Abstract:
BACKGROUND:Stress-induced hyperglycemia is prevalent in critical care, even in patients with no history of diabetes. Increased counter-regulatory hormone response increases gluconeogenesis and effective insulin resistance, which can be exacerbated by drug therapy. Control of blood glucose levels to the 4.0-6.1 mmol/L range has been shown to reduce mortality and improve clinical outcomes. The Specialized Relative Insulin and Nutrition Tables (SPRINT) protocol is a simple alternative intensive care unit protocol for modulating insulin and nutritional input to gain tight blood glucose control in the 4.0-6.1 mmol/L target band. The look-up tables, implemented in a wheel-based format, are used by nurses to determine glycemic control actions based on hourly or 2-hourly blood glucose measurements and nutrition and insulin administration rates. METHODS:An 11 patient pilot study was conducted comprising 2,152 hours of blood glucose level control using the SPRINT protocol. The patient cohort average Acute Physiology and Chronic Health Evaluation II score was 22, which was higher than previous intensive insulin clinical studies. RESULTS:Overall, 64% of measurements were in the 4.0-6.1 mmol/L band, 89% in the 4.0-7.0 mmol/L band, and 96% of all measurements in the 4.0-7.75 mmol/L band. The average value was 5.8 +/- 0.9 mmol/L. Only 1.4% of all measurements were below 4 mmol/L, with a minimum of 3.2 mmol/L. The maximum value recorded was 11.8 mmol/L. CONCLUSIONS:Control of blood glucose level was achieved using a protocol implemented by the nursing staff without the need for physician intervention or interpretation, where control is defined as maximizing time within a desired band. The results led to a high level of support for the SPRINT protocol among clinical staff and acceptance of the frequent measurement requirement for effective control. The ease-of-use of the protocol resulted in minimal noncompliance by clinical staff.
journal_name
Diabetes Technol Therjournal_title
Diabetes technology & therapeuticsauthors
Lonergan T,Compte AL,Willacy M,Chase JG,Shaw GM,Hann CE,Lotz T,Lin J,Wong XWdoi
10.1089/dia.2006.8.449subject
Has Abstractpub_date
2006-08-01 00:00:00pages
449-62issue
4eissn
1520-9156issn
1557-8593journal_volume
8pub_type
杂志文章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
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doi:10.1089/dia.2005.7.487
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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
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abstract:BACKGROUND:A1chieve(®) (Novo Nordisk A/S, Bagsværd, Denmark) was a prospective, multicenter, noninterventional study in 66,726 people with type 2 diabetes mellitus (T2DM) in 28 countries beginning biphasic insulin aspart 30 (aspart premix), insulin detemir, or insulin aspart in routine clinical care. SUBJECTS AND METH...
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
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abstract::Existing standards of the management of the diabetic patients are not efficient enough, and further improvement is needed. The major objective of this paper is to present and discuss the therapeutic effectiveness of an intensive care telematic system designed and applied for intensive treatment of pregnant type 1 diab...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章
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abstract::Treatments for type 1 diabetes have advanced significantly over recent years. There are now multiple hybrid closed-loop systems commercially available and additional systems are in development. Challenges remain, however. This review outlines the recent advances in closed-loop systems and outlines the remaining challe...
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pub_type: 杂志文章,多中心研究
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abstract::Self-monitoring of blood glucose (SMBG) is universally considered to be an integral part of type 1 diabetes management and crucial for optimizing the safety and efficacy of complex insulin regimens. This extends to type 2 diabetes patients on intensive insulin therapy, and there is also a growing body of evidence sugg...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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abstract:BACKGROUND:SAR342434 is a biosimilar follow-on of insulin lispro-Humalog®. This study aimed to show similar efficacy, safety, and immunogenicity of SAR342434 (SAR-Lis) versus insulin lispro-Humalog (Ly-Lis) in adult patients with type 1 diabetes (T1DM) treated with multiple daily injections while using basal insulin gl...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-02-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-12-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1089/dia.2006.0059
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abstract:BACKGROUND:Prediction of glycemic profile is an important task for both early recognition of hypoglycemia and enhancement of the control algorithms for optimization of insulin infusion rate. Adaptive models for glucose prediction and recognition of hypoglycemia based on statistical and artificial intelligence technique...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2011.0093
更新日期:2012-02-01 00:00:00
abstract::Skin integrity and diabetes device placement are ongoing concerns for people with diabetes who utilize continuous glucose monitors (CGMs) and continuous subcutaneous insulin infusion pumps. This is especially significant for individuals with skin sensitivities, pediatric patients, and those who use devices chronically...
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更新日期:2018-06-01 00:00:00
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journal_title:Diabetes technology & therapeutics
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abstract:OBJECTIVE:Exercise is a cornerstone of diabetes therapy in type 1 diabetes mellitus (DMT1) patients. The type of exercise is important in determining the propensity to hypoglycemia. We assessed, by continuous glucose monitoring (CGM), the glucose profiles during and in the following 20h after a session of two different...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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更新日期:2004-10-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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更新日期:2007-12-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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更新日期:2018-05-01 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
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pub_type: 杂志文章,随机对照试验
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更新日期:2017-01-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
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更新日期:2011-03-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2017-11-01 00:00:00
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更新日期:2014-05-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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更新日期:2014-05-01 00:00:00