Diabetes Technology &amp Therapeutics (DIABETES TECHNOL THE)

Publisher: Mary Ann Liebert

Journal description

This new peer-reviewed quarterly journal covers new technology and new products for the treatment, monitoring, diagnosis, and prevention of diabetes and its complications. Technologies include noninvasive glucose monitoring, implantable continuous glucose sensors, novel routes of insulin administration, genetic engineering, the artificial pancreas, measures of longterm control, computer applications for case management, telemedicine, the internet, and new medications.

Current impact factor: 2.11

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 2.106
2013 Impact Factor 2.293
2012 Impact Factor 2.205
2011 Impact Factor 1.931
2010 Impact Factor 2.146
2009 Impact Factor 2.62
2008 Impact Factor 2.127

Impact factor over time

Impact factor

Additional details

5-year impact 2.12
Cited half-life 4.30
Immediacy index 0.49
Eigenfactor 0.01
Article influence 0.62
Website Diabetes Technology & Therapeutics website
Other titles Diabetes technology & therapeutics (Online), Diabetes technology & therapeutics, Diabetes technology and therapeutics
ISSN 1557-8593
OCLC 43498340
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Mary Ann Liebert

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • On author's personal website
    • On institutional repository, pre-print server or research network after 12 months embargo
    • Publisher's version/PDF cannot be used
    • Set statement to accompany deposit (see policy)
    • Publisher copyright and source must be acknowledged
    • NIH authors will have their final paper, (post peer review, copy-editing and proof-reading) deposited in PubMed Central on their behalf
    • Must link to publisher version with DOI
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: The purpose of this study was to evaluate the performance of an insulin infusion protocol targeting a blood glucose (BG) level of 140-180 mg/dL and to characterize protocol adherence. Materials and methods: This was a retrospective observational cohort study including patients for whom the protocol was ordered from January 2012 to May 2013. Performance metrics were assessed in all patients and in patients with an initial BG level of ≥200 mg/dL. Protocol adherence was assessed in a random subset of 50 patients without hypoglycemia and in all hypoglycemic patients. Results: In patients with an initial BG level of ≥200 mg/dL, the mean time to goal was 7.1 h. The rate of decline of BG level in the first 6 h was 16.4 mg/dL/h. Mean BG level was 167 mg/dL, with 43.9% of BG values within goal and 80.3% between 80 and 199 mg/dL. The rate of hypoglycemic events was 0.14 per 100 h. The mean protocol violation rate was higher in patients with hypoglycemia compared with those without (39.8 vs. 23.5 per 100 h, P = 0.002), and 60.7% of hypoglycemic events were attributable to protocol violations. The protocol violation rate (42.8 vs. 17.6 per 100 h; P < 0.001) and the odds of hypoglycemia (odds ratio = 5.2; 95% confidence interval, 1.6, 16.5) were higher in the cardiac surgery patients compared with other patients. Conclusions: This protocol provides adequate BG control within the clinically acceptable range of 80-199 mg/dL but not within the narrower range of 140-180 mg/dL, with a low incidence of hypoglycemia. Risk factors for hypoglycemia and barriers to protocol adherence in the cardiac surgery population should be elucidated.
    Diabetes Technology &amp Therapeutics 11/2015; DOI:10.1089/dia.2015.0046

  • Diabetes Technology &amp Therapeutics 11/2015; DOI:10.1089/dia.2015.0328
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    ABSTRACT: Over the past several decades, insulin treatment has changed drastically, not only with the development of further insulin analogs but also with the introduction of novel insulin delivery devices such as pumps and pens. In addition, adjunct devices such as continuous glucose monitors and sensor-augmented pumps have become increasingly used in clinical care, increasing the volume of information available to patients and providers. However, with the development of new devices it has become clear that along with the many benefits of these advances, the use of these devices can also present a burden to people with diabetes. For example, some patients report being overwhelmed by too much data when using continuous glucose monitors. Furthermore, there are concerns regarding the accuracy of some of these new devices, particularly for glucose monitoring. As a result, some patients may choose not to use available devices, despite the recognized benefits. Therefore, it is critical to understand how the various insulin delivery devices available currently and in the future affect patients in terms of their diabetes management and perceived burdens and to understand which patient characteristics may predict a lack of satisfaction with these devices. This critical gap in our knowledge is addressed in an article in this issue of the journal through the development of a questionnaire that allows for a better understanding of the impact of insulin delivery devices on quality of life and diabetes management among both type 1 diabetes and insulin-dependent type 2 diabetes patients. The novelty, as well as limitations, of this new instrument for the assessment of insulin delivery device satisfaction are discussed.
    Diabetes Technology &amp Therapeutics 11/2015; 17(11):759-762. DOI:10.1089/dia.2015.0260
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    ABSTRACT: Objective: The Average Daily Risk Range (ADRR) is a measure of glycemic variability (GV) developed for adults with diabetes. Although the ADRR is increasingly being reported in pediatric diabetes research and may also be used in clinical management, it has never been examined for its sensitivity to predicting hyper- and hypoglycemia in youths or compared for its predictive ability with other measures of GV in youths. Thus, we present predictive validity data for the ADRR in youths with type 1 diabetes. Materials and methods: Glucometer data for 436 youths (mean age, 11.8±3.8 years) were collected from a clinical database. Using these data, we computed the ADRR, SD of blood glucose, coefficient of variation of blood glucose, Low Blood Glucose Index, High Blood Glucose Index, the percentage of glucose values ≥70 and ≤180 mg/dL, the percentage of high glucose values >180 mg/dL and >400 mg/dL, and the percentage of low glucose values <70 mg/dL and <40 mg/dL in Month 1. We then compared these with episodes of hypo- and hyperglycemia in Month 2. Results: The ADRR showed good concurrent validity with other measures of GV in youths experiencing hyperglycemic events but limited predictive validity in general and specifically with future hypoglycemic events. The percentages of current hyper- and hypoglycemic episodes appeared to be stronger predictors of future hyper- and hypoglycemic episodes, respectively. Conclusions: In a large pediatric sample, the ADRR was not the strongest predictor of future glycemic excursion. The percentages of current hyper- and hypoglycemic episodes appear to be stronger predictors.
    Diabetes Technology &amp Therapeutics 11/2015; 17(11):795-800. DOI:10.1089/dia.2015.0061
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    ABSTRACT: The evolution of diabetes technologies is pivoting from component-based approaches to systems. With this transition the performance of each component will be judged in the context of the performance of the overall system. The overall system will not be judged by metrics such as sensor accuracy and precision; rather, they will be evaluated on their clinical performance defined by their safety and efficacy. TheCGM is a critical component of closed-loop AP systems. Thabit et al.2 provide the first careful look at the performance of a CGM device in home closed-loop studies. The performance of the sensor - particularly its accuracy in the euglycemic and hyperglycemic range - combined with the safety and efficacy of the overall system suggest that there are sensor characteristics that may be defined to aid in further AP system development. Ultimately, critical CGM specifications will need to be developed in the broader context of the AP system. It will be the sum of the system that defines the achievement of the ultimate metric for success - improved diabetes outcomes.
    Diabetes Technology &amp Therapeutics 11/2015; 17(11):770-772. DOI:10.1089/dia.2015.0331
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    ABSTRACT: Background: Diabetes mellitus is rare in young infants and neonates. Continuous subcutaneous insulin infusion (CSII) is used most frequently for insulin treatment in this age group. However, the individual doctor's experience is scarce because of the low prevalence of diabetes in this age. For this study patients treated with CSII with an age below 1 year were selected from the German/Austrian DPV (Diabetes-Patienten-Verlaufsdokumentation) database, and basal rate and bolus calculation were described. Materials and methods: For all patients less than 1 year of age, basal rate and mealtime boluses were compared among infants with type 1 diabetes mellitus (T1DM), infants with neonatal diabetes mellitus (NDM), and infants with antibody status unknown diabetes mellitus (AUDM). Results: Fifty-eight patients with T1DM, 67 neonates with NDM, and 43 infants with early diabetes development after 6 months and negative β-cell antibodies (AUDM) could be analyzed. T1DM patients at onset required a median total insulin amount of 0.83 IU/kg of body weight, whereas NDM patients required 0.74 IU/kg of body weight (P = 0.63). Basal insulin requirement however, was different between the two groups (0.56 IU/kg of body weight in NDM vs. 0.43 IU/kg in T1DM) (P = 0.036). The percentage basal profile of NDM and T1DM patients was quite similar to children at the age of 1-5 years. The proportion of prandial insulin at onset was significantly different (32% in NDM vs. 53% in T1DM) (P < 0.00001). AUDM patients showed almost similar data to T1DM patients. The pattern of mealtime bolus insulin was not different among the groups. Conclusions: The presented data can be used as an initial guide value to start CSII treatment in neonates and infants. To be on the safe side we recommend the lower quartile for the dosage as the starting value in nonketotic patients.
    Diabetes Technology &amp Therapeutics 10/2015; DOI:10.1089/dia.2015.0030
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    ABSTRACT: Background: The aim of this study was to evaluate maternal and fetal pregnancy outcomes of women with type 1 diabetes managed on continuous subcutaneous insulin infusion (CSII) compared with multiple daily insulin injections (MDI). Subjects and methods: Pregnancy outcomes were assessed retrospectively in women with type 1 diabetes who were patients of the Diabetes Clinic of North Karelia Hospital (Joensuu, Finland) between 2000 and 2012. The medical records of 72 women experiencing 135 pregnancies and data of their infants were retrospectively reviewed. Results: In total, 48 pregnancies were treated with CSII and 87 with MDI. Women on CSII treatment were older and had more diabetes complications compared with women on MDI. No significant differences in glycated hemoglobin (HbA1c) levels were observed between the CSII and MDI groups before or during pregnancy. Maternal or fetal outcomes did not differ between the treatment groups. However, among women with complicated diabetes, HbA1c levels were significantly lower in the CSII group until the second trimester (prepregnancy, 7.22% vs. 8.14%, respectively [P = 0.034]; first trimester, 6.85% vs. 7.87% [P < 0.001]; second trimester, 6.41% vs. 7.03% [P = 0.029]) without an increased rate of maternal hypoglycemia. Conclusions: Pregnancy outcomes were similar regardless of insulin treatment modality. Although using an insulin pump did not result in improvement of pregnancy outcomes, it allowed for better glycemic control in pregnancies of women with complicated diabetes. Therefore, it is worth considering in high-risk T1DM pregnancies, especially if good glycemic control is not achieved otherwise.
    Diabetes Technology &amp Therapeutics 10/2015; DOI:10.1089/dia.2015.0165
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    ABSTRACT: Background: Gestational diabetes mellitus (GDM) is associated with adverse maternal and fetal outcomes, and the oral glucose tolerance test (OGTT) is the recommended test for its diagnosis. We evaluated the role of glycated hemoglobin (HbA1c) in screening and diagnosis of GDM and its correlation with adverse pregnancy outcomes. Subjects and methods: In this prospective observational study, OGTT and HbA1c were performed in 500 antenatal women between 24 and 28 weeks of gestation; the pregnant women were followed up thereafter. Repeat OGTT and HbA1c were done in women with GDM at 6 weeks postpartum. Results: Among the 500 women, 45 were diagnosed with GDM, for an incidence of 9%. The mean HbA1c level in women with GDM was 6.2 ± 0.6%, whereas it was 5.4 ± 0.5% in those with normoglycemia. Women with GDM had a higher incidence of pregnancy-related complications compared with normoglycemic women. An HbA1c cutoff of 5.3% had a sensitivity of 95.6% and a specificity of 51.6% for the diagnosis of GDM and would have avoided OGTT in approximately half of antenatal women, while missing 5% of the women. However, those with an abnormal HbA1c will require a confirmatory OGTT, as 50% of normoglycemic women would be misclassified as having GDM by this approach. On repeat testing postpartum, two of 45 women (4.4%) had overt diabetes mellitus, whereas five (11.1%) had impaired glucose tolerance. Conclusions: Although HbA1c cannot replace OGTT in the diagnosis of GDM, it can be used as a screening test, avoiding OGTT in approximately 50% of women, if a cutoff of 5.3% is used.
    Diabetes Technology &amp Therapeutics 10/2015; DOI:10.1089/dia.2015.0041
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    ABSTRACT: International experts in the fields of diabetes, diabetes technology, endocrinology, mobile health, sport science, and regulatory issues gathered for the 8(th) Annual Symposium on Self-Monitoring of Blood Glucose (SMBG) with a focus on personalized diabetes management. The aim of this meeting was to facilitate new collaborations and research projects to improve the lives of people with diabetes. The 2015 meeting comprised a comprehensive scientific program, parallel interactive workshops, and two keynote lectures.
    Diabetes Technology &amp Therapeutics 10/2015; 17(11). DOI:10.1089/dia.2015.0325
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    ABSTRACT: Background: Only a few studies have reported the use of oral antidiabetes drugs (OADs) for treating older adults with type 2 diabetes mellitus (T2DM) in China. This study assessed the status of OAD therapy and relevant factors associated with OAD treatment patterns and glycemic control among older patients. Patients and methods: We conducted a noninterventional, observational, cross-sectional, multicenter study, which was initiated by the Chinese Diabetes Society, in which 9,872 outpatients with T2DM were recruited who received OADs only. Current antidiabetes treatment regimens and related clinical data were collected from patients' self-reporting and medical records. Participants were divided into two groups: ≥65 years and <65 years. All data were tabulated, and statistical analyses were performed using SPSS version 16 software (SPSS Inc., Chicago, IL). Results: Insulin secretagogues (52.6%): sulfonylureas (SU) (26.6%) and glinides (26.0%) were commonly used as monotherapy in those ≥65 years. The most popular OAD pattern was dual combination therapy (46.8%), with SU plus glucosidase inhibitors (25.1%) being most common in older participants. Age, diabetes duration, body mass index, achieving the glycemic control targets, and hypoglycemia were influencing factors to those ≥65 years in diverse treatment pattern models (P < 0.05). Older patients receiving OADs with triple or more combination treatment and complications were more likely to have substandard glycemic control (hemoglobin A1c level ≥7%). Conclusions: The pattern of OADs alone in older adults with T2DM was significantly different from those <65 years in China. A comprehensive OAD treatment pattern or insulin combination may be necessary for better glycemic control in older patients with multiple combinations of OADs or complications.
    Diabetes Technology &amp Therapeutics 10/2015; 17(11). DOI:10.1089/dia.2015.0094
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    ABSTRACT: Background: Flexible (or functional) insulin therapy method is a self-management education approach for intensive insulin therapy in patients with type 1 diabetes. The serious game (or applied game) "L'Affaire Birman" ("Mr. Birman's File") (available at www.gluciweb.com ) was specifically designed as an educational tool for the flexible insulin therapy method. Its educational impact was evaluated in children with type 1 diabetes. Materials and methods: This prospective multicenter pilot study evaluated the effect of this videogame on the therapeutic knowledge and behavior of children with type 1 diabetes. PedCarbQuiz (PCQ) and Diabetes Self-Management Profile (DSMP) questionnaires were used before (T0), immediately after (T1), and 6 months after (T2) the unstructured use of the videogame. Results: The 38 children enrolled in the study were 42% boys and 58% girls; they had a mean age of 13.7 ± 2.1 years old, a diabetes duration of 6.0 ± 3.8 years, and hemoglobin A1c (HbA1c) levels of 8.5 ± 1.4% (69.4 ± 9.4 mmol/mol). The children connected to the game 3.3 ± 2.8 times during this 6-month study. Their PCQ score increased from 31.6 ± 4.9 at T0 to 36.0 ± 4.0 at T2 (P < 0.05). Two PCQ subscores also increased significantly: the insulin titration score at T1 and T2 and the carbohydrate quantification score at T2. Conversely, the DSMP score was not different at T0, T1, and T2 (59.1 ± 9.9, 60.2 ± 9.8, and 60.0 ± 10.0, respectively), and HbA1c levels also remained stable throughout the study (8.4 ± 1.3%, 8.4 ± 1.2%, and 8.5 ± 1.5% at T0, T1, and T2, respectively). Subgroup analysis found a greater impact of the game in children with poor glycemic control and low knowledge at baseline. Adherence to the game was rather low (half of the children played less than 2.5 bouts), but no criterion was found to be predictive of this low attractiveness. Conclusions: Nonsupervised usage of the serious game "L'Affaire Birman" was able to improve insulin titration and carbohydrate quantification in children with type 1 diabetes.
    Diabetes Technology &amp Therapeutics 10/2015; DOI:10.1089/dia.2015.0227
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    ABSTRACT: Background: The optimal treatment of diabetes in pregnancy requires accurate measurement of blood glucose levels, in order to minimize adverse outcomes for both mother and neonate. Self-monitoring of blood glucose is routinely used to measure glycemic control and to assess whether treatment targets are being met; however, the accuracy of blood glucose meters in pregnancy is unclear. Materials and methods: Pregnant women with gestational, type 1, or type 2 diabetes mellitus were eligible to participate. Nonfasting capillary blood glucose levels were measured in duplicate using the BGStar(®) (Sanofi, Sydney, Australia) and FreeStyle Lite(®) (Abbott, Sydney) blood glucose meters. Venous blood samples were collected and analyzed for plasma glucose, hematocrit, and glycated hemoglobin. Capillary blood glucose was compared with plasma glucose and further assessed according to International Organization for Standardization (ISO) 15197:2013 standards. Results: One hundred ten women were recruited, providing 96 samples suitable for analysis. The mean ± SD laboratory plasma glucose level was 4.6 ± 1.4 mmol/L; the BGStar and FreeStyle Lite capillary blood glucose values were 5.3 ± 1.4 mmol/L and 5.0 ± 1.3 mmol/L, respectively. Both meters showed a positive bias (0.42 mmol/L for the FreeStyle Lite and 0.65 mmol/L for the BGStar). Furthermore, neither meter fulfilled the ISO 15197:2013 standards, and there was a nonsignificant improvement in meter performance at blood glucose levels of ≤4.2 mmol/L. Hematocrit did not affect the results of either blood glucose meter. Clarke Error Grid analysis demonstrated that approximately 70% of the results of both meters would lead to appropriate clinical action. Conclusions: The BGStar and FreeStyle Lite blood glucose meters did not meet ISO 15197:2013 recommendations for blood glucose monitoring systems when assessed in a population of women with diabetes in pregnancy. Clinicians should consider this difference in blood glucose readings when making diabetes-related treatment decisions.
    Diabetes Technology &amp Therapeutics 10/2015; DOI:10.1089/dia.2015.0104
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    ABSTRACT: Background: Islet autoantibody testing provides the basis for assessment of risk of progression to type 1 diabetes. We set out to determine the feasibility and acceptability of dried capillary blood spot-based screening to identify islet autoantibody-positive relatives potentially eligible for inclusion in prevention trials. Materials and methods: Dried blood spot (DBS) and venous samples were collected from 229 relatives participating in the TrialNet Pathway to Prevention Study. Both samples were tested for glutamic acid decarboxylase, islet antigen 2, and zinc transporter 8 autoantibodies, and venous samples were additionally tested for insulin autoantibodies and islet cell antibodies. We defined multiple autoantibody positive as two or more autoantibodies in venous serum and DBS screen positive if one or more autoantibodies were detected. Participant questionnaires compared the sample collection methods. Results: Of 44 relatives who were multiple autoantibody positive in venous samples, 42 (95.5%) were DBS screen positive, and DBS accurately detected 145 of 147 autoantibody-negative relatives (98.6%). Capillary blood sampling was perceived as more painful than venous blood draw, but 60% of participants would prefer initial screening using home fingerstick with clinic visits only required if autoantibodies were found. Conclusions: Capillary blood sampling could facilitate screening for type 1 diabetes prevention studies.
    Diabetes Technology &amp Therapeutics 09/2015; DOI:10.1089/dia.2015.0133

  • Diabetes Technology &amp Therapeutics 09/2015; 17(10):679-81. DOI:10.1089/dia.2015.0269
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    ABSTRACT: Background: Devices for the treatment of diabetes are not always used as recommended in good practice. Our aim was to evaluate potential insulin underdelivery in cases of premature needle withdrawal after injection with insulin pens, which is a commonly observed misuse, especially in young type 1 diabetes patients. Materials and methods: Potential insulin underdelivery was evaluated using five prefilled insulin pens (lispro Kwikpen(®) [Eli Lilly, Indianapolis, IN], aspart Flexpen(®) [Novo Nordisk, Bagsvaerd, Denmark], glulisine Solostar(®) [Sanofi, Paris, France], detemir Flexpen(®) [Novo Nordisk], and glargine Solostar(®) [Sanofi]) and three reusable insulin pens (Humapen(®) Luxura HD with lispro cartridge [Eli Lilly], Novopen(®) Echo with aspart and detemir cartridge [Novo Nordisk], and JuniorSTAR(®) with glulisine and glargine cartridge [Sanofi]) in a laboratory. For each pen and insulin, we simulated premature needle withdrawal 2 and 3 s after an insulin injection of 5 and 10 units, respectively. Results: With prefilled pens, mean potential insulin underdelivery was 0.43±0.30 and 0.44±0.32 units after injection of 5 and 10 units, respectively. With reusable pens, mean potential insulin underdelivery was lower (0.29±0.13 and 0.29±0.12 units after injection of 5 and 10 units, respectively; P<0.001). The results were heterogeneous across pens, ranging from 2.6%/1.6% to 20.2%/8.6% of the selected insulin dose for prefilled/reusable pens, respectively (P<0.001). Conclusions: Potential insulin underdelivery varies across prefilled and reusable insulin pens but may represent up to one-fifth of the total injected dose. Clinicians should be aware of the potential consequences of premature needle withdrawal and should reinforce insulin injection education.
    Diabetes Technology &amp Therapeutics 09/2015; 17(10):712-6. DOI:10.1089/dia.2015.0067