Experimental and Clinical Endocrinology & Diabetes, Год журнала: 2023, Номер 131(01/02), С. 51 - 60
Опубликована: Янв. 13, 2023
Notice of Update The DDG practice recommendations are updated regularly during the second half calendar year. Please ensure that you read and cite respective current version.
Язык: Английский
Pediatric Diabetes, Год журнала: 2022, Номер 23(8), С. 1341 - 1372
Опубликована: Дек. 1, 2022
Язык: Английский
Процитировано
83
Diabetes Care, Год журнала: 2023, Номер 46(4), С. 704 - 713
Опубликована: Фев. 7, 2023
Maintenance of glycemic control during and after exercise remains a major challenge for individuals with type 1 diabetes. Glycemic responses to may differ by (aerobic, interval, or resistance), the effect activity on unclear.The Type Diabetes Exercise Initiative (T1DEXI) was real-world study at-home exercise. Adult participants were randomly assigned complete six structured aerobic, resistance sessions over 4 weeks. Participants self-reported nonstudy exercise, food intake, insulin dosing (multiple daily injection [MDI] users) using custom smart phone application provided pump (pump users), heart rate, continuous glucose monitoring data.A total 497 adults diabetes (mean age ± SD 37 14 years; mean HbA1c 6.6 0.8% [49 8.7 mmol/mol]) aerobic (n = 162), interval 165), 170) analyzed. The (± SD) change in -18 39, -14 32, -9 36 mg/dL resistance, respectively (P < 0.001), similar results closed-loop, standard pump, MDI users. Time range 70-180 (3.9-10.0 mmol/L) higher 24 h when compared days without 76 20% vs. 70 23%; P 0.001).Adults experienced largest drop level followed regardless delivery modality. Even well-controlled diabetes, contributed clinically meaningful improvement time but have slightly increased below range.
Язык: Английский
Процитировано
79
Current Topics in Diabetes, Год журнала: 2023, Номер 3(1), С. 1 - 133
Опубликована: Янв. 30, 2023
Conflict of
Язык: Английский
Процитировано
52
Nature Reviews Endocrinology, Год журнала: 2022, Номер 19(2), С. 98 - 111
Опубликована: Окт. 31, 2022
Язык: Английский
Процитировано
62
IEEE Transactions on Biomedical Engineering, Год журнала: 2021, Номер 68(7), С. 2251 - 2260
Опубликована: Янв. 5, 2021
Continuous glucose monitoring (CGM) enables prediction of the future concentration (GC) trajectory for making informed diabetes management decisions. The values are affected by various physiological and metabolic variations, such as physical activity (PA) acute psychological stress (APS), in addition to meals insulin. In this work, we extend our adaptive modeling framework incorporate effects PA APS on GC predictions.A wristband conducive use free-living ambulatory people is used. measured variables analyzed generate new quantifiable input features APS. Machine learning techniques estimate type intensity when they occur individually concurrently. Variables quantifying characteristics both integrated exogenous inputs an system identification technique enhancing accuracy predictions. Data from clinical experiments illustrate improvement accuracy.The average mean absolute error (MAE) one-hour-ahead predictions with testing data decreases 35.1 31.9 mg/dL (p-value = 0.01) inclusion information, it 16.9 14.2 0.006) information.The first-ever model developed that incorporates measures improve accuracy.Modeling will enable meal, insulin dosing
Язык: Английский
Процитировано
55
Current Topics in Diabetes, Год журнала: 2022, Номер 2(1), С. 1 - 130
Опубликована: Янв. 30, 2022
2022 Guidelines on the management of patients with diabetes A position Diabetes Poland Rules for diagnosing carbohydrate metabolism disordersKey recommendations• Blood sugar tests early detection prediabetes/type 2 should be performed people over 45, as well younger overweight or obese if there is at least one additional risk factor diabetes.[B]• Women not previously diagnosed undergo an oral glucose tolerance test between 24 th and 28 week pregnancy to diagnose gestational diabetes.[A]• Diagnosing in children during first 9 weeks after birth requires genetic neonatal diabetes.[a]• Patients cystic fibrosis aged 10 above each year diabetes.[a]Diabetes a group metabolic diseases characterised by hyperglycaemia resulting from defect insulin secretion and/or activity.Chronic associated damage, dysfunction failure various organs, especially eyes, kidneys, nerves, heart blood vessels. I. Symptoms indicative potentialdiabetes significant hyperglycaemia:• increased diuresis (polyuria);• thirst;• loss weight explained intentional dieting;• other, less typical symptoms: weakness sleepiness, purulent skin lesions inflammation genitourinary organs. II. disorders:• symptoms occur, random performed, result ≥ 200 mg/dl (≥ 11.1 mmol/l) constituting grounds diabetes;2022 Prevention delay Key pre-diabetes given recommendations healthy lifestyle (physical activity 150 min/week; case patients, reduction 7% maintenance) information effectiveness such measures preventing development Apart modification lifestyle, pharmacological prevention form metformin considered pre-diabetic concomitant IFG IGT body mass index (BMI) 35 kg/m under 60 years age, women history mellitus.[a]• Screening using fasting glucose, glucose.[c] Type 1 diabetesCurrently, no effective method type either general population at-risk people.Type 1. test.2. Risk factors (see chapter 1). Review delaying diabetes:2022 Monitoring Most therapy multiple daily injections self-monitor (SMBG) both before meals, bedtime, planned physical activity, when low suspected, activities where hypoglycaemia particularly dangerous (e.g.driving).[B] Setting objectives managementKey In individuals diabetes, overall target glycaemic control expressed HbA 1c level more than 7.0% (53 mmol/mol).[a]• LDL fraction cholesterol 55 (less 1.4mmol/l) 50% baseline very high cardiovascular LDL-C concentration 70 (1.8 levels 100 (2.6 moderate (young yrs.with without chronic complications other below 50 duration years, factors).[a]• Recommended arterial pressure: 130/80 mm Hg. [a]
Язык: Английский
Процитировано
29
Diabetes Care, Год журнала: 2023, Номер 47(1), С. 132 - 139
Опубликована: Ноя. 3, 2023
Data from the Type 1 Diabetes Exercise Initiative Pediatric (T1DEXIP) study were evaluated to understand glucose changes during activity and identify factors that may influence changes.In this real-world observational study, adolescents with type diabetes self-reported physical activity, food intake, insulin dosing (multiple-daily injection users) using a smartphone application. Heart rate continuous monitoring data collected, as well pump downloads.Two hundred fifty-one (age 14 ± 2 years [mean SD]; HbA1c 7.1 1.3% [54 14.2 mmol/mol]; 42% female) logged 3,738 activities over ∼10 days of observation. Preactivity was 163 66 mg/dL (9.1 3.7 mmol/L), dropping 148 (8.2 mmol/L) by end activity; median duration 40 min (20, 75 [interquartile range]) mean peak heart 109 16 bpm 130 21 bpm. Drops in greater those lower baseline levels (P = 0.002), shorter disease 0.02), less hypoglycemia fear 0.04), BMI 0.05). Event-level predictors drops included self-classified "noncompetitive" activities, on board >0.05 units/kg body mass, already prior preactivity >150 (>8.3 time 70-180 >70% 24 h before (all P < 0.001).Participant-level event-level can help predict magnitude drop youth diabetes. A better appreciation these improve decision support tools self-management strategies reduce activity-induced dysglycemia active living disease.
Язык: Английский
Процитировано
18
Diabetologia, Год журнала: 2024, Номер unknown
Опубликована: Дек. 10, 2024
Язык: Английский
Процитировано
7
Diabetes Care, Год журнала: 2021, Номер 45(1), С. 194 - 203
Опубликована: Ноя. 17, 2021
OBJECTIVE To compare glucose control with hybrid closed-loop (HCL) when challenged by high intensity exercise (HIE), moderate (MIE), and resistance (RE) while profiling counterregulatory hormones, lactate, ketones, kinetic data in adults type 1 diabetes. RESEARCH DESIGN AND METHODS This study was an open-label multisite randomized crossover trial. Adults diabetes undertook 40 min of HIE, MIE, RE random order using HCL (Medtronic MiniMed 670G) a temporary target set 2 h prior to during 15 g carbohydrates if pre-exercise <126 mg/dL prevent hypoglycemia. Primary outcome median (interquartile range) continuous monitoring time-in-range (TIR; 70–180 mg/dL) for 14 post–exercise commencement. Accelerometer venous glucose, hormones were measured 280 RESULTS Median TIR 81% (67, 93%), 91% (80, 94%), 80% (73, 89%) 0–14 commencement RE, respectively (n = 30), no difference between types (MIE vs. HIE; P 0.11, MIE 0.11; HIE 0.90). Time-below-range 0% all bouts. For compared there greater increases, respectively, noradrenaline (P 0.01 0.004), cortisol < 0.001 0.001), lactate ≤ heart rate 0.007 0.015). During increases growth hormone 0.024). CONCLUSIONS Under controlled conditions, provided satisfactory type. Lactate, differentiate exercise, their measurement may help inform insulin needs exercise. However, potential utility as modulators dosing will be limited the pharmacokinetics subcutaneous delivery.
Язык: Английский
Процитировано
38
Applied System Innovation, Год журнала: 2020, Номер 3(3), С. 31 - 31
Опубликована: Июль 28, 2020
This paper presents a comprehensive survey about the fundamental components of artificial pancreas (AP) system including insulin administration and delivery, glucose measurement (GM), control strategies/algorithms used for type 1 diabetes mellitus (T1DM) treatment control. Our main focus is on T1DM that emerges due to pancreas’s failure produce sufficient loss beta cells (β-cells). We discuss various delivery methods physiological methods, open-loop, closed-loop schemes. Furthermore, we report several factors such as hyperglycemia, hypoglycemia, many other physical need be considered while infusing in human body via AP systems. three prominent algorithms proportional-integral- derivative (PID), fuzzy logic, model predictive, which have been clinically evaluated all shown promising results. In addition, linear non-linear infusion schemes formally discussed. To best our knowledge, this first work systematically covers recent developments with solid foundation future studies field.
Язык: Английский
Процитировано
35