Abstract:
BACKGROUND:Computer decision support systems are potentially effective methods for adjusting insulin, but current models do not take into account simultaneous changes of more than one agent. We describe the development of the Multiagent Intelligent Dosing System (MAIDS, Dimensional Dosing Systems, Wexford, PA) for predicting glycemic outcome in response to concurrent dose adjustments in oral hypoglycemic agents and insulin. METHODS:Retrospective data from a patient cohort with type 2 diabetes who had simultaneous changes in insulin and metformin were analyzed. Glycemic markers (fasting glucose, random glucose, or hemoglobin A1c) expected at the visit subsequent to dose changes were calculated using two methods: the previously reported Intelligent Dosing System (IDStrade mark, Dimensional Dosing Systems), which accounts for changes in only one agent, and the MAIDS. Expected results from both systems were correlated with levels actually observed. RESULTS:We analyzed 32 patients with 40 paired visits. For fasting glucose (n = 8 paired visits), the correlation between expected and observed values was 0.07 when using the IDS but 0.78 when using the MAIDS. For random glucose (n = 16 paired visits) the correlation between expected and observed levels was 0.49 for the IDS but 0.79 for the MAIDS. With hemoglobin A1c as the marker (n = 16 paired visits), the correlation was 0.40 when using the IDS but 0.60 with the MAIDS. CONCLUSIONS:The MAIDS allows better prediction of glycemic outcome in circumstances where both insulin and an oral hypoglycemic drug are changed concurrently. Application of the MAIDS to other clinical scenarios, such as simultaneous adjustment of insulin and carbohydrate intake, requires further study.
journal_name
Diabetes Technol Therjournal_title
Diabetes technology & therapeuticsauthors
Cook CB,McMichael JP,Dunbar VG,Lieberman Rdoi
10.1089/dia.2005.7.937keywords:
subject
Has Abstractpub_date
2005-12-01 00:00:00pages
937-47issue
6eissn
1520-9156issn
1557-8593journal_volume
7pub_type
杂志文章abstract:AIM:This study explored the role of glycemic control on cardiac autonomic function, measured by heart rate variability (HRV), in youth with type 1 diabetes. PATIENTS AND METHODS:A retrospective cohort of 345 youth with type 1 diabetes (mean age, 18.5 years; duration, 10 years) participating in the SEARCH for Diabetes ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2013.0147
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Relatively little is known about parents' or children's attitudes toward recruitment for, and participation in, studies of new diabetes technologies immediately after diagnosis. This study investigated factors affecting recruitment of participants for studies in newly diagnosed youth with type 1 diabetes. M...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2016.0157
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:This study was designed to assess the accuracy, reliability, and contribution to clinical decision-making of two commercially available continuous glucose monitoring (CGM) devices using a novel analytical approach. STUDY DESIGN:Eleven individuals with type 1 diabetes and five with type 2 diabetes wore a Gua...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2008.0041
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:We sought to cross validate several metrics for quality of glycemic control, hypoglycemia, and hyperglycemia. RESEARCH DESIGN AND METHODS:We analyzed the mathematical properties of several metrics for overall glycemic control, and for hypo- and hyperglycemia, to evaluate their similarities, differences, and ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2017.0416
更新日期:2018-05-01 00:00:00
abstract::Prevalence of diabetes continues to increase in urban areas, and escalation is discernible in semi-urban and rural areas. It is reported to affect Asian Indians a decade earlier compared with other populations, and complications (e.g., nephropathy) occur earlier and are severe and more prevalent than in other races. B...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2013.0373
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:For patients with diabetes, the quality of outpatient glycemic control is readily assessed by hemoglobin A1c. In contrast, standardized measures for assessing the quality of blood glucose (BG) management in hospitalized patients are lacking. Because of recent studies demonstrating the benefits of strict glyc...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2006.8.560
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:This study assessed the feasibility of a portable bihormonal closed-loop system at home. SUBJECTS AND METHODS:Sixteen pump-treated patients with type 1 diabetes received 48 h of closed-loop therapy with a telemonitored insulin- and glucagon-delivering closed-loop system and 48 h of patient-managed open-loop...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2013.0166
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Patients with diabetes do daily self-monitoring of blood glucose (SMBG). For such patients, we devised an engine that predicts not only the expected blood glucose level at the next meal but also the pending risks of hypoglycemia. The purpose of this study was to validate the predictions and provide evidence ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2005.7.487
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Adherence to established standards (e.g., International Organization for Standardization [ISO] 15197) is important to ensure comparable and sufficient accuracy of systems for self-monitoring of blood glucose (SMBG). Accuracy evaluation was performed for different SMBG systems available in Europe with three r...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2015.0085
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:To protect against ischemia, pressure-induced vasodilation (PIV) causes an increase in skin blood flow. Endothelial dysfunction, which is commonly found in older patients and those with diabetes, and global temperatures can affect the resting blood flow in skin, which may reduce the blood flow during and aft...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2009.0097
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Microneedles have previously been used to deliver insulin to animal models, but not in human subjects. This study tested the hypothesis that hollow microneedles can deliver insulin to modulate blood glucose levels in subjects with type 1 diabetes in a minimally invasive manner. METHODS:This study was carrie...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2008.0103
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Skin autofluorescence (AF) as measured with the AGE Reader (DiagnOptics Technologies, Groningen, The Netherlands) is a noninvasive prognostic marker in diabetes mellitus and other diseases with increased cardiovascular risk. This study provides reference values of healthy Caucasian control subjects as a func...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2009.0113
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:This study assessed the association of serum adiponectin with carotid intimal medial thickness (IMT) in Asian Indians with different grades of glucose intolerance. METHODS:Subjects with normal glucose tolerance (NGT) (n = 520), impaired glucose tolerance (IGT) (n = 115), and type 2 diabetes mellitus (T2DM) (...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2009.0100
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Currently, it is still unknown whether differences in glycemic control have any effect on glucose and insulin kinetics after vildagliptin administration. The aim of this study was to evaluate the effect of vildagliptin on glucose and insulin concentrations during a 24-h period in type 2 diabetes patients wit...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2013.0020
更新日期:2013-07-01 00:00:00
abstract::This study was designed to determine plasma glucose and insulin levels after administration of three escalating doses of the oral insulin product hexyl-insulin monoconjugate 2 (HIM2) in fasting, insulin-deprived adult patients with type 1 diabetes. The study was also designed to assess the safety of the product. Sixte...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091502760306544
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Continuous glucose monitoring (CGM) and sensor-augmented pump (SAP) therapy improve glucose control provided good adherence. In France, not only diabetologists, nurses, and dieticians but also nurses employed by homecare providers (HCPNs) are together involved in the initiation and/or follow-up of continuous...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2015.0240
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:For patients with type 1 diabetes mellitus, a bihormonal artificial endocrine pancreas system utilizing glucagon and insulin has been found to stabilize glycemic control. However, commercially available formulations of glucagon cannot currently be used in such systems because of physical instability characte...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2014.0047
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Little information is available regarding glucose fluctuations in postprandial states and during the oral glucose tolerance test (OGTT) in Japanese people with normal glucose tolerance (NGT). METHODS:Glucose profiles of 27 Japanese people were measured for 4 days by using continuous glucose monitoring. A 75...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2008.0083
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Glucose monitoring based on sampling skin interstitial fluid (ISF) is being developed as an alternative to fingerstick blood glucose monitoring. Time delays between rapidly changing levels of glucose in blood and interstitial fluid have been reported in the literature to be between 5 and 20 minutes. This stu...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091599317530
更新日期:1999-04-01 00:00:00
abstract::Chronic hyperglycemia, as assessed by hemoglobin A1c (HbA1c) levels, has been associated with the development of microvascular and macrovascular complications of diabetes. Several studies have shown that acute hyperglycemia can add to the effect of chronic hyperglycemia in inducing tissue damage. Acute hyperglycemia c...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2010.0146
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Previous studies of aerobic exercise have found lower sensor accuracy during exercise. Whether or not resistance exercise would also be associated with lower sensor accuracy has not yet been examined. This study sought to investigate the accuracy of continuous glucose monitoring sensor values at rest, during...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2012.0182
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Accurate and economic detection of nerve damage in diabetes is key to more widespread diagnosis of patients with diabetic peripheral neuropathy (DPN) and painful diabetic neuropathy. This study examined the diagnostic performance of NerveCheck, an inexpensive ($500) quantitative sensory testing (QST) device....
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2016.0279
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:A reliable method to detect biochemical nocturnal hypoglycemia is highly needed, especially in patients with recurrent severe hypoglycemia. We evaluated reliability of nocturnal continuous glucose monitoring (CGM) in patients with type 1 diabetes at high risk of severe hypoglycemia. PATIENTS AND METHODS:Sev...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/dia.2013.0004
更新日期:2013-05-01 00:00:00
abstract::The World Wide Web now hosts a multitude of diabetes educational materials in various formats. Of particular interest is the diabetes/insulin tutorial available at the AIDA Website (accessible directly at: www.2aida.info). The tutorial combines textual or "static" information with an interactive diabetes simulator-AID...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2006.8.126
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:The Optimizing Control in Diabetes (OPTIMIZE) survey was conducted to understand the patients' perspective to achieving good glycemic control and to determine how patients' perceptions of insulin may affect their decisions to initiate or intensify their insulin therapy. METHODS:A total of 1,444 subjects wit...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2008.0249
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Recent evidence emphasizes the importance of maintaining normoglycemia in critically ill patients to reduce morbidity and mortality. Different analytical methods of varying accuracy exist for obtaining and measuring blood glucose in critically ill patients. The purpose of this study was to determine if there...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2008.0263
更新日期:2008-06-01 00:00:00
abstract::Current clinical guidelines for diabetes care encourage self-monitoring of blood glucose (SMBG) to improve glycemic control. Specific protocols remain variable, however, particularly among non-insulin-using patients. This is due in part to efficacy studies that neglect to consider (1) the performance of monitoring equ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2008.0104
更新日期:2008-12-01 00:00:00
abstract::Innovo (Novo Nordisk A/S, Hillerød, Denmark) is a new insulin injection system that offers built-in memory and a large, clear display to provide patients with more control during insulin injections. The aim of this trial was to compare the efficacy and safety of Innovo and NovoPen 3 (Novo Nordisk A/S) in patients expe...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1089/152091504322783413
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Patients undergoing intensive insulin therapy may have blood glucose (BG) samples drawn from arterial, capillary, or venous sources. This study compared capillary and venous BG across a range of glucose concentrations and under conditions of rapid change in BG. METHODS:Following a 10-h fast, 40 adult patien...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1089/dia.2009.0023
更新日期:2009-10-01 00:00:00
abstract::AIDA is a diabetes-computing program freely available from www.2aida.org on the Web. The software is intended to serve as an educational support tool, and can be used by anyone who has an interest in diabetes, whether they be patients, relatives, health-care professionals, or students. In previous "Diabetes Informatio...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091503763816490
更新日期:2003-01-01 00:00:00