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 glycemic control in critically ill patients, hospitals nationwide are dedicating resources to address this important issue. To facilitate advances in this nascent field, standardized metrics for inpatient glycemic control should be developed and validated. METHODS:We used 1 month of fingerstick BG levels from a general hospital ward to develop and test three analytic models, based on three units of inpatient BG analysis: population (i.e., ward), patient-day, and patient. To assess the effect of the source of blood samples, we repeated these analyses after adding venous plasma glucose levels. Finally, we employed an idealized intensive care unit data set to establish "gold standard" metrics for inpatient glycemic control. RESULTS:Mean and median BG levels and the proportion of BG levels within an "optimal" range (80-139 mg/dL) were similar among the three models, whereas hypoglycemic and hyperglycemic event rates varied considerably. Inclusion of venous glucose levels did not substantially affect the results. Of the three models tested, the patient-day model appears to most faithfully reflect the quality of inpatient glycemic control. Achieving 85% of BG levels within optimal range may be considered gold standard. CONCLUSIONS:If validated elsewhere, these "glucometrics" would permit objective comparisons of inpatient glycemic control among hospitals and patient care units, and would allow institutions to gauge the success of their quality improvement initiatives.
journal_name
Diabetes Technol Therjournal_title
Diabetes technology & therapeuticsauthors
Goldberg PA,Bozzo JE,Thomas PG,Mesmer MM,Sakharova OV,Radford MJ,Inzucchi SEdoi
10.1089/dia.2006.8.560subject
Has Abstractpub_date
2006-10-01 00:00:00pages
560-9issue
5eissn
1520-9156issn
1557-8593journal_volume
8pub_type
杂志文章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
doi:10.1089/dia.2010.0038
更新日期:2010-10-01 00:00:00
abstract::Many people with insulin-treated diabetes continue to experience inadequate glycemic control and a high incidence of hypoglycemic events, despite improvements in therapeutic strategies. While glycated hemoglobin (HbA1c) is currently recognized as the gold-standard for assessing glycemic control, the measure reflects m...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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更新日期:2021-01-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
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更新日期:2013-08-01 00:00:00
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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::Type 2 diabetes is thought to develop as a result of progressive beta-cell dysfunction in the setting of insulin resistance, leading to increased risks of microvascular and macrovascular complications. Type 2 diabetes is currently treated with diet and exercise, followed by oral drug therapy, and finally exogenous ins...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2006.8.385
更新日期:2006-06-01 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
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/15209150260007381
更新日期:2002-01-01 00:00:00
abstract:: Objective: To assess the degree, duration, mean absolute relative difference (MARD), and error analysis of discrepant values per continuous glucose monitoring (CGM) systems after hydroxyurea (HU) administration. Research Design and Methods: ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2020.0490
更新日期:2020-12-30 00:00:00
abstract:BACKGROUND:To examine trimester-specific associations among glycemic variability, fetal growth, and birthweight in pregnancies with type 1 diabetes mellitus (Type 1 DM). METHODS:In this retrospective cohort study of 41 pregnant women with Type 1 DM, we used continuous glucose monitoring (CGM) data to calculate glycemi...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2017.0443
更新日期:2018-06-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2014.0184
更新日期:2015-01-01 00:00:00
abstract:: Background: Continuous glucose monitoring (CGM) is a method of estimating blood glucose values from those recorded in the interstitial fluid. Because increasingly longer CGM measurements are possible, errors and data loss become more and more likely and potentially more da...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2018.0247
更新日期:2018-12-01 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:Proper healing of ulcers and wounds on the feet of diabetes patients is important in order to prevent amputation. If the wound area reduction during the first 4 weeks of the treatment is not 40% or more, reevaluation of the treatment is necessary. The wound area evaluation is not complicated when the patient...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2011.0004
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:This study evaluated whether education and use of the advanced meter features of the CONTOUR(®) (Bayer HealthCare LLC, Diabetes Care, Tarrytown, NY) blood glucose monitoring system (BGMS) affect the frequency and pattern of blood glucose testing in insulin-using subjects with diabetes who routinely perform s...
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.2012.0051
更新日期:2012-10-01 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:OBJECTIVE:The purpose of the present study was to determine the effectiveness of a fluorescent contact lens glucose sensor in monitoring glucose in patients with diabetes. METHODS:Under an institutional review board-approved protocol, five fasting patients with type II diabetes were given a challenge consisting of 75 ...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1089/dia.2004.6.782
更新日期:2004-12-01 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:BACKGROUND:Multicenter long-term studies of predictors for the effectiveness of continuous subcutaneous insulin infusion (CSII) in clinical practice are lacking. We hypothesized that there are substantially greater reductions in hemoglobin A1c (HbA1c) in patients with poor glycemic control and that other predictors may...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2014.0139
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Continuous glucose monitoring (CGM) time-series are often analyzed, retrospectively, to investigate glucose variability (GV), a risk factor for the development of complications in type 1 diabetes (T1D). In the literature, several tens of different indices for GV quantification have been proposed, but many of...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,meta分析
doi:10.1089/dia.2013.0252
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Diabetic foot ulcer area is a basic parameter used for monitoring the wound healing and effectiveness of the treatment applied. TeleDiaFoS (developed earlier in collaboration with the Department and Clinic of Gastroenterology and Metabolic Diseases, Medical University of Warsaw, Warsaw, Poland) is one of jus...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2011.0082
更新日期:2011-11-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2013.0098
更新日期:2013-10-01 00:00:00
abstract:AIM:Insulin therapy induces remission in subjects with newly diagnosed type 2 diabetes mellitus (T2DM). This study assessed the insulin and C-peptide levels in newly diagnosed T2DM subjects during low-dose insulin therapy. SUBJECTS AND METHODS:Twenty newly diagnosed, drug-naive, T2DM patients without acute or chronic ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2010.0187
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:This study was designed to assess whether waist circumference can predict metabolic syndrome abnormalities in primary schoolchildren. RESEARCH DESIGN AND METHODS:Of 5,103 children (2,526 males) 4-13 years old who underwent anthropometric measurements, 530 had more extensive testing. Body mass index (BMI), wa...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2006.0017
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:We evaluated the impact of a 2-year chat line involving adolescents with type 1 diabetes regarding quality of life and metabolic control. METHODS:We enrolled 193 children, 10-18 years of age (mean ± SD, 13.6 ± 2.7 years), with type 1 diabetes for 1.2-6 years (3.6 ± 2.4 years), body mass index of 23.2 ± 4.1 ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2010.0188
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:The quantitative analysis of glucose time-series can greatly help the management of diabetes. In particular, a static nonlinear transformation, which symmetrizes the distribution of glucose levels by bringing them in the so-called risk space, was proposed previously for both self-monitoring blood glucose and...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2011.0006
更新日期:2011-08-01 00:00:00
abstract::Continuous glucose monitoring (CGM) is a new tool that has recently become available to people with diabetes. Properly designing and conducting trials in order to answer important questions regarding the clinical usefulness of CGM is very difficult and fraught with many confounding variables and unique challenges. Ini...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2009.0012
更新日期:2009-06-01 00:00:00
abstract::Maintaining optimal blood glucose (BG) control is difficult for type 1 diabetes mellitus (T1DM) patients when typical daily regimens of food, insulin and exercise are altered. Artificial intelligence (AI) systems consisting of treatment algorithms calibrated through large datasets of patient specific information may o...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/15209150050501989
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Implanted insulin pumps using the peritoneal route provide long-term improvement of glucose control compared with subcutaneous insulin therapy in type 1 diabetes (T1D) patients. The stability of insulin preparation is critical for a safe use in implanted pumps. Insuman implantable(®) (400 IU/mL) (Sanofi-Aven...
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.2013.0369
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety and effectiveness of the Loop Do-It-Yourself (DIY) automated insulin delivery system. RESEARCH DESIGN AND METHODS:A prospective real-world observational study was conducted, which included 558 adults and children (age range 1 to 71 years, mean HbA1c 6.8±1.0%) who initiated Loop either ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2020.0535
更新日期:2020-11-23 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