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[PMID]:29411030
[Au] Autor:Karges B; Binder E; Rosenbauer J
[Ad] Endereço:Division of Endocrinology and Diabetes, RWTH Aachen University, Aachen, Germany.
[Ti] Título:Complications With Insulin Pump Therapy vs Insulin Injection Therapy-Reply.
[So] Source:JAMA;319(5):503-504, 2018 02 06.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Sistemas de Infusão de Insulina
Insulina
[Mh] Termos MeSH secundário: Diabetes Mellitus Tipo 1
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Insulin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20357


  2 / 4523 MEDLINE  
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[PMID]:29411027
[Au] Autor:Shah VN
[Ad] Endereço:Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora.
[Ti] Título:Complications With Insulin Pump Therapy vs Insulin Injection Therapy.
[So] Source:JAMA;319(5):502-503, 2018 02 06.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Sistemas de Infusão de Insulina
Insulina
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Insulin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20345


  3 / 4523 MEDLINE  
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[PMID]:29297058
[Au] Autor:Hampton T
[Ti] Título:Smart Artificial Beta Cells May Help Treat Diabetes.
[So] Source:JAMA;319(1):11-12, 2018 Jan 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Diabetes Mellitus Experimental/terapia
Sistemas de Infusão de Insulina
Células Secretoras de Insulina
[Mh] Termos MeSH secundário: Animais
Glicemia
Diabetes Mellitus/terapia
Seres Humanos
Células Secretoras de Insulina/ultraestrutura
Camundongos
Microscopia Eletrônica de Varredura
[Pt] Tipo de publicação:NEWS
[Nm] Nome de substância:
0 (Blood Glucose)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.12856


  4 / 4523 MEDLINE  
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[PMID]:29080577
[Au] Autor:McCrea DL
[Ad] Endereço:Department of Acute and Continuing Care, University of Texas Health Science Center at Houston, School of Nursing, 6901 Bertner Avenue, Suite 695, Houston, TX 77030, USA. Electronic address: Deborah.L.McCrea@uth.tmc.edu.
[Ti] Título:A Primer on Insulin Pump Therapy for Health Care Providers.
[So] Source:Nurs Clin North Am;52(4):553-564, 2017 Dec.
[Is] ISSN:1558-1357
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:An estimated 1 million people use an insulin pump to manage their diabetes. Few medical professionals understand or feel comfortable caring for people who use an insulin pump. This article will help the medical professional understand the reasons why the insulin pump helps the user to achieve better glycemic control, have more flexibility, and enjoy a better quality of life. Additionally, this article discusses the advantages, disadvantages, candidate selection, contraindications, basic functions, and troubleshooting of the insulin pump.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/tratamento farmacológico
Hipoglicemiantes/administração & dosagem
Bombas de Infusão Implantáveis/estatística & dados numéricos
Sistemas de Infusão de Insulina/estatística & dados numéricos
Insulina/administração & dosagem
[Mh] Termos MeSH secundário: Gerenciamento Clínico
Seres Humanos
Atenção Primária à Saúde/organização & administração
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:171030
[St] Status:MEDLINE


  5 / 4523 MEDLINE  
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[PMID]:29049584
[Au] Autor:Karges B; Schwandt A; Heidtmann B; Kordonouri O; Binder E; Schierloh U; Boettcher C; Kapellen T; Rosenbauer J; Holl RW
[Ad] Endereço:Division of Endocrinology and Diabetes, Medical Faculty, RWTH Aachen University, Aachen, Germany.
[Ti] Título:Association of Insulin Pump Therapy vs Insulin Injection Therapy With Severe Hypoglycemia, Ketoacidosis, and Glycemic Control Among Children, Adolescents, and Young Adults With Type 1 Diabetes.
[So] Source:JAMA;318(14):1358-1366, 2017 10 10.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Insulin pump therapy may improve metabolic control in young patients with type 1 diabetes, but the association with short-term diabetes complications is unclear. Objective: To determine whether rates of severe hypoglycemia and diabetic ketoacidosis are lower with insulin pump therapy compared with insulin injection therapy in children, adolescents, and young adults with type 1 diabetes. Design, Setting, and Participants: Population-based cohort study conducted between January 2011 and December 2015 in 446 diabetes centers participating in the Diabetes Prospective Follow-up Initiative in Germany, Austria, and Luxembourg. Patients with type 1 diabetes younger than 20 years and diabetes duration of more than 1 year were identified. Propensity score matching and inverse probability of treatment weighting analyses with age, sex, diabetes duration, migration background (defined as place of birth outside of Germany or Austria), body mass index, and glycated hemoglobin as covariates were used to account for relevant confounders. Exposures: Type 1 diabetes treated with insulin pump therapy or with multiple (≥4) daily insulin injections. Main Outcomes and Measures: Primary outcomes were rates of severe hypoglycemia and diabetic ketoacidosis during the most recent treatment year. Secondary outcomes included glycated hemoglobin levels, insulin dose, and body mass index. Results: Of 30 579 patients (mean age, 14.1 years [SD, 4.0]; 53% male), 14 119 used pump therapy (median duration, 3.7 years) and 16 460 used insulin injections (median duration, 3.6 years). Patients using pump therapy (n = 9814) were matched with 9814 patients using injection therapy. Pump therapy, compared with injection therapy, was associated with lower rates of severe hypoglycemia (9.55 vs 13.97 per 100 patient-years; difference, -4.42 [95% CI, -6.15 to -2.69]; P < .001) and diabetic ketoacidosis (3.64 vs 4.26 per 100 patient-years; difference, -0.63 [95% CI, -1.24 to -0.02]; P = .04). Glycated hemoglobin levels were lower with pump therapy than with injection therapy (8.04% vs 8.22%; difference, -0.18 [95% CI, -0.22 to -0.13], P < .001). Total daily insulin doses were lower for pump therapy compared with injection therapy (0.84 U/kg vs 0.98 U/kg; difference, -0.14 [-0.15 to -0.13], P < .001). There was no significant difference in body mass index between both treatment regimens. Similar results were obtained after propensity score inverse probability of treatment weighting analyses in the entire cohort. Conclusions and Relevance: Among young patients with type 1 diabetes, insulin pump therapy, compared with insulin injection therapy, was associated with lower risks of severe hypoglycemia and diabetic ketoacidosis and with better glycemic control during the most recent year of therapy. These findings provide evidence for improved clinical outcomes associated with insulin pump therapy compared with injection therapy in children, adolescents, and young adults with type 1 diabetes.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/tratamento farmacológico
Cetoacidose Diabética/induzido quimicamente
Hipoglicemia/induzido quimicamente
Hipoglicemiantes/efeitos adversos
Sistemas de Infusão de Insulina
Insulina/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Glicemia/análise
Criança
Pré-Escolar
Estudos de Coortes
Diabetes Mellitus Tipo 1/sangue
Feminino
Hemoglobina A Glicada/análise
Seres Humanos
Hipoglicemiantes/administração & dosagem
Lactente
Injeções
Insulina/administração & dosagem
Sistemas de Infusão de Insulina/efeitos adversos
Masculino
Análise de Regressão
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Glycated Hemoglobin A); 0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.13994


  6 / 4523 MEDLINE  
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[PMID]:28666360
[Au] Autor:Brown SA; Breton MD; Anderson SM; Kollar L; Keith-Hynes P; Levy CJ; Lam DW; Levister C; Baysal N; Kudva YC; Basu A; Dadlani V; Hinshaw L; McCrady-Spitzer S; Bruttomesso D; Visentin R; Galasso S; Del Favero S; Leal Y; Boscari F; Avogaro A; Cobelli C; Kovatchev BP
[Ad] Endereço:Center for Diabetes Technology, Division of Endocrinology, University of Virginia, Charlottesville, Virginia 22903.
[Ti] Título:Overnight Closed-Loop Control Improves Glycemic Control in a Multicenter Study of Adults With Type 1 Diabetes.
[So] Source:J Clin Endocrinol Metab;102(10):3674-3682, 2017 Oct 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Context: Closed-loop control (CLC) for the management of type 1 diabetes (T1D) is a novel method for optimizing glucose control, and strategies for individualized implementation are being developed. Objective: To analyze glycemic control in an overnight CLC system designed to "reset" the patient to near-normal glycemic targets every morning. Design: Randomized, crossover, multicenter clinical trial. Participants: Forty-four subjects with T1D requiring insulin pump therapy. Intervention: Sensor-augmented pump therapy (SAP) at home vs 5 nights of CLC (active from 23:00 to 07:00) in a supervised outpatient setting (research house or hotel), with a substudy of 5 nights of CLC subsequently at home. Main Outcome Measure: The percentage of time spent in the target range (70 to 180 mg/dL measured using a continuous glucose monitor). Results: Forty subjects (age, 45.5 ± 9.5 years; hemoglobin A1c, 7.4% ± 0.8%) completed the study. The time in the target range (70 to 180 mg/dL) significantly improved in CLC vs SAP over 24 hours (78.3% vs 71.4%; P = 0.003) and overnight (85.7% vs 67.6%; P < 0.001). The time spent in a hypoglycemic range (<70 mg/dL) decreased significantly in the CLC vs SAP group over 24 hours (2.5% vs 4.3%; P = 0.002) and overnight (0.9% vs 3.2%; P < 0.001). The mean glucose level at 07:00 was lower with CLC than with SAP (123.7 vs 145.3 mg/dL; P < 0.001). The substudy at home, involving 10 T1D subjects, showed similar trends with an increased time in target (70 to 180 mg/dL) overnight (75.2% vs 62.2%; P = 0.07) and decreased time spent in the hypoglycemic range (<70 mg/dL) overnight in CLC vs SAP (0.6% vs 3.7%; P = 0.03). Conclusion: Overnight-only CLC increased the time in the target range over 24 hours and decreased the time in hypoglycemic range over 24 hours in a supervised outpatient setting. A pilot extension study at home showed a similar nonsignificant trend.
[Mh] Termos MeSH primário: Glicemia/efeitos dos fármacos
Ritmo Circadiano
Diabetes Mellitus Tipo 1/tratamento farmacológico
Hipoglicemiantes/administração & dosagem
Sistemas de Infusão de Insulina
Insulina/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Glicemia/análise
Automonitorização da Glicemia/instrumentação
Automonitorização da Glicemia/métodos
Ritmo Circadiano/efeitos dos fármacos
Estudos Cross-Over
Diabetes Mellitus Tipo 1/sangue
Feminino
Hemoglobina A Glicada
Seres Humanos
Hipoglicemiantes/efeitos adversos
Insulina/efeitos adversos
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Glycated Hemoglobin A); 0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170702
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2017-00556


  7 / 4523 MEDLINE  
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[PMID]:28591776
[Au] Autor:Haymond MW; DuBose SN; Rickels MR; Wolpert H; Shah VN; Sherr JL; Weinstock RS; Agarwal S; Verdejo AS; Cummins MJ; Newswanger B; Beck RW; T1D Exchange Mini-dose Glucagon Study Group
[Ad] Endereço:Baylor College of Medicine, Houston, Texas 77030.
[Ti] Título:Efficacy and Safety of Mini-Dose Glucagon for Treatment of Nonsevere Hypoglycemia in Adults With Type 1 Diabetes.
[So] Source:J Clin Endocrinol Metab;102(8):2994-3001, 2017 Aug 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Context: Standard treatment of hypoglycemia is oral carbohydrate, but it often results in hyperglycemia and entails extra caloric intake. Objective: To evaluate low-dose glucagon to treat mild hypoglycemia in ambulatory adults with type 1 diabetes (T1D). Design: Randomized crossover trial (two 3-week periods). Setting: Five U.S. diabetes clinics. Patients: Twenty adults with T1D using an insulin pump and continuous glucose monitor (CGM) and experiencing frequent mild hypoglycemia. Intervention: Nonaqueous mini-dose glucagon (MDG) (150 µg) to treat nonsevere hypoglycemia. Main Outcome Measures: Successful treatment was defined as blood glucose (BG) ≥50 mg/dL 15 minutes and ≥70 mg/dL 30 minutes after intervention, on the study meter. Two authors, blinded to treatment arm, independently judged each event as a clinical success or failure. Results: Sixteen participants (mean age 39 years, 75% female, mean diabetes duration 23 years, mean hemoglobin A1c 7.2%) had 118 analyzable events with initial BG of 50 to 69 mg/dL. Successful treatment criteria were met for 58 (94%) of 62 events during the MDG period and 53 (95%) of 56 events during the glucose tablets (TABS) period (adjusted P = 0.99). Clinical assessments of success for these events were 97% and 96%, respectively. CGM-measured time in range did not differ between treatment groups during the 2 hours after events, but TABS resulted in higher maximum glucose (116 vs 102 mg/dL; P = 0.01) over the first hour. Conclusions: Low-dose glucagon can successfully treat mild hypoglycemia and may be a useful alternative to treatment with oral carbohydrate when trying to avoid unnecessary caloric intake.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/tratamento farmacológico
Glucagon/administração & dosagem
Hormônios/administração & dosagem
Hipoglicemia/tratamento farmacológico
Hipoglicemiantes/efeitos adversos
Insulina/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Glicemia/metabolismo
Automonitorização da Glicemia
Estudos Cross-Over
Feminino
Seres Humanos
Hipoglicemia/induzido quimicamente
Hipoglicemia/metabolismo
Sistemas de Infusão de Insulina
Masculino
Meia-Idade
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Hormones); 0 (Hypoglycemic Agents); 0 (Insulin); 9007-92-5 (Glucagon)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2017-00591


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[PMID]:28530380
[Au] Autor:Choby B
[Ad] Endereço:University of Tennessee Health Science Center Department of Medical Education, 920 Madison Building 7th floor, Memphis, TN 3816-30000.
[Ti] Título:Diabetes Update: Primary Care of Patients With Type 1 Diabetes.
[So] Source:FP Essent;456:11-19, 2017 May.
[Is] ISSN:2159-3000
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The incidence and prevalence of type 1 diabetes (T1D) are increasing among white, black, Hispanic, and Asian individuals in the United States. Children often present with acute symptoms, including severe polyuria, polydipsia, weight loss, and ketonemia; adults may develop more gradual symptoms that initially appear similar to those of type 2 diabetes (T2D). Latent autoimmune diabetes of adults and maturity-onset diabetes of the young are conditions that may be confused with T1D, although they are actually more closely related to T2D. Insulin analogues, continuous blood glucose level monitoring, and insulin pumps provide increased flexibility in T1D management. Noninsulin therapies also are being studied for management of T1D and T2D. The tailoring care of plans to the developmental age of each patient is critical to provide necessary screening and prevent common complications.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/tratamento farmacológico
Medicina de Família e Comunidade
Hipoglicemia/prevenção & controle
Hipoglicemiantes/administração & dosagem
Insulina/administração & dosagem
[Mh] Termos MeSH secundário: Complicações do Diabetes/diagnóstico
Complicações do Diabetes/etiologia
Complicações do Diabetes/terapia
Diabetes Mellitus Tipo 1/epidemiologia
Exercício
Seres Humanos
Hipoglicemia/induzido quimicamente
Hipoglicemia/terapia
Sistemas de Infusão de Insulina
Cuidado Pré-Concepcional
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170721
[Lr] Data última revisão:
170721
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170523
[St] Status:MEDLINE


  9 / 4523 MEDLINE  
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[PMID]:28514824
[Au] Autor:Biester T; Biester S; Kordonouri O; Danne T
[Ti] Título:[Attaching an Insulin Pump].
[Ti] Título:Anlage einer Insulinpumpe..
[So] Source:Dtsch Med Wochenschr;142(10):758-762, 2017 May.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/tratamento farmacológico
Hipoglicemiantes
Sistemas de Infusão de Insulina
Insulina
[Mh] Termos MeSH secundário: Cateteres
Seres Humanos
Hipoglicemiantes/administração & dosagem
Hipoglicemiantes/uso terapêutico
Insulina/administração & dosagem
Insulina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-119235


  10 / 4523 MEDLINE  
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[PMID]:28514821
[Au] Autor:Biester T; Danne T; Kordonouri O
[Ti] Título:[The Way to Closed Loop - Dream and Reality].
[Ti] Título:Auf dem Weg zum Closed-Loop ­ Ziel und Realität..
[So] Source:Dtsch Med Wochenschr;142(10):731-736, 2017 May.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:An old dream of patients with type 1 diabetes and medical teams alike is a fully automated insulin therapy. Available sensor-augmented insulin-pumps are able to intervene in insulin therapy by reducing the dose. Aim of several studies is to add an algorithm to the interaction of pump and sensor, so that insulin doses can be regulated fully automatically. Totally closed loop systems are currently not yet available for outpatient use. Hybrid closed loop systems have been approved in the US. They can improve the metabolic status of patients with type 1 diabetes. Risks are similar to sensor-augmented insulin-pump therapy. Patients' detailed education will continue to be essential for success.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/tratamento farmacológico
Sistemas de Infusão de Insulina
[Mh] Termos MeSH secundário: Algoritmos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-119492



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