[Show abstract][Hide abstract] ABSTRACT: There has been a significant increase in the prevalence of type 1 diabetes mellitus and type 2 diabetes mellitus in the past decade. The International Diabetes Foundation reported that there will be more than a half-billion people with diabetes by 2030, largely in emerging economies. Improved glucose control reduces microvascular and macrovascular complications and can be accomplished with intensive diabetes management. Continuous glucose monitors allow further improvement. The best way to emulate normal physiology is the development of an artificial pancreas. Early versions of closed-loop technology may be available in the United States in the next 3 to 5 years.
Endocrinology and metabolism clinics of North America 03/2012; 41(1):89-104. · 3.56 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The prevalence of diabetes is increasing globally and is expected to increase to 439 million people by the year 2030. Several studies have shown that improved glycemic control measured by glycosylated hemoglobin (A1c) in patients with type 1 and type 2 diabetes results in a reduction of both the micro- and macrovascular complications associated with the disease. The recent introduction of new oral medications, insulin analogs (long and rapid acting), insulin pens and pumps, better SMBG meters and continuous glucose monitoring (CGM) have all resulted in improvement of glycemic control. Closed-loop devices currently in development aim to integrate the CGM and pump system in order to more closely mimic the human pancreas. The other upcoming new basal insulin (Degludec), prandial insulin, other new technologies and improved oral therapies will significantly improve patient acceptance of intensive therapy, glycemic control and quality of life in patients with diabetes.
Diabetes research and clinical practice 02/2012; 97(1):16-26. · 2.74 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Diabetes mellitus is an independent risk factor for cardiovascular disease.
To compare the efficacy of devices for continuous glucose monitoring and capillary glucose monitoring in hospitalized patients with acute coronary syndrome using the following parameters: time to achieve normoglycemia, period of time in normoglycemia, and episodes of hypoglycemia.
We performed a pilot, non-randomized, unblinded clinical trial that included 16 patients with acute coronary artery syndrome, a capillary or venous blood glucose ≥140mg/dl, and treatment with a continuous infusion of fast acting human insulin. These patients were randomized into 2 groups: a conventional group, in which capillary measurement and recording as well as insulin adjustment were made every 4h, and an intervention group, in which measurement and recording as well as insulin adjustment were made every hour with a subcutaneous continuous monitoring system. Student's t-test was applied for mean differences and the X(2) test for qualitative variables.
We observed a statistically significant difference in the mean time for achieving normoglycemia, favoring the conventional group with a P=0.02.
Continuous monitoring systems are as useful as capillary monitoring for achieving normoglycemia.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.