Impact of Use Frequency of a Mobile Diabetes Management App on Blood Glucose Control: Evaluation Study.

Background: Technology has long been used to carry out self-management as well as to improve adherence to treatment in people with diabetes. However, most technology-based apps do not meet the basic requirements for engaging patients.

Objective: This study aimed to evaluate the effect of use frequency of a diabetes management app on glycemic control.

A review of personalized blood glucose prediction strategies for T1DM patients.

This paper presents a methodological review of models for predicting blood glucose (BG) concentration, risks and BG events. The surveyed models are classified into three categories, and they are presented in summary tables containing the most relevant data regarding the experimental setup for fitting and testing each model as well as the input signals and the performance metrics. Each category exhibits trends that are presented and discussed.

Improving the computational effort of set-inversion-based prandial insulin delivery for its integration in insulin pumps.

Objective: Set-inversion-based prandial insulin delivery is a new model-based bolus advisor for postprandial glucose control in type 1 diabetes mellitus (T1DM). It automatically coordinates the values of basal-bolus insulin to be infused during the postprandial period so as to achieve some predefined control objectives. However, the method requires an excessive computation time to compute the solution set of feasible insulin profiles, which impedes its integration into an insulin pump.

Robust fault detection system for insulin pump therapy using continuous glucose monitoring.

Background: The popularity of continuous subcutaneous insulin infusion (CSII), or insulin pump therapy, as a way to deliver insulin more physiologically and achieve better glycemic control in diabetes patients has increased. Despite the substantiated therapeutic advantages of using CSII, its use has also been associated with an increased risk of technical malfunctioning of the device, which leads to an increased risk of acute metabolic complications, such as diabetic ketoacidosis. Current insulin pumps already incorporate systems to detect some types of faults, such as obstructions in the infusion set, but are not able to detect other types of fault such as the disconnection or leakage of the infusion set.

Commentary on "Performance of a glucose meter with a built-in automated bolus calculator versus manual bolus calculation in insulin-using subjects".

Since the early 2000s, there has been an exponentially increasing development of new diabetes-applied technology, such as continuous glucose monitoring, bolus calculators, and "smart" pumps, with the expectation of partially overcoming clinical inertia and low patient compliance. However, its long-term efficacy in glucose control has not been unequivocally proven. In this issue of Journal of Diabetes Science and Technology, Sussman and colleagues evaluated a tool for the calculation of the prandial insulin dose.

Combining basal-bolus insulin infusion for tight postprandial glucose control: an in silico evaluation in adults, children, and adolescents.

Background: Achieving good postprandial glycemic control, without triggering hypoglycemia events, is a challenge of treatment strategies for type 1 diabetes subjects. Continuous subcutaneous insulin infusion, the gold standard of therapy, is based on heuristic adjustments of both basal and prandial insulin. Some tools, such as bolus calculators, are available to aid patients in selecting a meal-related insulin dose.

Computing the risk of postprandial hypo- and hyperglycemia in type 1 diabetes mellitus considering intrapatient variability and other sources of uncertainty.

Objective: The objective of this article was to develop a methodology to quantify the risk of suffering different grades of hypo- and hyperglycemia episodes in the postprandial state.

Methods: Interval predictions of patient postprandial glucose were performed during a 5-hour period after a meal for a set of 3315 scenarios. Uncertainty in the patient's insulin sensitivities and carbohydrate (CHO) contents of the planned meal was considered.

Coordinated basal-bolus infusion for tighter postprandial glucose control in insulin pump therapy.

Background: Basal and bolus insulin determination in intensive insulin therapy for type 1 diabetes mellitus (T1DM) are currently considered independently of each other. A new strategy that coordinates basal and bolus insulin infusion to cope with postprandial glycemia in pump therapy is proposed. Superior performance of this new strategy is demonstrated through a formal analysis of attainable performances in an in silico study.