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CamAPS FX Hybrid Closed-Loop with Ultra-Rapid Lispro Compared with Standard Lispro in Adults with Type 1 Diabetes: A Double-Blind, Randomized, Crossover Study. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-12-01 Munachiso Nwokolo,Rama Lakshman,Sara Hartnell,Heba Alwan,Julia Ware,Janet M Allen,Malgorzata E Wilinska,Mark L Evans,Roman Hovorka,Charlotte K Boughton
Introduction: To evaluate hybrid closed-loop with ultra-rapid insulin lispro (Lyumjev) compared with hybrid closed-loop with standard insulin lispro in adults with type 1 diabetes. Materials and Methods: In a single-center, double-blind, randomized, crossover study, 28 adults with type 1 diabetes (mean ± standard deviation [SD]: age 44.5 ± 10.7 years, glycated hemoglobin (HbA1c) 7.1 ± 0.9% [54 ± 10 mmol/mol])
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Does insulin delivery technology change our relationship with foods? A scoping review. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-30 Courtney South,Meryem Talbo,Amélie Roy-Fleming,Tricia Peters,Daiva Nielsen,Slyvain Iceta,Anne-Sophie Brazeau
INTRODUCTION Automated Insulin Delivery (AID) systems reduce burden and improve glycemic management for people with type 1 diabetes (PwT1D) by automatically adjusting insulin as a response to measured glucose levels. There is a lack of evidence on AID and nutrition variables such as dietary intake, eating behaviours, and disordered eating. OBJECTIVES This scoping review aimed to provide a summary of
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A minimized measurement scheme for predicting HbA1c using discrete self-monitoring blood glucose (SMBG) data within 4 weeks for people with T2D. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-30 Ang Li,Xiang Li,Zhanxiao Geng,Junqing Zhang,Xiaohao Wang,Fei Tang
OBJECTIVE To establish an accurate and robust calculation model for predicting HbA1c by using the fewest discrete blood glucose values according to an irregular data set, and propose an appropriate cost-effective and scientific scheme for routine blood glucose monitoring. METHODS By using two datasets obtained from 2017 to 2022, which involved 2,432 people, about 420,000 irregular blood glucose values
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Performance of Tandem Control IQ during outdoor physical activity in children and adolescents with type 1 diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-30 Chiara Mameli,Andrea Rigamonti,Barbara Felappi,Antonio Nicolucci,Giuseppe Lucisano,Stefanoi Baresi,Giorgia Florini,Maddalena Macedoni,Agnese Petitti,Adelina Hajro,Giacomo Tortu,Carmelo Pistone,Paola Guerraggio,Maria Zampolli,Gian Vincenzo Zuccotti,Riccardo Bonfanti
BACKGROUND Few data are available in children with type 1 diabetes (T1D) using automated insulin delivery systems during physical activity (PA). We evaluated the time in range (TIR) during 2-hours of outdoor PA in children using t:slim X2 with Control-IQ® technology. MATERIALS AND METHODS Caucasian children and adolescents, aged 9-18 years using t:slim X2 with Control-IQ® technology were recruited
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Impact of Body Composition and Anemia on Accuracy of a Real-Time Continuous Glucose Monitor in Diabetes Patients on Continuous Ambulatory Peritoneal Dialysis. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-27 James Ling,Jack K C Ng,Eric S H Lau,Andrea O Y Luk,Ronald C W Ma,Robert A Vigersky,Philip K T Li,Juliana C N Chan,Cheuk Chun Szeto,Elaine Chow
Continuous glucose monitoring (CGM) is proposed as an alternative for glycemic assessment in peritoneal dialysis, but volume overload and anemia may affect sensor accuracy. This is an exploratory analysis of a study of Guardian Connect™ with Guardian Sensor™ 3 in 30 participants with diabetes on continuous ambulatory peritoneal dialysis (CAPD) (age [mean ± standard deviation] 64.7 ± 5.6 years, 23 men
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A Randomized Controlled Trial Assessing the Impact of Continuous Glucose Monitoring with a Predictive Hypoglycemia Alert Function on Hypoglycemia in Physical Activity for People with Type 1 Diabetes (PACE). Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-27 Siân Rilstone,Nick Oliver,Ian Godsland,Bruno Tanushi,Maria Thomas,Neil Hill
Background: Uptake of exercise in people with type 1 diabetes (T1D) is low despite significant health benefits. Fear of hypoglycemia is the main barrier to exercise. Continuous glucose monitoring (CGM) with predictive alarms warning of impending hypoglycemia may improve self-management of diabetes around exercise. Aim: To assess the impact of Dexcom G6 real-time CGM system with a predictive hypoglycemia
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Feasibility and validity of in-home self-collected capillary blood spot screening for type 1 diabetes risk. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-17 Anna Sing,Gaetano Naselli,Dexing Huang,Kelly Watson,Peter G Colman,Leonard Harrison,John Wentworth
Aims Self-collection of a blood sample for autoantibody testing has potential to facilitate screening for type 1 diabetes risk. We sought to determine the feasibility and acceptability of this approach and the performance of downstream antibody assays. Methods People living with type 1 diabetes and their family members (N=97) provided paired capillary blood spot and serum samples collected, respectively
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MiniMedTM 780G Advanced Hybrid Closed-Loop System Study in Pregnant Women with Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-14 Clara Guibert,Lamia Amoura,Luc Rakotoarisoa,Francoise Plat,Emmanuel Sonnet,Sandrine Lablanche,Clémence Tréglia,Elisa Sarde,Viviane Leca,Frédérique Rimareix,Vincent Melki,Franciane Baucher,Bouchra Betari,Laurent Meyer,Laurence Kessler
Background: Evaluate the impact of the MiniMed™ 780G advanced hybrid closed-loop (AHCL) system on the glucose profile of pregnant women with type 1 diabetes (T1D) and maternal-neonatal complications. Methods: From April 2021 to September 2022, pregnant women with T1D treated with the AHCL system were included in an observational multicenter retrospective study. Continuous glucose monitoring parameters
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12-Month Efficacy of Advanced Hybrid Closed-Loop System in Adult Type 1 Diabetic Patients. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-14 Laura Nigi,Gabriele Iraci Sareri,Dorica Cataldo,Francesco Dotta
Automated insulin delivery (AID) systems have improved glycemic control in individuals with type 1 diabetes (T1D). The "advanced hybrid closed loop" (AHCL) stands out as the most recent development in AID systems for T1D management. In a real-world clinical environment, we retrospectively evaluated the AHCL MiniMed™ 780G system's effectiveness to achieve and sustain glycemic control over a 12-month
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Closed-loop insulin delivery systems for people with type 1 diabetes and chronic very poor metabolic control: it works and is safe! Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-13 Sonia Deepchand,Vanessa Balla,Juliette Eroukhmanoff,Khadijatou Ly Sall,Bénédicte Romain,Marie Lejeune,Alfred Penfornis,Coralie Amadou
OBJECTIVE To evaluate the percentage of patients with type 1 diabetes (T1D) and very poor metabolic control who would agree to be treated with a hybrid closed-loop (HCL) insulin delivery system, and to assess metabolic improvement and safety. RESEARCH DESIGN AND METHODS In a single center, we identified all patients aged >18 years with HbA1c>11% [97 mmol/mol] before HCL treatment. We collected metabolic
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The Role of a "Technology Navigator" in an Academic Diabetes Clinic: A Feasibility Evaluation. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-13 Paige Edmiston,Sarah Lukhang Klippel,Jesica D Baran,Dori Khakpour,Irl B Hirsch,Subbulaxmi Trikudanathan
Patient-generated device data plays an important role in diabetes management. However, acquiring this data remains a challenge. This project aimed to understand whether implementing a dedicated "Technology Navigator" (TN) personnel at a large academic diabetes clinic could facilitate access to device data without increasing work for clinic staff. A sample of visits pre- and post-TN implementation (n=173)
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Diabetic ketoacidosis (DKA) at diagnosis in youth with type 1 diabetes (T1D) is associated with a higher hemoglobin A1c even with intensive insulin management. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-13 Dessi P Zaharieva,Victoria Ding,Ananta Addala,Priya Prahalad,Franziska Bishop,Korey Hood,Manisha Desai,Darrell M Wilson,Bruce A Buckingham,David M Maahs
INTRODUCTION Diabetic ketoacidosis (DKA) at diagnosis is associated with short- and long-term complications. We assessed the relationship between DKA status and hemoglobin A1c (A1c) levels in the first year following type 1 diabetes (T1D) diagnosis. RESEARCH DESIGN AND METHODS The Pilot 4T study offered continuous glucose monitoring to youth with T1D within 1 month of diagnosis. A1c levels were compared
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The performance of Freestyle Libre Pro Flash continuous glucose monitoring in hospitalized patients treated with an intravenous insulin infusion for acute prednisolone-induced hyperglycemia. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-09 Angela Xun-Nan Chen,Anjana Radhakutty,Anthony Zimmermann,Stephen N Stranks,Campbell Thompson,Morton G Burt
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Advanced Hybrid Closed-Loop System Achieves and Maintains Recommended Time in Range Levels for Up To 2 Years: Predictors of Best Efficacy. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-08 Giuseppe Lepore,Nicolò Diego Borella,Giona Castagna,Silvia Ippolito,Silvia Bonfadini,Anna Corsi,Cristiana Scaranna,Alessandro Roberto Dodesini,Rosalia Bellante,Roberto Trevisan
Aim: To evaluate the long-term efficacy, up to 2 years, of an advanced hybrid closed-loop (AHCL) system and to assess predictors of best results of the therapy. Methods: We retrospectively evaluated 296 adults with type 1 diabetes mellitus [mean age 42.8 ± 16.5 years, men 42.9%, duration of diabetes 22.5 ± 12.8 years, body mass index 24.9 ± 4.7 kg/m2, baseline glycated hemoglobin (HbA1c) 63.4 ± 12
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Glucose and Psychosocial Outcomes 12 Months Following Transition from Multiple Daily Injections to Advanced Hybrid Closed Loop in Youth with Type 1 Diabetes and Suboptimal Glycemia. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-07 Venus R Michaels,Alisa Boucsein,Antony S Watson,Carla M Frewen,Olivia J Sanders,Jillian J Haszard,Shirley D Jones,Philippa J Milford-Hughes,Martin I de Bock,Benjamin J Wheeler
Objective: To investigate 12-month glycemic and psychosocial changes following transition from multiple daily injections (MDI) to advanced hybrid closed-loop (AHCL) therapy in youth (aged 13-25 years) with type 1 diabetes and suboptimal glycemia (glycated hemoglobin [HbA1c] ≥8.5% [69 mmol/mol]). Research Design and Methods: Prospective, single arm, dual-center study in 20 participants. Extension phase
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More Frequent Use of Glucose Alarms Is Associated with Continuous Glucose Monitoring-Specific Diabetes Education: Findings from the Dia·Link Diabetes Panel. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-07 Dominic Ehrmann,Lilli-Sophie Priesterroth,Birgit Olesen,Thomas Haak,Bernhard Kulzer,Norbert Hermanns
The associations of continuous glucose monitoring (CGM)-specific diabetes education with real-world utilization of glucose alerts and alarms were assessed in current CGM-users with type 1 or type 2 diabetes. A cross-sectional online survey was conducted in Germany assessing utilization (use and responses) of different alerts and alarms. Ordinal logistic regression analyses were conducted to analyze
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Listening to Women: Experiences of Using Closed-Loop in Type 1 Diabetes Pregnancy. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-07 Julia Lawton,Barbara Kimbell,Mia Closs,Sara Hartnell,Tara T M Lee,Anna R Dover,Rebecca M Reynolds,Corinne Collett,Katharine Barnard-Kelly,Roman Hovorka,David Rankin,Helen R Murphy
Introduction: Recent high-profile calls have emphasized that women's experiences should be considered in maternity care provisioning. We explored women's experiences of using closed-loop during type 1 diabetes (T1D) pregnancy to inform decision-making about antenatal rollout and guidance and support given to future users. Methods: We interviewed 23 closed-loop participants in the Automated insulin
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Historical Insights and Current Perspectives on the Diagnosis and Management of Presymptomatic Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-01 Kimber M W Simmons,Brigette I Frohnert,Holly K O'Donnell,Kimberly Bautista,Cristy Geno Rasmussen,Andrea Gerard Gonzalez,Andrea K Steck,Marian J Rewers
Objective: The article provides practical guidance for (1) interpreting and confirming islet autoantibody screening results for type 1 diabetes (T1D) and (2) follow-up of individuals with early stages of T1D with the goal of ensuring medical safety and providing patients and their families with an assessment of risk for progression to a clinical diagnosis of T1D. Research Design and Methods: We used
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Continuous Glucose Monitoring Metrics in High-Risk Pregnant Women with Type 2 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-30 Anna McLean,Elizabeth Barr,Georgina Tabuai,Helen R Murphy,Louise Maple-Brown
Objective: To describe glucose metrics in a high-risk population of women with type 2 diabetes (T2DM) in pregnancy and to explore the associations with neonatal outcomes. Research Design and Methods: Prospective observational study of 57 women. Continuous glucose monitoring (CGM) trajectories were determined from metrics collected in early and late gestation using the first and last two (mean 16 and
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Ultrarapid insulin use can reduce postprandial hyperglycemia and late hypoglycemia, even in delayed insulin injections. A connected insulin cap-based real-world study. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-30 Fernando Gómez Peralta,Xoan Valledor,Amanda López-Picado,Cristina Abreu,Elsa Fernández-Rubio,Laura Cotovad,Pedro Pujante,Elena García-Fernández,Sharona Azriel,Rosa Corcoy,Jesús Pérez-González,Luis Ruiz
OBJECTIVES Reaching optimal postprandial glucose dynamics is a daily challenge for people with type 1 diabetes (T1D). This study aimed to analyze the postprandial hyperglycemia excursions (PHE) and late postprandial hypoglycemia (LPH) risk according to prandial insulin time and type. RESEARCH DESIGN AND METHODS Real-world, retrospective study in T1D using multiple daily insulin injections (MDI) analyzing
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Aiming for the Best Glycemic Control Beyond Time in Range: Time in Tight Range as a new CGM Metric in Children and Adolescents with Type 1 Diabetes using Different Treatment Modalities. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-30 Stefano Passanisi,Claudia Piona,Giuseppina Salzano,Marco Marigliano,Bruno Bombaci,Anita Morandi,Angela Alibrandi,Claudio Maffeis,Fortunato Lombardo
INTRODUCTION To evaluate time in tight range (TITR) 70-140 mg/dL (3.9- 7.8 mmol/L), its correlation with standard continuous glucose monitoring (CGM) metrics and the clinical variables that possibly have a substantial impact on its value, in a large cohort of pediatric subjects using different treatment strategies. MATERIAL AND METHODS A total of 854 children and adolescents with type 1 diabetes were
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Real-World Use of Control-IQ Technology is Associated with a Lower Rate of Severe Hypoglycemia and Diabetic Ketoacidosis Than Historical Data: Results of the Control-IQ Observational (CLIO) Prospective Study. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-26 Rishi Graham,Lars Mueller,Michelle Manning,Steph Habif,Laurel H Messer,Jordan E Pinsker,Eliah Aronoff-Spencer
Objective: Severe hypoglycemia (SH) and diabetic ketoacidosis (DKA) remain significant risks with intensive insulin therapy. While these adverse event (AE) rates are generally very low in advanced hybrid closed-loop (AHCL) clinical studies, prospectively collected real-world AE rates are lacking. Research Design and Methods: The Control-IQ Observational (CLIO) study was a single-arm, prospective, longitudinal
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Endocrine Management and Clinical Outcomes in a Cohort of Pediatric Patients Undergoing Total Pancreatectomy with Islet Autotransplantation. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-26 Siobhan E Tellez,Lindsey N Hornung,David S Vitale,Sarah A Lawson,Maisam A Abu-El-Haija,Deborah A Elder
Objective: To describe management strategies that contributed to optimal outcomes in pediatric recipients of a total pancreatectomy with islet autotransplantation (TPIAT). Research Design and Methods: We provide a comprehensive report of the approach to endocrine management of the pediatric TPIAT recipient from initial evaluation through the first 4 years postsurgery. We performed a retrospective review
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Therapy Settings Associated with Optimal Outcomes for t:slim X2 with Control-IQ Technology in Real-World Clinical Care. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-25 Laurel H Messer,Marc D Breton
Objective: To determine insulin dosing parameters that are associated with and predict optimal outcomes for people using t:slim X2 with Control-IQ technology (CIQ). Methods: Retrospective deidentified data from CIQ users were analyzed to determine the effect of Correction Factor, Carbohydrate-to-Insulin (C:I) Ratio, and basal rate settings (standardized by total daily insulin [TDI]) on glycemic control
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Safety and Glycemic Outcomes During the MiniMedTM Advanced Hybrid Closed-Loop System Pivotal Trial in Children and Adolescents with Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-25 Catherine Pihoker,Dorothy I Shulman,Gregory P Forlenza,Kevin B Kaiserman,Jennifer L Sherr,James R Thrasher,Bruce A Buckingham,Mark S Kipnes,Bruce W Bode,Anders L Carlson,Scott W Lee,Kashif Latif,David R Liljenquist,Robert H Slover,Zheng Dai,Fang Niu,John Shin,Richard A M Jonkers,Anirban Roy,Benyamin Grosman,Melissa Vella,Toni L Cordero,Jennifer McVean,Andrew S Rhinehart,Robert A Vigersky,
Background: During MiniMed™ advanced hybrid closed-loop (AHCL) use by adolescents and adults in the pivotal trial, glycated hemoglobin (A1C) was significantly reduced, time spent in range (TIR) was significantly increased, and there were no episodes of severe hypoglycemia or diabetic ketoacidosis (DKA). The present study investigated the same primary safety and effectiveness endpoints during AHCL use
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Comparison of Glycemia Risk Index with Time in Range for Assessing Glycemic Quality. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-25 Ji Yoon Kim,Jee Hee Yoo,Jae Hyeon Kim
Background: The glycemia risk index (GRI) is a novel composite continuous glucose monitoring (CGM) metric that gives greater weight to hypoglycemia than to hyperglycemia and to extreme hypo/hyperglycemia over less extreme hypo/hyperglycemia. This study aimed at validating the effectiveness of GRI and at comparing it with time in range (TIR) in assessing glycemic quality in clinical practice. Methods:
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Shining the Spotlight on Multiple Daily Insulin Therapy: Real-World Evidence of the InPen Smart Insulin Pen. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-29 Janice MacLeod,Glen Heungyong Im,Madison Smith,Robert A Vigersky
Objective: Connected insulin pens are creating opportunities for the millions of individuals with diabetes using multiple daily injections (MDIs) therapy across the globe. Continuous glucose monitoring (CGM) data from connected insulin pens are revealing gaps and opportunities to significantly improve care for this population. In this article, we report real-world findings of the InPen™ smart insulin
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Two Years with a Tubeless Automated Insulin Delivery System: A Single-Arm Multicenter Trial in Children, Adolescents, and Adults with Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-11-30 Amy B Criego,Anders L Carlson,Sue A Brown,Gregory P Forlenza,Bruce W Bode,Carol J Levy,David W Hansen,Irl B Hirsch,Richard M Bergenstal,Jennifer L Sherr,Sanjeev N Mehta,Lori M Laffel,Viral N Shah,Anuj Bhargava,Ruth S Weinstock,Sarah A MacLeish,Daniel J DeSalvo,Thomas C Jones,Grazia Aleppo,Bruce A Buckingham,Trang T Ly
Background: The Omnipod® 5 Automated Insulin Delivery (AID) System was shown to be safe and effective following 3 months of use in people with type 1 diabetes (T1D); however, data on the durability of these results are limited. This study evaluated the long-term safety and effectiveness of Omnipod 5 use in people with T1D during up to 2 years of use. Materials and Methods: After a 3-month single-arm
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Longitudinal Trends in Glycemic Outcomes and Technology Use for Over 48,000 People with Type 1 Diabetes (2016-2022) from the T1D Exchange Quality Improvement Collaborative. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-16 Osagie Ebekozien,Ann Mungmode,Janine Sanchez,Saketh Rompicherla,Carla Demeterco-Berggren,Ruth S Weinstock,Laura M Jacobsen,Georgia Davis,Alexis McKee,Halis K Akturk,David M Maahs,Manmohan K Kamboj
Objective: Previous studies revealed that hemoglobin A1c (HbA1c) increased overall in the United States in the past decade. In addition, health inequities in type 1 diabetes (T1D) outcomes by race/ethnicity and insurance type persist. This study examines the trends in HbA1c from 2016 to 2022 stratified by race/ethnicity and insurance in a large multicenter national database. Research Design and Methods:
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A Comparison of Continuous Glucose Monitoring-Measured Time-in-Range 70-180 mg/dL Versus Time-in-Tight-Range 70-140 mg/dL. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-13 Roy W Beck,Dan Raghinaru,Peter Calhoun,Richard M Bergenstal
Objective: To evaluate the relationship between continuous glucose monitoring (CGM)-measured time-in-range 70-180 mg/dL (TIR) and time-in-tight-range 70-140 mg/dL (TITR). Methods: TIR and TITR were calculated from CGM data collected using blinded or unblinded Dexcom sensors from 9 studies with 912 participants with type 1 diabetes (T1D) and 2 studies with 184 participants with type 2 diabetes (T2D)
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A European Cost-Utility Analysis of the MiniMed™ 780G Advanced Hybrid Closed-Loop System Versus Intermittently Scanned Continuous Glucose Monitoring with Multiple Daily Insulin Injections in People Living with Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-12-01 Johan Jendle,Maria Ida Buompensiere,Asli Zeynep Ozdemir Saltik,Simona de Portu,Jayne Smith-Palmer,Richard F Pollock,Ohad Cohen
Background: Advanced hybrid closed-loop (AHCL) automated insulin delivery systems are the most effective therapy in terms of assisting people with type 1 diabetes (T1D) to achieve glycemic targets; however, the cost can represent a barrier to uptake. In this study, a cost-utility analysis of the MiniMed™ 780G AHCL system (MM780G) versus intermittently scanned continuous glucose monitoring (is-CGM)
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Testing the Real-World Accuracy of the Dexcom G6 Pro CGM During the Insulin-Only Bionic Pancreas Pivotal Trial. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-03 Martin Chase Marak,Peter Calhoun,Edward R Damiano,Steven J Russell,Katrina J Ruedy,Roy W Beck
Continuous glucose monitors (CGMs) have transformed the way people with type 1 diabetes can self-monitor glucose levels. Past studies have evaluated the accuracy of CGMs in clinic-based studies, but few have analyzed their accuracy in real-world settings. The Insulin-Only Bionic Pancreas Trial provided the opportunity to assess real-world accuracy of the blinded Dexcom G6 Pro sensor over the first
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Effects of 12-Week Freestyle Libre 2.0 in Children with Type 1 Diabetes and Elevated HbA1c: A Multicenter Randomized Controlled Trial. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-10-20 Craig A Jefferies,Alisa Boucsein,Sara E Styles,Bronte Chamberlain,Venus R Michaels,Hamish R Crockett,Michel De Lange,Anita Lala,Vicki Cunningham,Esko J Wiltshire,Anna S Serlachius,Benjamin J Wheeler
Objective: To investigate whether intermittently scanned continuous glucose monitoring (isCGM) reduced glycated hemoglobin (HbA1c) compared with capillary self-monitored capillary blood glucose (SMBG) in children with type 1 diabetes (T1D) and elevated glycemic control. Research Design and Methods: This multicenter 12-week 1:1 randomized, controlled, parallel-arm trial included 100 participants with
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Insulin Pump Technology for Patients with Alcoholism: A Dangerous Combination or Worth a Try? Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-12-01 Pieter Maes,An Nollet,Barbara Deconinck,Pieter Gillard
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Expected Basal Insulin Requirement During Continuous Subcutaneous Insulin Infusion Therapy by Age Group, Sex, and Body Mass Index, Based on 25,718 Young People with Type 1 Diabetes in the DPV Registry. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-09-20 Torben Biester,Alexander Eckert,Marianne Becker,Claudia Boettcher,Sven Golembowski,Bettina Heidtmann,Christoph Klinkert,Silvia Müther,Birgit Rami-Merhar,Reinhard W Holl
Background: Since the introduction of insulin pumps into the therapy of pediatric subjects, different approaches have been taken to find optimal basal rates. Previously, the DPV registry provided circadian basal rate patterns for different age groups. As the number of pump users has increased recently and short-acting insulin analogues are now predominant, we performed a new analysis with a larger
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Real-World Glycemic Outcomes with Early Omnipod 5 Use in Youth with Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-09-20 Brynn E Marks,Seema Meighan,Anum Zehra,Julia L Douvas,Andrew Rearson,Reshma Suresh,Elizabeth A Brown,Risa M Wolf
Background: Pivotal trials of diabetes technologies have demonstrated glycemic improvements; however, these trials include patients of limited diversity and ranges of glycemic control. We assessed changes in glycemic control during the first 90 days of Omnipod 5 use in a real-world cohort of youth with type 1 diabetes (T1D). Methods: Youth 2-21 years with T1D initiating Omnipod 5 at two pediatric academic
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Safety Event Outcomes and Glycemic Control with a Hybrid Closed-Loop System Used by Chinese Adolescents and Adults with Type 1 Diabetes Mellitus. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-09-05 Yu Pei,Weijian Ke,Jing Lu,Yi Lin,Zhijian Zhang,Yongde Peng,Yan Bi,Yanbing Li,Jue Hou,Xiaolu Zhang,Xiaoxiao Chen,Yuri Treminio,Scott W Lee,John Shin,Andrew S Rhinehart,Robert A Vigersky,Yiming Mu
Background: While evidence supports glycemic control benefits for individuals with type 1 diabetes mellitus (T1DM) using hybrid closed-loop (HCL) systems, HCL automated insulin delivery therapy in China has not been assessed. This study evaluated safety events and effectiveness during HCL system use by Chinese adolescents and adults with T1DM. Methods: Sixty-two participants (n = 12 adolescents with
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Psychosocial Impact of the Insulin-Only iLet Bionic Pancreas for Adults, Youth, and Caregivers of Youth with Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-09-05 Jill Weissberg-Benchell,Anthony T Vesco,Jenna Shapiro,Peter Calhoun,Edward R Damiano,Steven J Russell,Zoey Li,Firas H El-Khatib,Katrina J Ruedy,Courtney A Balliro,Roy W Beck
Objective: To evaluate the psychosocial impact and user experience for the insulin-only configuration of iLet bionic pancreas (BP) in persons 6-83 years years of age with type 1 diabetes. Research Design and Methods: In this multicenter, randomized controlled, 13-week trial, 275 adults (221 randomly assigned to the BP group and 54 to the standard of care [SC] group) and 165 youth and their caregivers
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Automated Insulin Delivery with Remote Real-Time Continuous Glucose Monitoring for Hospitalized Patients with Diabetes: A Multicenter, Single-Arm, Feasibility Trial. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-08-28 Georgia M Davis,Michael S Hughes,Sue A Brown,Judy Sibayan,M Citlalli Perez-Guzman,Meaghan Stumpf,Zachary Thompson,Marina Basina,Ronak M Patel,Joi Hester,Amalia Abraham,Trang T Ly,Cherie Chaney,Marilyn Tan,Liana Hsu,Craig Kollman,Roy W Beck,Rayhan Lal,Bruce Buckingham,Francisco J Pasquel
Introduction: Multiple daily injection insulin therapy frequently fails to meet hospital glycemic goals and is prone to hypoglycemia. Automated insulin delivery (AID) with remote glucose monitoring offers a solution to these shortcomings. Research Design and Methods: In a single-arm multicenter pilot trial, we tested the feasibility, safety, and effectiveness of the Omnipod 5 AID System with real-time
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Limitations of Reporting Time Below Range as a Percentage. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-08-18 Viral N Shah
Continuous glucose monitoring (CGM)-based metrics such as time in range and time below range (TBR) and their clinical targets are recommended along with glycated hemoglobin (A1c) to optimize diabetes care. CGM metrics are easy to understand by people with diabetes and have been widely accepted among health care providers. TBR, that is, time spent below a certain glucose level (e.g., <70 mg/dL and <54 mg/dL)
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Coverage for Continuous Glucose Monitoring for Individuals with Type 2 Diabetes Treated with Nonintensive Therapies: An Evidence-Based Approach to Policymaking. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-08-03 Grazia Aleppo,Irl B Hirsch,Christopher G Parkin,Janet McGill,Rodolfo Galindo,Davida F Kruger,Carol J Levy,Gregory P Forlenza,Guillermo E Umpierrez,George Grunberger,Richard M Bergenstal
Numerous studies have demonstrated the clinical benefits of continuous glucose monitoring (CGM) in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) who are treated with intensive insulin regimens. Based on this evidence, CGM is now a standard of care for individuals within these diabetes populations and widely covered by commercial and public insurers. Moreover, recent clinical guidelines
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Racial and Ethnic Differences in the Association Between Mean Glucose and Hemoglobin A1c. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-08-02 Andrew J Karter,Melissa M Parker,Howard H Moffet,Lisa K Gilliam
Background: Studies have reported significantly higher hemoglobin A1c (A1C) in African American patients than in White patients with the same mean glucose, but less is known about other racial/ethnic groups. We evaluated racial/ethnic differences in the association between mean glucose, based on continuous glucose monitor (CGM) data, and A1C. Methods: Retrospective study among 1788 patients with diabetes
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The Advanced Hybrid Closed Loop Improves Glycemia Risk Index, Continuous Glucose Monitoring Index, and Time in Range in Children with Type 1 Diabetes: Real-World Data from a Single Center Study. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-09-01 Elif Eviz,Gul Yesiltepe Mutlu,Kagan Ege Karakus,Ecem Can,Tugba Gokce,Serra Muradoglu,Sukru Hatun
Introduction: The Glycemia Risk Index (GRI) and Continuous Glucose Monitoring Index (COGI) are newly defined composite metric parameters derived from continuous glucose monitoring (CGM) data. GRI is divided into five separate risk zones (from lowest to highest: A-E). In this study, the effect of the advanced hybrid closed loop (AHCL) system on GRI and COGI in children with type 1 diabetes was evaluated
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A Systematic Review of Exocrine Pancreatic Insufficiency Prevalence and Treatment in Type 1 and Type 2 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-07-13 Dana M Lewis
Type 1 diabetes and type 2 diabetes have high rates of associated exocrine pancreatic insufficiency (EPI). This review evaluated the current evidence on prevalence and treatment of EPI in type 1 and type 2 diabetes and compared general population prevalence rates of EPI and prevalence of other common gastrointestinal conditions such as celiac disease and gastroparesis based on within-diabetes rates
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A Comparison of Faster Insulin Aspart with Standard Insulin Aspart Using Hybrid Automated Insulin Delivery System in Active Children and Adolescents with Type 1 Diabetes: A Randomized Double-Blind Crossover Trial. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-09-01 Klemen Dovc,Simon Bergford,Elke Fröhlich-Reiterer,Dessi P Zaharieva,Nejka Potocnik,Alexander Müller,Ziva Lenarcic,Peter Calhoun,Maria Fritsch,Harald Sourij,Natasa Bratina,Craig Kollman,Tadej Battelino
Objective: To evaluate the use of faster acting (FIA) and standard insulin aspart (SIA) with hybrid automated insulin delivery (AID) in active youth with type 1 diabetes. Research Design and Methods: In this double-blind multinational randomized crossover trial, 30 children and adolescents with type 1 diabetes (16 females; aged 15.0 ± 1.7 years; baseline HbA1c 7.5% ± 0.9% [58 ± 9.8 mmol/mol]) underwent
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Continuous Glucose Monitoring by Insulin-Treated Pilots Flying Commercial Aircraft Within the ARA.MED.330 Diabetes Protocol: A Preliminary Feasibility Study. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-08-01 Gillian L Garden,Fariba Shojaee-Moradie,Ewan J Hutchison,Brian M Frier,Kenneth M Shaw,Simon R Heller,Gerd Koehler,Julia K Mader,Declan Maher,Graham A Roberts,David L Russell-Jones
Background and Aims: A preliminary study compared the use of continuous glucose monitoring (CGM) with the use of self-monitored blood glucose (SMBG) by aircraft pilots with insulin-treated diabetes in the United Kingdom, Ireland, and Austria, certified to fly commercial aircraft within the European Aviation Safety Agency ARA.MED.330 protocol. Methods: SMBG and simultaneous interstitial glucose measurements
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Closed-Loop from Diagnosis of Type 1 Diabetes in Children and Young People. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-07-12 Atrayee Ghatak,Charlotte K Boughton,Janet M Allen,Julia Ware,Malgorzata E Wilinska,Sara Hartnell,Ajay Thankamony,Tabitha Randell,Rachel E J Besser,Daniela Elleri,Nicola Trevelyan,Fiona M Campbell,Roman Hovorka
Not applicable.
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Under-Representation of Diverse Populations and Glycemic Outcomes in Major Clinical Trials of Automated Insulin Delivery. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-07-11 José García-Tirado,Orianne Villard,Megan Hall,Alessandro Bisio,Linda Gonder-Frederick
Individuals with type 1 diabetes of minoritized race-ethnicities and low-socioeconomic status (SES) do not access nor use automated insulin delivery (AID) technology at equal rates compared to their non-Hispanic White (NHW) and high SES counterparts. Using four AID trials (n=292), we ran linear mixed models to compare glycemic outcomes using race/ethnicity, education, and income. These trials overrepresented
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Unannounced Meal Challenges Using an Advanced Hybrid Closed-Loop System. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-09-01 Roy Shalit,Noga Minsky,Maya Laron-Hirsh,Ohad Cohen,Natalie Kurtz,Anirban Roy,Benyamin Grosman,Andrea Benedetti,Amir Tirosh
Background: The advanced hybrid closed-loop (AHCL) algorithm combines automated basal rates and corrections yet requires meal announcement for optimal outcomes. We aimed to compare the performance of the MiniMed™ 780G AHCL algorithm with and without meal announcement. Methods: In a single-arm study involving 14 adults with type 1 diabetes, we evaluated the safety and efficacy of AHCL when meals were
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Association Between Continuous Glucose Monitoring-Derived Glycemia Risk Index and Albuminuria in Type 2 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-08-29 Jee Hee Yoo,Ji Yoon Kim,Jae Hyeon Kim
Background: The glycemia risk index (GRI) is a new composite metric derived from continuous glucose monitoring (CGM) data to assess the quality of glycemia. This study investigates the association between the GRI and albuminuria. Methods: Professional CGM and urinary albumin-to-creatinine ratio (UACR) data from 866 individuals with type 2 diabetes were retrospectively reviewed. Albuminuria and macroalbuminuria
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Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-08-17 Daniel I Bisno,Mark W Reid,Elizabeth A Pyatak,Jaquelin Flores Garcia,Elizabeth Salcedo-Rodriguez,Alejandra Torres Sanchez,D Steven Fox,Sarah Hiyari,Jennifer L Fogel,Ian Marshall,Gloria Bachmann,Jennifer K Raymond
Background: Adolescents and young adults (AYA) from diverse and marginalized backgrounds with type 1 diabetes (T1D) generally have higher hemoglobin A1c (HbA1c) levels and less frequent continuous glucose monitor (CGM) use than AYA from more privileged backgrounds. Further, scant data address the impact of virtual peer groups (VPG) on health-related outcomes for ethnically and racially diverse AYA
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Diabetic Hand Disease Associated with Long-Standing Operation of an Insulin Pump. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-07-17 Shannon L Christen,Robert H Eckel,W Timothy Garvey,Michael Gordon,Irl B Hirsch
This case report describes a rare complication of insulin pump therapy in a 74-year-old male patient with a long-standing history of type 1 diabetes. The patient developed destruction of the left index finger metacarpal-phalangeal (MCP) joint after years of repeated use of the insulin pump's touch screen and "T" button, resulting in significant pain and limited hand mobility. Radiographic findings
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An Occlusive Hydrocolloid-Based Patch Is Effective, Feasible, and Safe As a Treatment of Irritant Contact Dermatitis due to Diabetes Devices in Children and Adolescents with Type 1 Diabetes. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-06-27 Anna Korsgaard Berg,Mads Holmegaard Sørensen,Henrik Sigaard Knoth,Jannet Svensson
Irritant contact dermatitis (ICD) occurs frequently with the use of diabetes devices, but no guidelines for treatment exist. Since subsequent devices need intact skin for intended use, quick healing is crucial. Normal wound healing is expected to be 7-10 days. This was a single-center cross-over study that investigated the effectiveness of an occlusive hydrocolloid-based patch versus nonocclusive treatment
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PIONEER PLUS: An Opportunity Knocking the Door for the Management of Diabesity. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-07-21 Neeraj Mittal,Sanjay Kumar Bhadada
NA.
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The Type 1 Diabetes and EXercise Initiative: Predicting Hypoglycemia Risk During Exercise for Participants with Type 1 Diabetes Using Repeated Measures Random Forest. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-06-20 Simon Bergford,Michael C Riddell,Peter G Jacobs,Zoey Li,Robin L Gal,Mark A Clements,Francis J Doyle,Corby K Martin,Susana R Patton,Jessica R Castle,Melanie B Gillingham,Roy W Beck,Michael R Rickels,Peter Calhoun
Objective: Exercise is known to increase the risk for hypoglycemia in type 1 diabetes (T1D) but predicting when it may occur remains a major challenge. The objective of this study was to develop a hypoglycemia prediction model based on a large real-world study of exercise in T1D. Research Design and Methods: Structured study-specified exercise (aerobic, interval, and resistance training videos) and
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Ultrasound Detected Subcutaneous Changes in a Pediatric Cohort After Initiation of a New Insulin Pump or Glucose Sensor. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-06-06 Fiona M W Sørensen,Jannet Svensson,Christina Kinnander,Anna K Berg
Objective: This study examined subcutaneous tissue changes at sites used by continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM), and tested whether these changes, if any, were associated with glycated hemoglobin (HbA1c). Research Design and Methods: This prospective study investigated recently used CSII or CGM sites in 161 children and adolescents during the first
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Advancements in Diabetes Technology Are Outpacing the Evidence. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-06-01 Michael Rickson,Eugene E Wright,Anila Bindal,Laith Ghonim
Diabetes technologies such as continuous glucose monitoring (CGM) continue to evolve at an increasingly rapid pace. Seventeen new CGM devices have been introduced to the market during the past decade. The introduction of each new system is supported by well-designed randomized controlled trials and real-world retrospective and prospective studies. However, translation of the evidence into clinical
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Continuous Glucose Monitoring Use in Older Adults for Optimal Diabetes Management. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-06-01 Medha N Munshi
More than one third of U.S. adults age ≥65 years have diabetes. According to early studies, 61% of all diabetes-related costs in the United States were for individuals age ≥65 years, and more than half of these costs attributable to treating diabetes-related complications. Numerous studies have shown that use of continuous glucose monitoring (CGM) has been shown to improve glycemic control and reduce
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Prevalence, Cost, and Burden of Diabetic Ketoacidosis. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-06-01 Naunihal Virdi,Yeesha Poon,Richard Abaniel,Richard M Bergenstal
Diabetic ketoacidosis (DKA) is a life-threatening complication, which is most common in individuals with type 1 diabetes (T1D) and is a significant risk for morbidity and mortality, and it is an economic burden on individuals, health care systems, and payers. Younger children, minority ethnic groups, and those with limited insurance are at the greatest risk for presentation of DKA at T1D diagnosis
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Practical Application of Continuous Glucose Monitoring in Clinical Practice: Case Studies. Diabetes Technol. Ther. (IF 5.4) Pub Date : 2023-06-01 Jeff Unger,Denise R Franco
The prevalence of diabetes continues to rise exponentially and contributes significantly to morbidity, mortality, and health care resource utilization. Individuals with diabetes have adopted continuous glucose monitoring (CGM) as their preferred method for glucose measurement. Primary care clinicians should become proficient in utilizing this technology in their practices. This case-based article provides