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1.
J Diabetes Sci Technol ; 17(5): 1337-1363, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37542367

RESUMEN

BACKGROUND: The use of continuous subcutaneous insulin infusion (CSII) therapy in pregnancies affected by pregestational diabetes mellitus (DM) has generated mixed outcome data worthy of further investigation. This systematic review and meta-analysis aims to evaluate clinical outcomes associated with CSII versus multiple daily injections (MDIs) in pregnant persons with pregestational DM. METHODS: A predefined, systematic, librarian-assisted search of MEDLINE (PubMed), Embase, Cochrane Library, Scopus, ClinicalTrials.gov, and World Health Organization International Clinical Trial Registry Platform (published from 2010 to 2022) yielded 3003 studies describing pregnancy outcomes associated with CSII and/or MDI for pregestational DM. The primary exposure was mode of insulin administration, with cesarean delivery and neonatal hypoglycemia as the primary maternal and neonatal outcomes, respectively. Secondary outcomes included hypertensive disorders of pregnancy, first and third-trimester glycemic control, large-for-gestational age (LGA) neonate, preterm birth, neonatal intensive care unit admission, need for respiratory support, hyperbilirubinemia, 5-minute Apgar <7, shoulder dystocia, and perinatal mortality. We calculated pooled odds ratios (OR) with 95% confidence intervals (CI) using random-effects models. RESULTS: Among 39 eligible studies, 39% of the 5518 pregnancies included were exposed to CSII. Odds of cesarean delivery were higher with CSII (20 studies: 63% vs 56%, odds ratio [OR] 1.3 [95% confidence interval (CI) 1.2-1.5]), but we did not identify a difference in the odds of neonatal hypoglycemia (23 studies: 31% vs 34%, OR 1.1 [95% CI 0.9-1.5]). Among secondary outcomes, only the odds of LGA (20 studies: 47% vs 38%, OR 1.4 [95% CI 1.2-1.6]) were higher in individuals using CSII versus MDI. CONCLUSIONS: Use of CSII (vs MDI) for pregestational DM in pregnancy is associated with higher odds of cesarean delivery and delivery of an LGA neonate. Further evaluation of how CSII use may influence neonatal size and delivery route is warranted.


Asunto(s)
Diabetes Mellitus Tipo 1 , Hipoglucemia , Embarazo en Diabéticas , Nacimiento Prematuro , Embarazo , Femenino , Recién Nacido , Humanos , Insulina/uso terapéutico , Hipoglucemiantes/uso terapéutico , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Embarazo en Diabéticas/tratamiento farmacológico , Hemoglobina Glucada , Nacimiento Prematuro/tratamiento farmacológico , Insulina Regular Humana/uso terapéutico , Hipoglucemia/inducido químicamente , Hipoglucemia/epidemiología , Hipoglucemia/tratamiento farmacológico , Infusiones Subcutáneas , Inyecciones Subcutáneas , Sistemas de Infusión de Insulina
2.
J Diabetes Sci Technol ; : 19322968231171399, 2023 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-37102472

RESUMEN

Type 2 diabetes (T2D) is a risk factor for cognitive decline. In neurodegenerative disease research, remote digital cognitive assessments and unobtrusive sensors are gaining traction for their potential to improve early detection and monitoring of cognitive impairment. Given the high prevalence of cognitive impairments in T2D, these digital tools are highly relevant. Further research incorporating remote digital biomarkers of cognition, behavior, and motor functioning may enable comprehensive characterizations of patients with T2D and may ultimately improve clinical care and equitable access to research participation. The aim of this commentary article is to review the feasibility, validity, and limitations of using remote digital cognitive tests and unobtrusive detection methods to identify and monitor cognitive decline in neurodegenerative conditions and apply these insights to patients with T2D.

3.
J Diabetes Sci Technol ; 17(4): 1085-1120, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-36704821

RESUMEN

Diabetes Technology Society hosted its annual Diabetes Technology Meeting from November 3 to November 5, 2022. Meeting topics included (1) the measurement of glucose, insulin, and ketones; (2) virtual diabetes care; (3) metrics for managing diabetes and predicting outcomes; (4) integration of continuous glucose monitor data into the electronic health record; (5) regulation of diabetes technology; (6) digital health to nudge behavior; (7) estimating carbohydrates; (8) fully automated insulin delivery systems; (9) hypoglycemia; (10) novel insulins; (11) insulin delivery; (12) on-body sensors; (13) continuous glucose monitoring; (14) diabetic foot ulcers; (15) the environmental impact of diabetes technology; and (16) spinal cord stimulation for painful diabetic neuropathy. A live demonstration of a device that can allow for the recycling of used insulin pens was also presented.


Asunto(s)
Diabetes Mellitus Tipo 1 , Humanos , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Glucemia , Automonitorización de la Glucosa Sanguínea , Insulina/uso terapéutico , Sistemas de Infusión de Insulina , Tecnología , Hipoglucemiantes/uso terapéutico
4.
J Diabetes Sci Technol ; 16(4): 887-895, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35533135

RESUMEN

INTRODUCTION: The first meeting of the Integration of Continuous Glucose Monitor Data into the Electronic Health Record (iCoDE) project, organized by Diabetes Technology Society, took place virtually on January 27, 2022. METHODS: Clinicians, government officials, data aggregators, attorneys, and standards experts spoke in panels and breakout groups. Three themes were covered: 1) why digital health data integration into the electronic health record (EHR) is needed, 2) what integrated continuously monitored glucose data will look like, and 3) how this process can be achieved in a way that will satisfy clinicians, healthcare organizations, and regulatory experts. RESULTS: The meeting themes were addressed within eight sessions: 1) What Do Inpatient Clinicians Want to See With Integration of CGM Data into the EHR?, 2) What Do Outpatient Clinicians Want to See With Integration of CGM Data into the EHR?, 3) Why Are Data Standards and Guidances Useful?, 4) What Value Can Data Integration Services Add?, 5) What Are Examples of Successful Integration?, 6) Which Privacy, Security, and Regulatory Issues Must Be Addressed to Integrate CGM Data into the EHR?, 7) Breakout Group Discussions, and 8) Presentation of Breakout Group Ideas. CONCLUSIONS: Creation of data standards and workflow guidance are necessary components of the Integration of Continuous Glucose Monitor Data into the Electronic Health Record (iCoDE) standard project. This meeting, which launched iCoDE, will be followed by a set of working group meetings intended to create the needed standard.


Asunto(s)
Diabetes Mellitus , Registros Electrónicos de Salud , Glucemia , Diabetes Mellitus/terapia , Humanos , Flujo de Trabajo
5.
J Diabetes Sci Technol ; 16(4): 1016-1056, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35499170

RESUMEN

Diabetes Technology Society hosted its annual Diabetes Technology Meeting on November 4 to November 6, 2021. This meeting brought together speakers to discuss various developments within the field of diabetes technology. Meeting topics included blood glucose monitoring, continuous glucose monitoring, novel sensors, direct-to-consumer telehealth, metrics for glycemia, software for diabetes, regulation of diabetes technology, diabetes data science, artificial pancreas, novel insulins, insulin delivery, skin trauma, metabesity, precision diabetes, diversity in diabetes technology, use of diabetes technology in pregnancy, and green diabetes. A live demonstration on a mobile app to monitor diabetic foot wounds was presented.


Asunto(s)
Diabetes Mellitus Tipo 1 , Diabetes Mellitus , Glucemia , Automonitorización de la Glucosa Sanguínea , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Femenino , Humanos , Insulina/uso terapéutico , Sistemas de Infusión de Insulina , Embarazo , Tecnología
6.
J Diabetes Sci Technol ; 16(1): 233-247, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34672207

RESUMEN

On July 21, 2021, Diabetes Technology Society convened the virtual Green Diabetes Summit. The event consisted of 23 representatives from key stakeholder groups based in both the United States and Europe. The purposes of the summit were to (1) provide background on the complexity of addressing sustainability-related issues, including waste management, of diabetes devices from many different perspectives along the products' life cycle stages, and (2) determine the feasibility and role of a coalition of stakeholders to find solutions, particularly in the design, use, and proper disposal of diabetes devices used in home care that no one stakeholder can resolve on their own.


Asunto(s)
Diabetes Mellitus , Administración de Residuos , Diabetes Mellitus/terapia , Europa (Continente) , Humanos , Tecnología , Estados Unidos
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