Effectiveness of Mobile Health Applications for Cardiometabolic Risk Reduction in Urban and Rural India: A Pilot, Randomized Controlled Study.

Introduction: mHealth technology has the potential to deliver personalized health care; however, data on cardiometabolic risk factors are limited. This study aims to assess the effectiveness of mobile health applications (apps) on cardiometabolic risk factor reduction in adults aged 25 to 60 years in urban and rural India.

Methods: The study design was a pilot randomized controlled trial conducted in Tamil Nadu, India.

Accuracy of the Dexcom G7 Continuous Glucose Monitoring Sensors in People with Diabetes Undergoing Hemodialysis (ALPHA-2 Study).

The accuracy of the latest generation Dexcom G7 sensors in individuals with diabetes undergoing hemodialysis has not previously been investigated. Participants with diabetes undergoing hemodialysis were recruited, with paired sensor glucose from Dexcom G7 recorded with plasma glucose analyzed in the laboratory, as well as the Freestyle Precision Pro glucometer and EKF Biosen C-Line analyzer. Ten adults (median age 64.

Using technology to support diabetes care in hospital: Guidelines from the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) group and Diabetes Technology Network (DTN) UK.

This article summarises the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) Group guidelines on the use of technology to support diabetes care in hospital. The guideline incorporates two main areas: (i) use of wearable technology devices to improve diabetes management in hospital (including continuous glucose monitoring and insulin pump therapy) and (ii) information technology. Although it is reasonable to extrapolate from the evidence available, that devices developed to enhance diabetes care outside hospital will show similar benefits, there are challenges posed within the inpatient setting in hospital.

Batteries Within Diabetes Devices: A Narrative Review on Recycling, Environmental, and Sustainability Perspective.

The adoption of diabetes technology for the management of type 1 and insulin-treated type 2 diabetes has greatly increased. The annual volume of discarded continuous glucose monitoring (CGM) devices, considering only Dexcom and Freestyle Libre brands, totals more than 153 million units and Omnipod contributes an additional estimated 43.8 million units.

Extraocular muscle Diffusion Weighted Imaging as a quantitative metric of posterior orbital involvement in thyroid associated orbitopathy.

Objectives: The clinical activity score (CAS) and European severity scale (ESS) are established clinical tools to assess thyroid eye disease (TED) but are limited in terms of subjectivity and their reliability in non-Caucasian individuals, and can underestimate significant disease in the posterior orbit. Preliminary data from pilot studies have shown that diffusion-weighted imaging (DWI) using extraocular muscle (EOM) apparent diffusion coefficient (ADC) measurements may provide complementary information in TED. This study expands on previous research to assess for correlations between clinical scores and EOM-ADCs in stratifying disease activity and severity in a large patient cohort from an ethnically diverse population.

Switching from Intermittently Scanned Continuous Glucose Monitoring to Real-Time Continuous Glucose Monitoring with a Predictive Urgent Low Soon Alert Reduces Exposure to Hypoglycemia.

Differences in the effectiveness of real-time continuous glucose monitoring (rtCGM) and intermittently scanned continuous glucose monitoring (isCGM) in type 1 diabetes (T1D) are reported. The impact on percent time in range of switching from an isCGM with glucose threshold-based optional alerts only (FreeStyle Libre 2 [FSL2]) to an rtCGM (Dexcom G7) with an urgent low soon predictive alert was assessed, alongside other secondary outcomes including hemoglobin A1c (HbA1c) and other continuous glucose monitoring metrics. Adults with T1D using FSL2 were switched to Dexcom G7 for 12 weeks.

Accuracy and impact on quality of life of real-time continuous glucose monitoring in children with hyperinsulinaemic hypoglycaemia.

Objective: Continuous glucose monitoring (CGM) is the standard of care for glucose monitoring in children with diabetes, however there are limited data reporting their use in hyperinsulinaemic hypoglycaemia (HH). Here, we evaluate CGM accuracy and its impact on quality of life in children with HH.

Methods: Real-time CGM (Dexcom G5 and G6) was used in children with HH aged 0-16years.

Adaptive bolus calculators for people with type 1 diabetes: A systematic review.

Aim: To conduct a systematic review of studies assessing adaptive insulin bolus calculators for people with type 1 diabetes (T1D).

Methods: Electronic databases (Medline, Embase and Web of Science) were systematically searched from date of inception to 13 October 2022 for single-arm or randomized controlled studies assessing adaptive bolus calculators only, in children or adults with T1D on multiple daily injections or insulin pumps with glycaemic outcomes reported. The Clinicaltrials.

The Accuracy of Continuous Glucose Sensors in People with Diabetes Undergoing Hemodialysis (ALPHA Study).

Real-time and intermittently scanned continuous glucose monitoring are increasingly used for glucose monitoring in people with diabetes requiring renal replacement therapy, with limited data reporting their accuracy in this cohort. We evaluated the accuracy of Dexcom G6 and Abbott Freestyle Libre 1 glucose monitoring systems in people with diabetes undergoing hemodialysis. Participants on hemodialysis with diabetes (on insulin or sulfonylureas) were recruited.

Variation in the Current Use of Technology to Support Diabetes Management in UK Hospitals: Results of a Survey of Health Care Professionals.

Background: There has been a significant increase in the use of wearable diabetes technologies in the outpatient setting over recent years, but this has not consistently translated into inpatient use.

Methods: An online survey was undertaken to understand the current use of technology to support inpatient diabetes care in the United Kingdom.

Results: Responses were received from 42 different organizations representing 104 hospitals across the United Kingdom.

How Can Point-of-Care Technologies Support In-Hospital Diabetes Care?

People with diabetes admitted to hospital are at risk of diabetes related complications including hypoglycaemia and diabetic ketoacidosis. Point-of-care (POC) tests undertaken at the patient bedside, for glucose, ketones, and other analytes, are a key component of monitoring people with diabetes, to ensure safety. POC tests implemented with a quality framework are critical to ensuring accuracy and veracity of results and preventing erroneous clinical decision making.

Adjustment of Maternal Variable Rate Insulin Infusions Using Real-Time Continuous Glucose Monitoring in Pregnant Women with Type 1 Diabetes.

Real-time continuous glucose monitoring (CGM) in hospital holds promise; however, further evidence is required on its use to guide adjustment of variable rate intravenous insulin infusion (VRIII). We retrospectively analyzed data from 20 women with type 1 diabetes during the peripartum period who were commenced on VRIII. Data were analyzed for CGM accuracy (Dexcom G6) using point-of-care glucose-CGM matched pairs.

A Novel Somatic Mutation Implicates ATP6V0D1 in Proinsulin Processing.

Context: Prohormone convertase 1/3 (PC1/3), encoded by protein convertase subtilisin kexin type 1 (PCSK1), converts inactive prohormones into biologically active peptides. Somatic mutations of insulinomas are associated with genetic defects interfering with control of insulin secretion from pancreatic beta cells. However, somatic mutations in proinsulinomas have not been described.

Insulin Pumps and Hybrid Close Loop Systems Within Hospital: A Scoping Review and Practical Guidance From the Joint British Diabetes Societies for Inpatient Care.

This article is the second of a two-part series providing a scoping review and summary of the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) guidelines on the use of diabetes technology in people with diabetes admitted to hospital. The first part reviewed the use of continuous glucose monitoring (CGM) in hospital. In this article, we focus on the use of continuous subcutaneous insulin infusion (CSII; insulin pumps) and hybrid closed-loop systems in hospital.

Continuous Glucose Monitoring Within Hospital: A Scoping Review and Summary of Guidelines From the Joint British Diabetes Societies for Inpatient Care.

Increasing numbers of people, particularly with type 1 diabetes (T1D), are using wearable technologies. That is, continuous subcutaneous insulin infusion (CSII) pumps, continuous glucose monitoring (CGM) systems, and hybrid closed-loop systems, which combine both these elements. Given over a quarter of all people admitted to hospital have diabetes, there is a need for clinical guidelines for when people using them are admitted to hospital.

Using Technology to Improve Diabetes Care in Hospital: The Challenge and the Opportunity.

The past 10 years have seen a revolution in technology improving the lives of people with diabetes. This has implications for diabetes care in hospitalized inpatients. These technological developments have the potential to significantly improve the care of people with diabetes in hospital.

Promising Findings that the Cultivating Healthy Intentional Mindful Educators' Program (CHIME) Strengthens Early Childhood Teachers' Emotional Resources: An Iterative Study.

Findings suggest that an eight-week mindfulness compassion-based program, Cultivating Healthy Intentional Mindful Educators (CHIME), is a feasible professional development intervention for early childhood (EC) teachers to support their emotion regulation and psychological and workplace well-being. We offer preliminary evidence that learning about mindfulness, self-compassion, and social-emotional learning supports EC teachers in strengthening their knowledge and application of practices to be more mindful and less emotionally reactive and emotionally exhausted at work. In analyzing both EC teacher feedback and survey data from two pilot studies, there was promising evidence that participating in CHIME enhanced awareness of emotions and the development of strategies to manage emotions.

The impact of socio-economic deprivation on access to diabetes technology in adults with type 1 diabetes.

Background: With advances in technology, there is an emerging concern that inequalities exist in provision and diabetes outcomes in areas of greater deprivation. We assess the relationship between socio-economic status and deprivation with access to diabetes technology and their outcomes in adults with type 1 diabetes.

Methods: Retrospective, observational analysis of adults attending a tertiary centre, comprising three urban hospitals in the UK.

Optimizing type 1 diabetes after multiple daily injections and capillary blood monitoring: Pump or sensor first? A meta-analysis using pooled differences in outcome measures.

Aims: Most people living with type 1 diabetes self-manage using multiple daily injection (MDI) insulin regimens and self-monitoring of blood glucose (SMBG). Continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) are adjuncts to education and support self-management optimization. The aim of this systematic review and meta-analysis was to assess which first-line technology is most effective.

Improved glycaemia during the Covid-19 pandemic lockdown is sustained post-lockdown and during the "Eat Out to Help Out" Government Scheme, in adults with Type 1 diabetes in the United Kingdom.

Aims: The majority of studies report that the Covid-19 pandemic lockdown did not have a detrimental effect on glycaemia. We sought to explore the impact of lockdown on glycaemia and whether this is sustained following easing of restrictions.

Methods: Retrospective, observational analysis in adults and children with type 1 diabetes attending a UK specialist centre, using real-time or intermittently scanned continuous glucose monitoring.

Association of Other Autoimmune Diseases With Thyroid Eye Disease.

Background: Thyroid eye disease (TED) is a potentially disfiguring and sight-threatening autoimmune (AI) orbitopathy, affecting up to 400,000 people in the UK. There are no accurate early predictors of TED severity. Although polyautoimmunity has been shown to affect AI disease severity, its influence on TED severity has never been investigated.

Safety and Feasibility of the PEPPER Adaptive Bolus Advisor and Safety System: A Randomized Control Study.

The Patient Empowerment through Predictive Personalized Decision Support (PEPPER) system provides personalized bolus advice for people with type 1 diabetes. The system incorporates an adaptive insulin recommender system (based on case-based reasoning, an artificial intelligence methodology), coupled with a safety system, which includes predictive glucose alerts and alarms, predictive low-glucose suspend, personalized carbohydrate recommendations, and dynamic bolus insulin constraint. We evaluated the safety and efficacy of the PEPPER system compared to a standard bolus calculator.