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Glucose Monitor (glucose + monitor)
Selected AbstractsSick day management using blood 3-hydroxybutyrate (3-OHB) compared with urine ketone monitoring reduces hospital visits in young people with T1DM: a randomized clinical trialDIABETIC MEDICINE, Issue 3 2006L. M. B. Laffel Abstract Aims Diabetic ketoacidosis (DKA), a life-threatening acute complication of Type 1 diabetes, may be preventable with frequent monitoring of glycaemia and ketosis along with timely supplemental insulin. This prospective, two-centre study assessed sick day management using blood 3-hydroxybutyrate (3-OHB) monitoring compared with traditional urine ketone testing, aimed at averting emergency assessment and hospitalization. Methods One hundred and twenty-three children, adolescents and young adults, aged 3,22 years, and their families received sick day education. Participants were randomized to receive either a blood glucose monitor that also measures blood 3-OHB (blood ketone group, n = 62) or a monitor plus urine ketone strips (urine ketone group, n = 61). All were encouraged to check glucose levels , 3 times daily and to check ketones during acute illness or stress, when glucose levels were consistently elevated (, 13.9 mmol/l on two consecutive readings), or when symptoms of DKA were present. Frequency of sick days, hyperglycaemia, ketosis, and hospitalization/emergency assessment were ascertained prospectively for 6 months. Results There were 578 sick days during 21 548 days of follow-up. Participants in the blood ketone group checked ketones significantly more during sick days (276 of 304 episodes, 90.8%) than participants in the urine ketone group (168 of 274 episodes, 61.3%) (P < 0.001). The incidence of hospitalization/emergency assessment was significantly lower in the blood ketone group (38/100 patient-years) compared with the urine ketone group (75/100 patient-years) (P = 0.05). Conclusions Blood ketone monitoring during sick days appears acceptable to and preferred by young people with Type 1 diabetes. Routine implementation of blood 3-OHB monitoring for the management of sick days and impending DKA can potentially reduce hospitalization/emergency assessment compared with urine ketone testing and offers potential cost savings. [source] Accuracy and reliability of continuous blood glucose monitor in post-surgical patientsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2009K. YAMASHITA Background: The STG-22Ô is the only continuous blood glucose monitoring system currently available. The aim of this study is to determine the accuracy and reliability of the STG-22Ô for continuously monitoring blood glucose level in post-surgical patients. Methods: Fifty patients scheduled for routine surgery were studied in surgical intensive care unit (ICU) of a university hospital. After admission to the ICU, the STG-22Ô was connected to the patients. An attending physician obtained blood samples from a radial arterial catheter. Blood glucose level was measured using the ABLÔ800FLEX immediately after blood collection at 0, 4, 8, and 16 h post-admission to the ICU (total of 200 blood glucose values). Results: The correlation coefficient (R2) was 0.96. In the Clarke error grid, 100% of the paired measurements were in the clinically acceptable zone A and B. The Bland and Altman analysis showed that bias±limits of agreement (percent error) were 0.04(0.7)±0.35(6.3) mmol (mg/dl) (7%), ,0.11(,2)±1.22(22) (15%) and ,0.33(,6)±1.28(23) (10%) in hypoglycemia (<70(3.89) mmol (mg/dl), normoglycemia (3.89(70),10(180) mmol (mg/dl), and hyperglycemia (>10(180) mmol (mg/dl), respectively. Conclusions: The STG-22Ô can be used for measuring blood glucose level continuously and measurement results are consistent with intermittent measurement (percentage error within 15%). Therefore, the STG-22Ô is a useful device for monitoring in blood glucose level in the ICU for 16 h. [source] Prolonged use of continuous glucose monitors in children with type 1 diabetes on continuous subcutaneous insulin infusion or intensive multiple-daily injection therapyPEDIATRIC DIABETES, Issue 2 2009Diabetes Research in Children Network (DirecNet) Study Group Objective:, For continuous glucose sensors to improve the treatment of children with type 1 diabetes (T1D), they must be accurate, comfortable to wear, and easy to use. We conducted a pilot study of the FreeStyle NavigatorÔ Continuous Glucose Monitoring System (Abbott Diabetes Care) to examine the feasibility of daily use of a continuous glucose monitor (CGM) in an extended ambulatory setting. Methods:, Following a 13-wk trial of daily Navigator use, 45 children with T1D [10.7 ± 3.7 yr, range 4.6,17.6, 24 using insulin pumps; continuous subcutaneous insulin infusion (CSII) and 21 using glargine-based multiple daily injections (MDI)] used the Navigator for an additional 13 wk. Results:, Navigator use was initially slightly higher in the CSII users than in the MDI users but declined similarly in both groups by 22,26 wk. After 26 wk, 11 (46%) of 24 CSII users and 7 (33%) of 21 MDI users were using the CGM at least 5 d a week. No baseline demographic or clinical factors were predictive of the amount of sensor use at 26 wk. However, Navigator use during weeks 1,13 and scores on a CGM satisfaction survey at 13 wk were predictive of use in weeks 22,26. Conclusions:, CGM was generally well-tolerated in children with T1D for more than 6 months, and early acceptance of CGM was predictive of extended use of the device. Although many subjects and parents found CGM valuable, the declining usage over time underscores the need to develop new technologies and strategies to increase acceptance, effectiveness, and long-term use of these devices in youth with T1D. [source] Use of the DirecNet Applied Treatment Algorithm (DATA) for diabetes management with a real-time continuous glucose monitor (the FreeStyle Navigator)PEDIATRIC DIABETES, Issue 2 2008Diabetes Research In Children Network (DirecNet) Study Group Background:, There are no published guidelines for use of real-time continuous glucose monitoring data by a patient; we therefore developed the DirecNet Applied Treatment Algorithm (DATA). The DATA provides algorithms for making diabetes management decisions using glucose values: (i) in real time which include the direction and rate of change of glucose levels, and (ii) retrospectively based on downloaded sensor data. Objective:, To evaluate the use and effectiveness of the DATA in children with diabetes using a real-time continuous glucose sensor (the FreeStyle Navigator). Subjects:, Thirty children and adolescents (mean ± standard deviation age = 11.2 ± 4.1 yr) receiving insulin pump therapy. Methods:, Subjects were instructed on use of the DATA and were asked to download their Navigator weekly to review glucose patterns. An Algorithm Satisfaction Questionnaire was completed at 3, 7, and 13 wk. Results:, At 13 wk, all of the subjects and all but one parent thought that the DATA gave good, clear directions for insulin dosing, and thought the guidelines improved their postprandial glucose levels. In responding to alarms, 86% of patients used the DATA at least 50% of the time at 3 wk, and 59% reported doing so at 13 wk. Similar results were seen in using the DATA to adjust premeal bolus doses of insulin. Conclusions:, These results show the feasibility of implementing the DATA when real-time continuous glucose monitoring is initiated and support its use in future clinical trials of real-time continuous glucose monitoring. [source] Potential impact of a new blood glucose monitoring device: the GlucoWatch® BiographerPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 4 2002NN Chan Abstract Home blood glucose monitoring may be laborious, time-consuming, inconvenient and painful. Failure to test may preclude optimisation of glycaemic control. We aimed to evaluate the potential usefulness of a new noninvasive automatic glucose monitor, the GlucoWatch® Biographer. Eight patients with type 1 diabetes and two with type 2 diabetes (4M:6F) aged between 23 and 65 years participated in this study. All participants were given 1 hour of instruction prior to provision of the GlucoWatch®. They were given contact numbers and reviewed weekly. Several disadvantages were encountered by the participants, which included the daily 3 hour calibration period (n = 10), skin irritations (n = 6) and skipped measurements (n = 2) due to unsatisfactory probe contact due to skin temperature or sweats. Several patients, however, found it invaluable to have their daily profile monitored to allow insulin dosage adjustment and detection of hypoglycaemia. The GlucoWatch® Biographer is an invaluable tool that allows noninvasive detection of glucose trends, which contributes to glycaemic control. However, it is not suitable for every patient. Self-motivation and ability to learn how to use the device are the key factors. Copyright © 2002 John Wiley & Sons, Ltd. [source] |