Abstract:
: Background: Current manual diabetic retinopathy (DR) screening using eye care experts cannot scale to screen the growing population of diabetes patients who are at risk for vision loss. EyeArt system is an automated, cloud-based artificial intelligence (AI) eye screening technology designed to easily detect referral-warranted DR immediately through automated analysis of patient's retinal images. Methods: This retrospective study assessed the diagnostic efficacy of the EyeArt system v2.0 analyzing 850,908 fundus images from 101,710 consecutive patient visits, collected from 404 primary care clinics. Presence or absence of referral-warranted DR (more than mild nonproliferative DR [NPDR]) was automatically detected by the EyeArt system for each patient encounter, and its performance was compared against a clinical reference standard of quality-assured grading by rigorously trained certified ophthalmologists and optometrists. Results: Of the 101,710 visits, 75.7% were nonreferable, 19.3% were referable to an eye care specialist, and in 5.0%, the DR level was unknown as per the clinical reference standard. EyeArt screening had 91.3% (95% confidence interval [CI]: 90.9-91.7) sensitivity and 91.1% (95% CI: 90.9-91.3) specificity. For 5446 encounters with potentially treatable DR (more than moderate NPDR and/or diabetic macular edema), the system provided a positive "refer" output to 5363 encounters achieving sensitivity of 98.5%. Conclusions: This study captures variations in real-world clinical practice and shows that an AI DR screening system can be safe and effective in the real world. This study demonstrates the value of this easy-to-use, automated tool for endocrinologists, diabetologists, and general practitioners to address the growing need for DR screening and monitoring.
journal_name
Diabetes Technol Therjournal_title
Diabetes technology & therapeuticsauthors
Bhaskaranand M,Ramachandra C,Bhat S,Cuadros J,Nittala MG,Sadda SR,Solanki Kdoi
10.1089/dia.2019.0164subject
Has Abstractpub_date
2019-11-01 00:00:00pages
635-643issue
11eissn
1520-9156issn
1557-8593journal_volume
21pub_type
杂志文章abstract::Thanks to significant improvements in the precision, accuracy, and usability of continuous glucose monitoring (CGM), its relevance in both ambulatory diabetes care and clinical research is increasing. In this study, we address the latter perspective and derive provisional reporting recommendations. CGM systems have be...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2017.0054
更新日期:2017-07-01 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:Glucose variability (GV) has been increasingly (or more extensively) studied in patients with type 1 diabetes (T1D) in the ambulatory setting; limited data exist on GV in hospitalized patients with T1D. MATERIALS AND METHODS:Retrospective single center cohort study, we analyzed in-hospital glucose measureme...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2017.0107
更新日期:2017-10-01 00:00:00
abstract:: Objective: To assess the safety and efficacy of a simplified initialization for the Tandem t:slim X2 Control-IQ hybrid closed-loop system, using parameters based on total daily insulin ("MyTDI") in adolescents with type 1 diabetes under usual activity and during periods of...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2019.0471
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The hyperinsulinemic euglycemic clamp is the gold standard for assessment of insulin resistance and requires frequent, accurate measurements of blood glucose concentrations, typically utilizing the YSI 2300 STAT Plus™ glucose analyzer (YSI, Inc., Yellow Springs, OH). Despite its accuracy, the YSI has several...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2013.0288
更新日期:2014-05-01 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::Several biopharmaceuticals, including insulin and insulin analogs, are, or shortly will be, off-patent, thereby providing an opportunity for companies to attempt to manufacture "copies" commonly referred to as biosimilars and also known as follow-on biologics. Reassurance that such copy biologics are equally safe and ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2012.0105
更新日期:2012-11-01 00:00:00
abstract:AIMS:This study compared glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes mellitus (T1DM) treated with multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) using regular (RI) or lispro (LP) insulin. METHODS:Three hundred fifteen consecutive singleton...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2010.0111
更新日期:2010-12-01 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:OBJECTIVE:This study was designed to develop predictive formulas for precise insulin dosing in young children with type 1 diabetes (T1DM). RESEARCH DESIGN AND METHODS:Consecutive 1-year data from a group of 14 young patients (eight girls, six boys) 3.9 ± 0.8 years old with diabetes duration of 2.0 ± 0.8 years, transit...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2011.0184
更新日期:2012-05-01 00:00:00
abstract::Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are highly effective at lowering hemoglobin A1c (HbA1c) and facilitating weight loss. Four agents in the GLP-1 RA class, albiglutide, liraglutide, dulaglutide, and semaglutide, also have cardioprotective effects. However, subcutaneous administration of these agents...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2019.0185
更新日期:2020-01-01 00:00:00
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:AIMS:Skin autofluorescence (AF) has been associated with complications of diabetes. We evaluated the influence of skin color and ethnicity on the association between skin AF and the presence of diabetes-related complications. MATERIALS AND METHODS:In a multiethnic type 2 diabetes cohort we investigated all patients wi...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2013.0374
更新日期:2015-02-01 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: The prevalence of diabetes in youth is increasing worldwide in parallel with the obesity epidemic. This study aimed to determine the incidence rates of dysglycemia (diabetes or prediabetes) and evaluate the predictors of its progression or regression to normal ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2020.0109
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:The OpT2mise randomized trial was designed to compare the effects of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) on glucose profiles in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS:Patients with glycated hemoglobin (HbA1c) levels of ≥8% (64 mmol/mol) and...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2015.0159
更新日期:2016-01-01 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:BACKGROUND:Improved insulin infusion set survival and faster insulin action are important issues for pump users and for the development of an artificial pancreas. The current recommendation is to change infusion sets every 3 days. Our objectives were to determine the effect of lipohypertrophy (LH) on infusion set survi...
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.2015.0432
更新日期:2016-07-01 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:The aim of this study was to elucidate the characteristics of accuracy of subcutaneous continuous glucose monitoring (SCGM) in the perioperative period for neurosurgical and cardiac surgery patients. METHODS:Forty-five subjects, including healthy volunteers (n = 15), neurosurgical patients (n = 15), and car...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2018.0140
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:There is no consensus as to the best method to assess glycemic variability from continuous glucose monitoring (CGM) data. Rate of change has been suggested as a preferred method of assessing glycemic variability, but this assertion has not been validated. METHODS:Forty-eight hours of CGM data were analyzed ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2010.0215
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Drugs with unspecific stimulating effects on beta-cell secretion increase the homeostasis model assessment (HOMA)-B score, indicating improved beta-cell "function." We investigated whether the beta-cell protection provided by adding pioglitazone (PIO) to glimepiride (GLIM) in comparison to up-titrating the G...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2010.0019
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Long-term treatment is necessary to slow the progression of type 2 diabetes (T2D). Here, we examined the safety and efficacy of 6 years of treatment with exenatide once weekly (QW) among patients with T2D in the DURATION-1 trial. METHODS:The study enrolled patients aged ≥16 years with T2D treated primarily ...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1089/dia.2016.0107
更新日期:2016-11-01 00:00:00
abstract:: Background: The use of real-time continuous glucose monitoring (rtCGM) systems has proved to positively impact the management of type 1 diabetes with the potential to lower HbA1c, reduce frequency and time spent in hypoglycemia, and lower glycemic variability. Nevertheless...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2018.0397
更新日期:2019-05-01 00:00:00
abstract::New glucose sensors based on various technologies are being developed to provide information for improved therapy in diabetes. There is a need to establish rational performance standards for these sensors. Frequently sampled, direct blood glucose recordings representative of blood glucose excursions in diabetes are th...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/15209150152607196
更新日期:2001-10-01 00:00:00
abstract::Subcutaneous (s.c.) injections of identical insulin doses may lead to considerable intra- and inter-individual differences in the current metabolic control of patients with diabetes mellitus. This well-known variability of the metabolic effect of insulin hampers practical insulin therapy considerably. The aim of this ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/152091502320798312
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Weight gain often occurs when insulin therapy is initiated. The long-acting insulin analog insulin detemir has been shown to be effective and well tolerated when used in basal-bolus regimens or as an add-on to oral antidiabetic drugs (OADs) and causes less weight gain than other insulins. The aim of this exp...
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.2008.0282
更新日期:2008-08-01 00:00:00
abstract::By the year 2030, the diabetes pandemic will likely affect more than 10% of the world's population. The personal, public health, and economic crises implicit in this trend call for decisive action. Yet, escalating dilemmas thwart full realization of current therapies. First, controversial studies, such as the Action t...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2012.0132
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Continuous glucose monitoring (CGM) provides glucose trend information that can be used to guide treatment and motivate patients with diabetes. Currently, the evidence on effectiveness of CGM in patients with type 2 diabetes is debatable. We aim to provide a systematic review and meta-analysis to synthesize ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,meta分析
doi:10.1089/dia.2018.0177
更新日期:2018-09-01 00:00:00
abstract::Rates of diabetes are increasing worldwide and there is not a sufficient clinical workforce to care for these patients. Diabetes-related apps are a feasible way to provide diabetes education to large numbers of people with diabetes but attrition rates are high. Apps enhanced by virtual coaching may be a way to circumn...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2019.0016
更新日期:2019-06-01 00:00:00