, such as glucometers with built-in memory chips and cameras with digital images that can retrieve years of past data. 25 Communication strategies that include electronic messaging can also provide an unambiguous method to return long afterwards to check what was and was not mentioned. 26,27 Another corrective strategy is to write down during the initial patient contact the specific expectations that are intended at the time of subsequent follow-up.…”

Section: Unwanted Forgetfulnessmentioning

confidence: 99%

Judging Whether a Patient is Actually Improving: More Pitfalls from the Science of Human Perception

Redelmeier

Dickinson

2012

J GEN INTERN MED

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“…There are many reasons that vary from individual to individual, but it is clear that the tools today do not easily allow for the normalization of glycemia for patients lacking b-cell function. Self-monitoring of blood glucose levels (27), continuous subcutaneous insulin infusion (28), CGM (18), and now low-glucose suspend (LGS) pumps (29) have all been demonstrated to significantly improve glycemic control either by reducing A1C or hypoglycemia levels. However, wide glucose excursions above and below the target range persist in almost all patients and attempts to achieve tighter and tighter glycemic control take more and more effort with diminishing returns.…”

Section: Patient-reported Outcomesmentioning

confidence: 99%

Pathway to Artificial Pancreas Systems Revisited: Moving Downstream

Kowalski

2015

Diabetes Care

105

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Artificial pancreas (AP) systems, a long-sought quest to replicate mechanically islet physiology that is lost in diabetes, are reaching the clinic, and the potential of automating insulin delivery is about to be realized. Significant progress has been made, and the safety and feasibility of AP systems have been demonstrated in the clinical research center and more recently in outpatient "real-world" environments. An iterative road map to AP system development has guided AP research since 2009, but progress in the field indicates that it needs updating. While it is now clear that AP systems are technically feasible, it remains much less certain that they will be widely adopted by clinicians and patients. Ultimately, the true success of AP systems will be defined by successful integration into the diabetes health care system and by the ultimate metric: improved diabetes outcomes.An electromechanical approach to improve glycemic control and quality of life for people with diabetesdan artificial pancreas (AP) (or an automated insulin-delivery system or bionic pancreas)dhas been a long-sought technological goal of diabetes researchers (1). However, a number of significant challenges needed to be overcome to deliver an AP system to people with diabetes. The past 10 years have seen many of these challenges addressed, and recent studies have demonstrated compelling safety and efficacy of the prototype systems (2). Technical feasibility is only a step toward declaring victory. Research and development efforts will continue to improve upon first-generation AP systems. But, it is clear that resources will need to be deployed to address clinical adoption challengesdincluding device usability and reimbursement.Research and development efforts over the past 10 years have addressed a number of the critical issues facing AP development, and recent studies again signal a move to a new phase and a call for a new road map to AP systems. A number of groups have demonstrated proof of concept with a variety of algorithmic approaches and closed-loop strategies and the data are compelling. In a Bench to Clinic narrative, Cefalu and Tamborlane (3) dive much deeper than this Perspective intends into the "how" of AP systems. They note quite astutely that "it is not the journey, but the destination that matters" (3).It may come as a surprise to many clinicians, but a small and growing group of lay, "do-it-yourself," technically savvy people with diabetes or loved ones of people with diabetes has been using semiautomated closed-loop systems at home for well over 2 years with impressive results (4-6). These systems, similar to systems being studied in academic studies, combine off-the-shelf insulin pumps and continuous glucose monitors with control algorithms (computer software that interprets glucose information and drives the dosing of insulin) powered by cell phone devices. The results from academia and these anecdotal reports are harbingers of a JDRF, New York, NY

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Improved Glycemic Control in Intensively Treated Type 1 Diabetic Patients Using Blood Glucose Meters With Storage Capability and Computer-Assisted Analyses

Cited by 69 publications

References 18 publications

Evaluation of Adherence to Therapy In Patients of Type 2 Diabetes Mellitus

Evaluation of Adherence to Therapy In Patients of Type 2 Diabetes Mellitus

Judging Whether a Patient is Actually Improving: More Pitfalls from the Science of Human Perception

Pathway to Artificial Pancreas Systems Revisited: Moving Downstream

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