Journal of diabetes science and technology
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J Diabetes Sci Technol · Jan 2018
ReviewThe Long and Winding Road Toward Personalized Glycemic Control in the Critically Ill.
Hyperglycemia is very common in critically ill patients and interventional studies of intensive insulin therapy with the goal of returning ICU glycemia to normal levels have demonstrated mixed results. A large body of literature has demonstrated that diabetes, per se, is not independently associated with increased risk of mortality in this population and that the relationship of glucose metrics to mortality is different for patients with and without diabetes. Moreover, these relationships are confounded by preadmission glycemia; in this regard, patients with diabetes and good preadmission glucose control, as reflected by HbA1c levels obtained at the time of ICU admission, are similar to patients without diabetes. These data point the way toward an era when blood glucose targets in the ICU will be "personalized," based on assessment of preadmission glycemia.
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J Diabetes Sci Technol · Aug 2015
ReviewThe Role of Mobile Applications in Improving Alcohol Health Literacy in Young Adults With Type 1 Diabetes: Help or Hindrance?
Mobile health (mHealth) is an expanding field which includes the use of social media and mobile applications (apps). Apps are used in diabetes self-management but it is unclear whether these are being used to support safe drinking of alcohol by people with type 1 diabetes (T1DM). Alcohol health literacy is poor among young adults with T1DM despite specific associated risks. ⋯ Use of mobile apps is commonplace but the use of apps to support safe drinking in this population was rare. Most participants expressed a preference for direct communication with their health care teams about this subject. Further research is needed to determine the preferences of health care professionals and how they can best support young adults in safe drinking.
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J Diabetes Sci Technol · Aug 2015
ReviewThe Role of Mobile Applications in Improving Alcohol Health Literacy in Young Adults With Type 1 Diabetes: Help or Hindrance?
Mobile health (mHealth) is an expanding field which includes the use of social media and mobile applications (apps). Apps are used in diabetes self-management but it is unclear whether these are being used to support safe drinking of alcohol by people with type 1 diabetes (T1DM). Alcohol health literacy is poor among young adults with T1DM despite specific associated risks. ⋯ Use of mobile apps is commonplace but the use of apps to support safe drinking in this population was rare. Most participants expressed a preference for direct communication with their health care teams about this subject. Further research is needed to determine the preferences of health care professionals and how they can best support young adults in safe drinking.
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J Diabetes Sci Technol · Jul 2015
ReviewVascular Glucose Sensor Symposium: Continuous Glucose Monitoring Systems (CGMS) for Hospitalized and Ambulatory Patients at Risk for Hyperglycemia, Hypoglycemia, and Glycemic Variability.
Hyperglycemia, hypoglycemia, and glycemic variability have been associated with increased morbidity, mortality, length of stay, and cost in a variety of critical care and non-critical care patient populations in the hospital. The results from prospective randomized clinical trials designed to determine the risks and benefits of intensive insulin therapy and tight glycemic control have been confusing; and at times conflicting. The limitations of point-of-care blood glucose (BG) monitoring in the hospital highlight the great clinical need for an automated real-time continuous glucose monitoring system (CGMS) that can accurately measure the concentration of glucose every few minutes. Automation and standardization of the glucose measurement process have the potential to significantly improve BG control, clinical outcome, safety and cost.
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Soon after the discovery that insulin regulates blood glucose by Banting and Best in 1922, the symptoms and risks associated with hypoglycemia became widely recognized. This article reviews devices to warn individuals of impending hypo- and hyperglycemia; biosignals used by these devices include electroencephalography, electrocardiography, skin galvanic resistance, diabetes alert dogs, and continuous glucose monitors (CGMs). While systems based on other technology are increasing in performance and decreasing in size, CGM technology remains the best method for both reactive and predictive alarming of hypo- or hyperglycemia.