An adrenal mass and increased catecholamines: monoamine oxidase or pheochromocytoma effect?

Hormonal evaluation in patients with an adrenal incidentaloma can be difficult in patients with comorbidities or in patients using interfering drugs. We present a case of a 54-year-old man who was evaluated for an adrenal mass. The medical history reported treatment with a monoamine oxidase (MAO) inhibitor for recurrent psychoses.

Sensor-augmented insulin pump therapy to treat hyperglycemia at the coronary care unit: a randomized clinical pilot trial.

Background: The relationship between admission hyperglycemia and adverse outcome in myocardial infarction has been shown consistently. However, achieving and maintaining normoglycemia in ST elevated myocardial infarction (STEMI) patients has proven difficult. This study aimed to investigate the efficacy of sensor-augmented insulin pump (SAP) therapy to treat hyperglycemia.

An analysis of the SEVEN system: have we reached the summit of needle-type sensor accuracy?

In this issue of Journal of Diabetes Science and Technology, Zisser and colleagues show improved sensor accuracy with the newest generation of needle-type sensors as compared to first generation sensors. Can we expect further improvement? It is unknown what the future holds, but there certainly seems much to be gained from improved calibration procedures. In addition, sensor operating times are increasing and it is hoped that this will translate into improved sensor use and thereby into improved glycemic control.

Evaluating clinical accuracy of continuous glucose monitoring devices: other methods.

With more and more continuous glucose monitoring devices entering the market, the importance of adequate accuracy assessment grows. This review discusses pros and cons of Regression Analysis and Correlation Coefficient, Relative Difference measures, Bland Altman plot, ISO criteria, combined curve fitting, and epidemiological analyses, the latter including sensitivity, specificity and positive predictive value for hypoglycaemia. Finally, recommendations for much needed head-to-head studies are given.

No apparent local effect of insulin on microdialysis continuous glucose- monitoring measurements.

Objective: Data investigating the possible disturbing influence of insulin in the vicinity of continuous glucose monitoring (CGM) is lacking. We investigated the hypothesis that high local insulin concentrations would interfere with sensor readings.

Research Design And Methods: Two microdialysis sensors were inserted in the periumbilical region of 10 continuous subcutaneous insulin infusion (CSII)-treated type 1 patients.

Relationship between interstitial and blood glucose in type 1 diabetes patients: delay and the push-pull phenomenon revisited.

Background: Interpretation of glucose sensor results requires clarification of the relationship between interstitial (IG) and blood (BG) glucose. We examined the delay of IG upon BG change and reinvestigated the push-pull phenomenon in type 1 diabetes patients. The push-pull phenomenon postulates that IG shows a delayed increase but earlier decrease compared to BG.

A critical appraisal of the continuous glucose-error grid analysis.

Objective: There is no consensus on how to optimally assess the accuracy of continuous glucose sensors. We examined the continuous glucose-error grid analysis (CG-EGA) and compared it with classical accuracy assessment methods, using data from a previously reported study comparing two different continuous glucose sensors in type 1 diabetic patients.

Research Design And Methods: Drift, delay, mean absolute difference (MAD), sensitivity, and specificity for detecting hypo- and hyperglycemia were calculated, and a Clarke error grid and a CG-EGA were constructed for both sensors, also including an examination of the influence of choosing different time intervals for paired sensor and reference glucose values.

Comparison of a needle-type and a microdialysis continuous glucose monitor in type 1 diabetic patients.

Objective: We examined the reliability of two continuous glucose sensors in type 1 diabetic patients at night and during rapid glucose excursions and verified the hypothesized nocturnal hypoglycemic drift of the needle-type sensor (CGMSgold) and delay of the microdialysis sensor (GlucoDay).

Research Design And Methods: Blood was sampled overnight twice per hour in 13 patients. Rapid-acting insulin was given subcutaneously 30 min after breakfast.

Nocturnal hypoglycaemia in type 1 diabetes--consequences and assessment.

Hypoglycaemia is inevitable when striving for low HbA1c values. Nocturnal hypoglycaemia often occurs without symptoms, but results in diminished next day well-being and hypoglycaemia unawareness. Frequency of nocturnal hypoglycaemia was first assessed in research ward settings, but suffered from insufficient glucose sampling frequency.