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1.
Diabetes Care ; 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39265091

RESUMEN

In the article cited above, affiliation information for author Ana Chico was inadvertently omitted. The complete affiliation list for this author is below.Department of Endocrinology and Nutrition, Hospital Santa Creu i Sant Pau, Barcelona, SpainUniversitat Autònoma de Barcelona, Barcelona, SpainCIBER-BBN, Madrid, Spain The authors apologize for the omission. The online version of the article (https://doi.org/10.2337/dc23-1355) has been revised.

3.
Diabetes Care ; 47(2): 216-224, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-37948469

RESUMEN

OBJECTIVE: Advanced hybrid closed-loop systems (AHCL) have been shown to improve glycemic control and patient-reported outcomes in type 1 diabetes. The aim was to analyze the outcomes of two commercially available AHCL in real life. RESEARCH DESIGN AND METHODS: A prospective study was performed, including adolescents and adults with type 1 diabetes, AHCL naïve, from 14 centers, who initiated the use of MM780G with SmartGuard or Tandem t:slimX2 with Control-IQ. Baseline and 3-month evaluations were performed, assessing HbA1c, time in different glycemic ranges, and patient-reported outcomes. The primary outcome was the between-group time in range 70-180 mg/dL difference from beginning to end of follow-up. RESULTS: One hundred fifty participants were included, with 75 initiating each system (age: 39.9 ± 11.4 years [16-72]; 64% female; diabetes duration: 21.6 ± 11.9 years). Time in range increased from 61.53 ± 14.01% to 76.17 ± 9.48% (P < 0.001), with no between-group differences (P = 0.591). HbA1c decreased by 0.56% (95% CI 0.44%, 0.68%) (6 mmol/mol, 95% CI 5, 7) (P < 0.001), from 7.43 ± 1.07% to 6.88 ± 0.60% (58 ± 12 to 52 ± 7 mmol/mol) in the MM780G group, and from 7.14 ± 0.70% to 6.56 ± 0.53% (55 ± 8 to 48 ± 6 mmol/mol) in the Control-IQ group (both P < 0.001 to baseline, P = 0.819 between groups). No superiority of one AHCL over the other regarding fear of hypoglycemia or quality of life was found. Improvement in diabetes-related distress was higher in Control-IQ users (P = 0.012). Sleep quality was improved (PSQI: from 6.94 ± 4.06 to 6.06 ± 4.05, P = 0.004), without differences between systems. Experience with AHCL, evaluated by the INSPIRE measures, exceeded the expectations. CONCLUSIONS: The two AHCL provide significant improvement in glucose control and satisfaction, with no superiority of one AHCL over the other.


Asunto(s)
Diabetes Mellitus Tipo 1 , Adolescente , Adulto , Humanos , Femenino , Persona de Mediana Edad , Masculino , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Glucemia , Hemoglobina Glucada , Estudios Prospectivos , Calidad de Vida , Medición de Resultados Informados por el Paciente , Insulina , Hipoglucemiantes/uso terapéutico , Sistemas de Infusión de Insulina , Automonitorización de la Glucosa Sanguínea
4.
Am J Infect Control ; 43(7): 711-4, 2015 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-25934065

RESUMEN

BACKGROUND: Cost-effectiveness analyses show that chlorhexidine-silver sulfadiazine (CHSS)-impregnated catheters reduce catheter-related bloodstream infection (CRBSI) and central venous catheter (CVC)-related costs. However, no studies have reported the efficiency of CHSS-impregnated catheters for venous access when the risk of CRBSI is low; for example, at the subclavian site. This study determined the cost of a CVC, diagnosis of CRBSI, and antimicrobial agents to treat CRBSI; we did not consider the cost of increased hospital stay. METHODS: This retrospective study included patients admitted to the intensive care unit at Hospital Universitario de Canarias (Tenerife, Spain) who had a subclavian venous catheter. RESULTS: Patients with CHSS catheters (n = 353) had a lower incidence density of CRBSI (2.12 vs 0 out of 1,000 catheter-days; P = .02) and lower CVC-related cost per catheter-day (3.35 ± 3.75 vs 3.94 ± 9.95; P = .002) than those with standard catheters (n = 518). CHSS-impregnated catheters were associated with a lower risk of CRBSI (exact logistic regression) (odds ratio, 0.10; 95% confidence interval, -∞ to 0.667; P = .008) than standard catheters when controlling for catheter duration. CHSS-impregnated catheters were also associated with a lower CVC-related cost per catheter day than standard catheters (Poisson regression) (odds ratio, 0.85; 95% confidence interval, 0.001-0.873; P < .001). CONCLUSIONS: CHSS-impregnated catheters may be efficient in preventing CRBSI in patients with subclavian venous access.


Asunto(s)
Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/métodos , Catéteres Venosos Centrales/microbiología , Clorhexidina/farmacología , Desinfectantes/farmacología , Desinfección/métodos , Sulfadiazina de Plata/farmacología , Adulto , Anciano , Infecciones Relacionadas con Catéteres/diagnóstico , Infecciones Relacionadas con Catéteres/economía , Catéteres Venosos Centrales/economía , Costos y Análisis de Costo , Desinfección/economía , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , España , Vena Subclavia
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