This document discusses the use and future of continuous glucose monitoring (CGM). It provides the following key points:
1) CGM provides over 100,000 glucose readings per year, complementing the limited data from fingerstick tests, to give a more comprehensive view of glucose control.
2) Current CGM technology displays real-time glucose values and trends to help people proactively respond to changes in glucose levels.
3) Future automation through features like threshold suspend can help reduce dangerous high and low glucose events.
4) The integrated insulin pump and CGM is the platform that will allow the development of an artificial pancreas through steps like closed-loop control.
Risk of Hypoglycemia Associated with Different Insulin Delivery Systems in Ty...dylanturner22
Closed-loop insulin delivery systems have the potential to improve glycemic control for type 1 diabetes patients by reducing hypoglycemia risk compared to open-loop systems. However, this meta-analysis found no significant difference in hypoglycemia risk between closed-loop and open-loop systems based on current studies. Dual-hormone closed-loop systems may reduce risk according to one study. Closed-loop was associated with more daytime hypoglycemia and risk decreased with longer diabetes duration. Larger and longer studies are still needed to fully evaluate hypoglycemia risk with closed-loop systems.
Carelink is a service provided by North Somerset Council that supports vulnerable people to live independently at home through an easy-to-use monitored alarm system. The demographic of the area was changing with an aging population and increasing costs for adult care. The council conducted small-scale research and profiling of customers to identify four target groups to focus their marketing on to increase awareness of Carelink. This approach led to a large number of new customers and over 95% customer satisfaction. It is estimated that for every new Carelink customer, the council saves around £13,000 per year in residential care costs, yielding significant savings.
The document discusses tackling health inequalities in North Lincolnshire, England. It aims to reduce teenage pregnancy and binge drinking using new technologies like Bluetooth marketing and crowd-sourcing. Initial campaigns found that mobile phone messages were accepted 61% of the time on average, with 40% of users visiting the website. Key findings showed using simple language and focusing on benefits, facts, and social support work best to influence health behaviors among youth.
Cloud Performance Monitoring: Medtronic's CareLink(R) Cloud ApplicationKeynote Mobile Testing
This document summarizes a presentation about how Medtronic's CareLink Cloud application delivers patient data to doctors worldwide through a high-performance cloud. It discusses how Medtronic monitors the application's various cloud segments both externally and internally to ensure speedy delivery of critical patient information and meet service level agreements. Over 600,000 patients across 30 countries rely on CareLink's 24/7 access to reports on cardiac devices like pacemakers.
Finding Flexibility in a Rigid World: A Component Content Management Case Stu...Vasont Systems
In order to manage content in a regulated life sciences industry, it takes tools that are configurable and capable of meeting the many requirements and rigidity of the industry while still providing flexibility for writers to work in ways that fit their unique corporate or divisional processes. This session will present a case study of how Medtronic uses one component content management system across four divisions of their company to work similarly in certain areas while adapting to each division’s different needs in other areas. The case study will also provide tips on “what to do” and “what not to do” to implement a successful content management strategy.
- The document discusses the history and evolution of glucose monitoring technologies from urine testing to current continuous glucose monitoring systems (CGM).
- It provides details on the advantages of real-time CGM (rtCGM) over self-monitoring of blood glucose (SMBG), including continuous readings without pain and ability to detect trends and prevent hypoglycemic events.
- The document compares different CGM systems like Dexcom G5 and G6, Medtronic Guardian Connect, and FreeStyle Libre Pro interms of features, calibration needs, and accuracy.
- It describes how sensor-augmented insulin pumps that suspend insulin delivery can help minimize hypoglycemia, and discusses hybrid closed-loop systems like
This document discusses Continuous Glucose Monitoring (CGM) compared to Blood Glucose Meters (BGM). CGM continuously monitors glucose levels throughout the day and night, while BGM only provides single readings. CGM provides dynamic data on direction and rate of change of glucose levels. It works by placing a sensor under the skin connected to a transmitter that sends readings to a receiver or app. CGM has benefits like reduced A1C levels, less time spent experiencing hypoglycemia, and alerts users to impending high or low glucose levels. It is especially useful for those not meeting glucose goals or experiencing wide variability or nighttime lows.
Risk of Hypoglycemia Associated with Different Insulin Delivery Systems in Ty...dylanturner22
Closed-loop insulin delivery systems have the potential to improve glycemic control for type 1 diabetes patients by reducing hypoglycemia risk compared to open-loop systems. However, this meta-analysis found no significant difference in hypoglycemia risk between closed-loop and open-loop systems based on current studies. Dual-hormone closed-loop systems may reduce risk according to one study. Closed-loop was associated with more daytime hypoglycemia and risk decreased with longer diabetes duration. Larger and longer studies are still needed to fully evaluate hypoglycemia risk with closed-loop systems.
Carelink is a service provided by North Somerset Council that supports vulnerable people to live independently at home through an easy-to-use monitored alarm system. The demographic of the area was changing with an aging population and increasing costs for adult care. The council conducted small-scale research and profiling of customers to identify four target groups to focus their marketing on to increase awareness of Carelink. This approach led to a large number of new customers and over 95% customer satisfaction. It is estimated that for every new Carelink customer, the council saves around £13,000 per year in residential care costs, yielding significant savings.
The document discusses tackling health inequalities in North Lincolnshire, England. It aims to reduce teenage pregnancy and binge drinking using new technologies like Bluetooth marketing and crowd-sourcing. Initial campaigns found that mobile phone messages were accepted 61% of the time on average, with 40% of users visiting the website. Key findings showed using simple language and focusing on benefits, facts, and social support work best to influence health behaviors among youth.
Cloud Performance Monitoring: Medtronic's CareLink(R) Cloud ApplicationKeynote Mobile Testing
This document summarizes a presentation about how Medtronic's CareLink Cloud application delivers patient data to doctors worldwide through a high-performance cloud. It discusses how Medtronic monitors the application's various cloud segments both externally and internally to ensure speedy delivery of critical patient information and meet service level agreements. Over 600,000 patients across 30 countries rely on CareLink's 24/7 access to reports on cardiac devices like pacemakers.
Finding Flexibility in a Rigid World: A Component Content Management Case Stu...Vasont Systems
In order to manage content in a regulated life sciences industry, it takes tools that are configurable and capable of meeting the many requirements and rigidity of the industry while still providing flexibility for writers to work in ways that fit their unique corporate or divisional processes. This session will present a case study of how Medtronic uses one component content management system across four divisions of their company to work similarly in certain areas while adapting to each division’s different needs in other areas. The case study will also provide tips on “what to do” and “what not to do” to implement a successful content management strategy.
- The document discusses the history and evolution of glucose monitoring technologies from urine testing to current continuous glucose monitoring systems (CGM).
- It provides details on the advantages of real-time CGM (rtCGM) over self-monitoring of blood glucose (SMBG), including continuous readings without pain and ability to detect trends and prevent hypoglycemic events.
- The document compares different CGM systems like Dexcom G5 and G6, Medtronic Guardian Connect, and FreeStyle Libre Pro interms of features, calibration needs, and accuracy.
- It describes how sensor-augmented insulin pumps that suspend insulin delivery can help minimize hypoglycemia, and discusses hybrid closed-loop systems like
This document discusses Continuous Glucose Monitoring (CGM) compared to Blood Glucose Meters (BGM). CGM continuously monitors glucose levels throughout the day and night, while BGM only provides single readings. CGM provides dynamic data on direction and rate of change of glucose levels. It works by placing a sensor under the skin connected to a transmitter that sends readings to a receiver or app. CGM has benefits like reduced A1C levels, less time spent experiencing hypoglycemia, and alerts users to impending high or low glucose levels. It is especially useful for those not meeting glucose goals or experiencing wide variability or nighttime lows.
These slides use concepts from my (Jeff Funk) course entitled Biz Models for Hi-Tech Products to analyze the business model for Infra V’s Smart Watch. This watch can continuously monitor glucose using a non-invasive spectrometric process, which enables better management of diabetes through more timely insulin injections. The watch replaces the widely used finger-pricking method that is painful for users and thus discourages effective monitoring of a patient’s glucose levels. The watch is also smaller and cheaper than other methods of continuous monitoring. These slides describe the specific value proposition for patients and doctors other aspects of the business model such as the method of value capture, scope of activities, and method of strategic control.
The document discusses real-time continuous glucose monitoring (rtCGM) and its clinical implementation aspects. It provides a brief history of glucose monitoring technologies and outlines some key barriers to self-monitoring of blood glucose. The document then discusses several currently available rtCGM systems, including the Dexcom G6, Guardian Connect, and FreeStyle Libre. It notes their sensor wear times, calibration requirements, alarm features, and accuracy levels. The document also discusses using rtCGM data to generate ambulatory glucose profiles and the limitations of rtCGM technologies, such as sensor interference and lag times between interstitial and blood glucose readings.
Diabetes prediction based on discrete and continuous mean amplitude of glycem...journalBEEI
Chronic hyperglycemia and acute glucose fluctuations are the two main factors that trigger complications in diabetes mellitus (DM). Continuous and sustainable observation of these factors is significant to be done to reduce the potential of cardiovascular problems in the future by minimizing the occurrence of glycemic variability (GV). At present, observations on GV are based on the mean amplitude of glycemic excursion (MAGE), which is measured based on continuous blood glucose data from patients using particular devices. This study aims to calculate the value of MAGE based on discrete blood glucose observations from 43 volunteer patients to predict the diabetes status of patients. Experiments were carried out by calculating MAGE values from original discrete data and continuous data obtained using Spline Interpolation. This study utilizes the machine learning algorithm, especially k-Nearest Neighbor with dynamic time wrapping (DTW) to measure the distance between time series data. From the classification test, discrete data and continuous data from the interpolation results show precisely the same accuracy value that is equal to 92.85%. Furthermore, there are variations in the MAGE value for each patient where the diabetes class has the most significant difference, followed by the pre-diabetes class, and the typical class.
This document describes the design and evaluation of an automated dual-hormone artificial pancreas system for controlling blood glucose levels in patients with type 1 diabetes. The system uses continuous glucose sensors and insulin and glucagon pumps controlled by an adaptive proportional-derivative control algorithm. Clinical studies showed the system was able to maintain glucose levels in the target range 73.1-71.6% of the time and reduce average glucose levels compared to subjects' pre-study levels, with elimination of hypoglycemic events in the second study.
Smart Blood Sugar builds upon the foundation of CGM technology and takes diabetes management a step further. It encompasses not only real-time glucose monitoring but also integrates advanced algorithms and data analytics to provide actionable insights and personalized recommendations.
Does technology helps adolescents with type 1 DM fast Ramadan?Abdulmoein AlAgha
This document discusses the use of technology to help adolescents with type 1 diabetes fast safely during Ramadan. It outlines the risks of fasting with type 1 diabetes like hypoglycemia and hyperglycemia. The EPIDIAR study found increased risks during Ramadan fasting. Newer technologies like continuous glucose monitors and insulin pumps with low glucose suspend features can help patients better monitor their glucose levels and adjust insulin doses to minimize risks. A recent study showed patients using a flash glucose monitor were able to fast safely without severe hypoglycemia or ketoacidosis during Ramadan.
This document summarizes a presentation on metrics for assessing glycemic control beyond HbA1c. It discusses limitations of HbA1c and explores additional metrics like time in range, glucose variability, and their correlation with outcomes. Recent evidence shows continuous glucose monitoring can help evaluate treatment effectiveness, safety, and improve patient outcomes by assessing these other important glycemic metrics. The adoption of standards for reporting metrics beyond HbA1c is needed to better capture the daily glycemic experience and inform clinical decision making.
This document discusses the technical challenges involved in obtaining accurate glucose meter results. Glucose meters analyze whole blood to measure glucose levels, but glucose is unstable in whole blood and establishing the true glucose value is difficult. Accuracy is defined by comparing to isotope dilution mass spectrometry, but this technique cannot analyze whole blood directly. Standards recommend comparing glucose meters to laboratory tests on plasma/serum from the same sample, but obtaining enough sample for both tests can be challenging. Multiple factors like temperature, operator technique, and patient conditions can also impact accuracy.
The MICELab group conducts interdisciplinary research on modeling, identification, and control engineering, with a focus on biomedical systems like diabetes technologies. The team has over 12 years experience researching diabetes and has developed tools like glucose prediction models, bolus calculators, closed-loop insulin delivery, and mobile applications to manage diabetes and analyze clinical data. They collaborate with food companies and restaurants to develop products and guidelines to help diabetics control their blood glucose levels in response to meals.
Nemaura Medical (NASDAQ: NMRD) is a medical technology company developing sugarBEAT® as a non-invasive, affordable and flexible glucose trending device designed to provide persons with diabetes and pre-diabetics with an Ambulatory Glucose Profile (AGP) as a superior metric to better manage their blood sugar levels as compared to a HbA1c reading. SugarBEAT® consists of a daily disposable adhesive skin-patch connected to a rechargeable transmitter, with an app displaying glucose readings at five-minute intervals for periods up to 24 hours. SugarBEAT® can additionally be used as an adjunctive Continuous Glucose Monitoring (CGM) device by insulin users when calibrated by a finger stick reading.
Visit NMRDinfo.com for more information.
This document proposes a glucose-insulin regulator for type 1 diabetes using artificial neural networks. It describes using a recurrent high order neural network to identify and control the nonlinear dynamics of a virtual patient's pancreas. The neural network is trained online using an extended Kalman filter algorithm. Simulation results over 3 days are presented, comparing open-loop and closed-loop control, as well as introducing feedforward control to help regulate glucose levels, especially after meals. The controller was able to maintain glucose levels near the target range during overnight fasting periods and feedforward control helped regulate levels after meals.
This document discusses advancements in glucose monitoring and insulin delivery technologies. It summarizes the evolution from invasive to non-invasive glucose monitoring methods using interstitial fluid. Current continuous glucose monitoring systems provide real-time data without finger pricks but have some lag time and inaccuracy compared to blood glucose readings. Insulin pumps have advanced from external pumps to patch pumps and integrated sensor-augmented pumps that can suspend insulin delivery to prevent hypoglycemia. The FDA recently approved the first hybrid closed loop system that automatically increases or decreases insulin based on continuous glucose sensor readings.
The document provides an overview of a presentation on leveraging continuous glucose monitoring (CGM) in diabetes care. It includes an agenda that covers CGM technology, utilization of CGM, patient case examples, and ensuring success with CGM. Faculty disclosures are also presented, noting consulting relationships with diabetes device and pharmaceutical companies. Guidelines from professional organizations recommend CGM for those on intensive insulin regimens or those experiencing problematic hypoglycemia. Studies show CGM improves glucose control and reduces hypoglycemia compared to self-monitoring of blood glucose alone.
Diabetes technology has advanced significantly over time, starting with insulin pumps and continuous glucose monitors (CGM), and now including hybrid closed loop systems that both monitor glucose and deliver insulin. The goals of diabetes technology include improving glycemic control as measured by time in range, reducing hypoglycemia and hyperglycemia, and providing insights to help prevent complications through improved self-management. Current and emerging technologies like smart insulin pens, implantable insulin pumps, and wearable glucose meters continue pushing the field forward to better mimic a natural pancreas.
Glucose uptake and calcium influx assays.pptxashharnomani
This document discusses methods for measuring glucose uptake and calcium influx in cells. It describes glucose uptake assays that use radioactive 2-deoxyglucose or the glucose analog 2-NBDG to measure glucose transporter activity. It also discusses assays using 3T3-L1 adipocytes to monitor insulin-stimulated glucose uptake and GLUT4 translocation. Finally, it compares a new luminescent glucose uptake assay to the traditional radioactive method.
This document discusses diabetes prevalence, blood glucose monitoring technology, the importance of self-monitoring, and selecting the right blood glucose monitoring system for patients. It notes that over 20 million Americans have diabetes, and outlines the evolution of glucose testing from urine tests to current electrochemical blood glucose meters. The benefits of self-monitoring for glycemic control are described. Factors to consider when helping patients select a meter include physical abilities, financial needs, and lifestyle. Accuracy can be affected by user technique and system variables.
This document discusses continuous glucose monitoring (CGM) and its benefits over traditional blood glucose testing methods. CGM uses a sensor to continuously monitor blood sugar levels every 15 minutes and can be worn for 14 days. It provides hidden patterns of blood sugar variations and avoids the need for finger pricks. CGM allows for easy assessment of glucose values 24/7 and helps keep blood sugar in a target range by avoiding high and low levels. Analyzing CGM data reports helps adjust food, medication, and exercise to improve diabetes management long-term.
This document discusses the application of point-of-care devices, mobile apps, and augmented reality in cardiovascular and diabetes management. It outlines how point-of-care devices like glucose sensors and insulin devices can provide convenient monitoring. Mobile apps can help track goals, share information, and educate patients. Future technologies like augmented reality show potential to enhance education and monitoring by simulating conditions. User readiness for new technologies depends on diffusion models, and augmented reality may require further development before widespread healthcare adoption.
The document discusses emerging blood glucose monitoring technologies. It notes that the growing diabetes epidemic poses diagnostic and management challenges. There is an immediate need for new approaches to support patient self-management and treatment adherence. The document summarizes various emerging monitoring technologies like continuous glucose monitors, closed loop insulin delivery systems, mobile apps, and alternatives to glucose monitoring. It emphasizes that technology must be tailored to individual patient needs and that self-monitoring of blood glucose remains an important management tool when used properly.
The document reports a 783% increase in something, but provides no other context or details to explain this large percentage increase. It is unclear what exactly increased by 783% or over what period of time. Further information would be needed to understand the significance of the reported percentage change.
This document discusses Manny Hernandez and the Diabetes Hands Foundation's efforts to support those living with diabetes. It provides information on the growth of their online communities for English and Spanish speakers, their advocacy work around issues like diabetes technology and costs, and campaigns to improve diabetes education and Medicare coverage of continuous glucose monitors. Statistics are given on the rising economic burden of diabetes in the US and projections that as many as 1 in 3 US adults could have diabetes by 2050.
These slides use concepts from my (Jeff Funk) course entitled Biz Models for Hi-Tech Products to analyze the business model for Infra V’s Smart Watch. This watch can continuously monitor glucose using a non-invasive spectrometric process, which enables better management of diabetes through more timely insulin injections. The watch replaces the widely used finger-pricking method that is painful for users and thus discourages effective monitoring of a patient’s glucose levels. The watch is also smaller and cheaper than other methods of continuous monitoring. These slides describe the specific value proposition for patients and doctors other aspects of the business model such as the method of value capture, scope of activities, and method of strategic control.
The document discusses real-time continuous glucose monitoring (rtCGM) and its clinical implementation aspects. It provides a brief history of glucose monitoring technologies and outlines some key barriers to self-monitoring of blood glucose. The document then discusses several currently available rtCGM systems, including the Dexcom G6, Guardian Connect, and FreeStyle Libre. It notes their sensor wear times, calibration requirements, alarm features, and accuracy levels. The document also discusses using rtCGM data to generate ambulatory glucose profiles and the limitations of rtCGM technologies, such as sensor interference and lag times between interstitial and blood glucose readings.
Diabetes prediction based on discrete and continuous mean amplitude of glycem...journalBEEI
Chronic hyperglycemia and acute glucose fluctuations are the two main factors that trigger complications in diabetes mellitus (DM). Continuous and sustainable observation of these factors is significant to be done to reduce the potential of cardiovascular problems in the future by minimizing the occurrence of glycemic variability (GV). At present, observations on GV are based on the mean amplitude of glycemic excursion (MAGE), which is measured based on continuous blood glucose data from patients using particular devices. This study aims to calculate the value of MAGE based on discrete blood glucose observations from 43 volunteer patients to predict the diabetes status of patients. Experiments were carried out by calculating MAGE values from original discrete data and continuous data obtained using Spline Interpolation. This study utilizes the machine learning algorithm, especially k-Nearest Neighbor with dynamic time wrapping (DTW) to measure the distance between time series data. From the classification test, discrete data and continuous data from the interpolation results show precisely the same accuracy value that is equal to 92.85%. Furthermore, there are variations in the MAGE value for each patient where the diabetes class has the most significant difference, followed by the pre-diabetes class, and the typical class.
This document describes the design and evaluation of an automated dual-hormone artificial pancreas system for controlling blood glucose levels in patients with type 1 diabetes. The system uses continuous glucose sensors and insulin and glucagon pumps controlled by an adaptive proportional-derivative control algorithm. Clinical studies showed the system was able to maintain glucose levels in the target range 73.1-71.6% of the time and reduce average glucose levels compared to subjects' pre-study levels, with elimination of hypoglycemic events in the second study.
Smart Blood Sugar builds upon the foundation of CGM technology and takes diabetes management a step further. It encompasses not only real-time glucose monitoring but also integrates advanced algorithms and data analytics to provide actionable insights and personalized recommendations.
Does technology helps adolescents with type 1 DM fast Ramadan?Abdulmoein AlAgha
This document discusses the use of technology to help adolescents with type 1 diabetes fast safely during Ramadan. It outlines the risks of fasting with type 1 diabetes like hypoglycemia and hyperglycemia. The EPIDIAR study found increased risks during Ramadan fasting. Newer technologies like continuous glucose monitors and insulin pumps with low glucose suspend features can help patients better monitor their glucose levels and adjust insulin doses to minimize risks. A recent study showed patients using a flash glucose monitor were able to fast safely without severe hypoglycemia or ketoacidosis during Ramadan.
This document summarizes a presentation on metrics for assessing glycemic control beyond HbA1c. It discusses limitations of HbA1c and explores additional metrics like time in range, glucose variability, and their correlation with outcomes. Recent evidence shows continuous glucose monitoring can help evaluate treatment effectiveness, safety, and improve patient outcomes by assessing these other important glycemic metrics. The adoption of standards for reporting metrics beyond HbA1c is needed to better capture the daily glycemic experience and inform clinical decision making.
This document discusses the technical challenges involved in obtaining accurate glucose meter results. Glucose meters analyze whole blood to measure glucose levels, but glucose is unstable in whole blood and establishing the true glucose value is difficult. Accuracy is defined by comparing to isotope dilution mass spectrometry, but this technique cannot analyze whole blood directly. Standards recommend comparing glucose meters to laboratory tests on plasma/serum from the same sample, but obtaining enough sample for both tests can be challenging. Multiple factors like temperature, operator technique, and patient conditions can also impact accuracy.
The MICELab group conducts interdisciplinary research on modeling, identification, and control engineering, with a focus on biomedical systems like diabetes technologies. The team has over 12 years experience researching diabetes and has developed tools like glucose prediction models, bolus calculators, closed-loop insulin delivery, and mobile applications to manage diabetes and analyze clinical data. They collaborate with food companies and restaurants to develop products and guidelines to help diabetics control their blood glucose levels in response to meals.
Nemaura Medical (NASDAQ: NMRD) is a medical technology company developing sugarBEAT® as a non-invasive, affordable and flexible glucose trending device designed to provide persons with diabetes and pre-diabetics with an Ambulatory Glucose Profile (AGP) as a superior metric to better manage their blood sugar levels as compared to a HbA1c reading. SugarBEAT® consists of a daily disposable adhesive skin-patch connected to a rechargeable transmitter, with an app displaying glucose readings at five-minute intervals for periods up to 24 hours. SugarBEAT® can additionally be used as an adjunctive Continuous Glucose Monitoring (CGM) device by insulin users when calibrated by a finger stick reading.
Visit NMRDinfo.com for more information.
This document proposes a glucose-insulin regulator for type 1 diabetes using artificial neural networks. It describes using a recurrent high order neural network to identify and control the nonlinear dynamics of a virtual patient's pancreas. The neural network is trained online using an extended Kalman filter algorithm. Simulation results over 3 days are presented, comparing open-loop and closed-loop control, as well as introducing feedforward control to help regulate glucose levels, especially after meals. The controller was able to maintain glucose levels near the target range during overnight fasting periods and feedforward control helped regulate levels after meals.
This document discusses advancements in glucose monitoring and insulin delivery technologies. It summarizes the evolution from invasive to non-invasive glucose monitoring methods using interstitial fluid. Current continuous glucose monitoring systems provide real-time data without finger pricks but have some lag time and inaccuracy compared to blood glucose readings. Insulin pumps have advanced from external pumps to patch pumps and integrated sensor-augmented pumps that can suspend insulin delivery to prevent hypoglycemia. The FDA recently approved the first hybrid closed loop system that automatically increases or decreases insulin based on continuous glucose sensor readings.
The document provides an overview of a presentation on leveraging continuous glucose monitoring (CGM) in diabetes care. It includes an agenda that covers CGM technology, utilization of CGM, patient case examples, and ensuring success with CGM. Faculty disclosures are also presented, noting consulting relationships with diabetes device and pharmaceutical companies. Guidelines from professional organizations recommend CGM for those on intensive insulin regimens or those experiencing problematic hypoglycemia. Studies show CGM improves glucose control and reduces hypoglycemia compared to self-monitoring of blood glucose alone.
Diabetes technology has advanced significantly over time, starting with insulin pumps and continuous glucose monitors (CGM), and now including hybrid closed loop systems that both monitor glucose and deliver insulin. The goals of diabetes technology include improving glycemic control as measured by time in range, reducing hypoglycemia and hyperglycemia, and providing insights to help prevent complications through improved self-management. Current and emerging technologies like smart insulin pens, implantable insulin pumps, and wearable glucose meters continue pushing the field forward to better mimic a natural pancreas.
Glucose uptake and calcium influx assays.pptxashharnomani
This document discusses methods for measuring glucose uptake and calcium influx in cells. It describes glucose uptake assays that use radioactive 2-deoxyglucose or the glucose analog 2-NBDG to measure glucose transporter activity. It also discusses assays using 3T3-L1 adipocytes to monitor insulin-stimulated glucose uptake and GLUT4 translocation. Finally, it compares a new luminescent glucose uptake assay to the traditional radioactive method.
This document discusses diabetes prevalence, blood glucose monitoring technology, the importance of self-monitoring, and selecting the right blood glucose monitoring system for patients. It notes that over 20 million Americans have diabetes, and outlines the evolution of glucose testing from urine tests to current electrochemical blood glucose meters. The benefits of self-monitoring for glycemic control are described. Factors to consider when helping patients select a meter include physical abilities, financial needs, and lifestyle. Accuracy can be affected by user technique and system variables.
This document discusses continuous glucose monitoring (CGM) and its benefits over traditional blood glucose testing methods. CGM uses a sensor to continuously monitor blood sugar levels every 15 minutes and can be worn for 14 days. It provides hidden patterns of blood sugar variations and avoids the need for finger pricks. CGM allows for easy assessment of glucose values 24/7 and helps keep blood sugar in a target range by avoiding high and low levels. Analyzing CGM data reports helps adjust food, medication, and exercise to improve diabetes management long-term.
This document discusses the application of point-of-care devices, mobile apps, and augmented reality in cardiovascular and diabetes management. It outlines how point-of-care devices like glucose sensors and insulin devices can provide convenient monitoring. Mobile apps can help track goals, share information, and educate patients. Future technologies like augmented reality show potential to enhance education and monitoring by simulating conditions. User readiness for new technologies depends on diffusion models, and augmented reality may require further development before widespread healthcare adoption.
The document discusses emerging blood glucose monitoring technologies. It notes that the growing diabetes epidemic poses diagnostic and management challenges. There is an immediate need for new approaches to support patient self-management and treatment adherence. The document summarizes various emerging monitoring technologies like continuous glucose monitors, closed loop insulin delivery systems, mobile apps, and alternatives to glucose monitoring. It emphasizes that technology must be tailored to individual patient needs and that self-monitoring of blood glucose remains an important management tool when used properly.
The document reports a 783% increase in something, but provides no other context or details to explain this large percentage increase. It is unclear what exactly increased by 783% or over what period of time. Further information would be needed to understand the significance of the reported percentage change.
This document discusses Manny Hernandez and the Diabetes Hands Foundation's efforts to support those living with diabetes. It provides information on the growth of their online communities for English and Spanish speakers, their advocacy work around issues like diabetes technology and costs, and campaigns to improve diabetes education and Medicare coverage of continuous glucose monitors. Statistics are given on the rising economic burden of diabetes in the US and projections that as many as 1 in 3 US adults could have diabetes by 2050.
ADA submitted comments on two proposed rules from the FDA modifying the Nutrition Facts label that appears on most packaged foods in the United States and gives consumers information on the nutritional content of the food. The FDA is proposing changes to the content and layout of the Nutrition Facts label.
ADA submitted comments on two proposed rules from the FDA modifying the Nutrition Facts label that appears on most packaged foods in the United States and gives consumers information on the nutritional content of the food. The FDA is proposing changes to the content and layout of the Nutrition Facts label.
This document provides information about diabetes advocacy and working with elected officials. It discusses defining stakeholders in diabetes advocacy, including people with diabetes and those at risk. It encourages advocating to ensure access to optimal health and opportunities for those with diabetes. The document discusses meeting with members of Congress and providing follow-up. It emphasizes that governments and businesses make decisions with financial impacts in mind, and that balanced diabetes management reduces costs. The document encourages advocacy and working with others to help improve lives of those with diabetes.
This document discusses the value of social media in diabetes advocacy. It notes that social media allows advocates to increase knowledge and make a difference by connecting, offering support, and sharing information. Data shows huge growth in the number of people engaging about diabetes on Facebook and through Twitter hashtags. The document advocates using targeted tweets to draw attention from government agencies and lawmakers to support issues. It also discusses collaborating with partners at conferences and providing a roadmap to improve focus, inclusion and impact in diabetes advocacy efforts.
The document is a letter from Kelly Close and Nancy Liu of The diaTribe Foundation expressing opposition to California bill AB 1893. The letter argues that the bill, which requires consumers to purchase sharps containers when buying syringes or lancets, would unfairly burden people with diabetes by adding unnecessary costs. It suggests instead requiring insurers to cover sharps disposal costs. The letter also notes there is little evidence people with diabetes improperly dispose of needles, and more affordable disposal options exist beyond containers. It urges reconsidering the bill's impact on those living with diabetes in California.
The American Association of Diabetes Educators opposes AB 1893, which would mandate patients with chronic diseases purchase sharps containers when buying medical sharps. The AADE believes the bill places an unnecessary burden on patients, lacks scientific basis, and fails to adequately address disposal needs while penalizing those with chronic conditions. Additional data is needed on sharps in waste streams before responsible legislation can be considered. The AADE cannot support the bill unless harmful provisions are removed and significant amendments are made.
The National Diabetes Volunteer Leadership Council opposes AB 1893 unless amended for the following reasons:
1) The bill mandates that patients with chronic diseases like diabetes purchase sharps containers when buying medical supplies, which is an unworkable framework that punishes people for their medical conditions.
2) The rhetoric used by bill authors to promote the legislation is inflammatory and falsely suggests people with chronic diseases improperly dispose of needles, when most are responsible.
3) There are cheaper sharps containment options approved by health authorities that are mandated by the bill.
4) The bill conflicts with health insurance coverage and does not address disposal by intravenous drug users.
The letter opposes AB 1893 and asks the committee to oppose the bill or significantly amend it. The letter expresses concerns about inflammatory language used in materials supporting the bill that are disrespectful towards people with diabetes. It also argues that the bill's approach of mandating the purchase of sharps containers is unworkable and more expensive than free or cheaper disposal options. The letter requests an apology for false claims in supporting materials and suggests alternative approaches like requiring insurance coverage of disposal options.
An endocrinologist and director of a diabetes education non-profit opposes bill AB 1893, which would mandate patients purchase a sharps container each time they obtain needles or other supplies. He argues that most people with diabetes already know about proper disposal through education programs and free community disposal locations. Forcing purchases of containers would cause financial hardship without improving education or disposal practices. The bill appears aimed at benefiting certain companies and groups rather than patients.
#OpposeAB1893: California Bill that Burdens People with Diabetes on InsulinDiabetes Hands Foundation
The letter opposes bill AB 1893 which would mandate consumers purchase a sharps container each time they buy needles, syringes, or lancets. The letter argues the bill is misleading and benefits a single company. It claims existing practices endorsed by health organizations are sufficient and the bill does not accomplish its goals of reducing costs and injuries while helping with disposal compliance. The letter requests removing the container purchase mandate from the bill.
Big Blue Test poster: Immediate Impact of Exercise on Blood Glucose in People...Diabetes Hands Foundation
Diabetes Hands Foundation presented a poster abstract at the AADE in Philadelphia that uses the data collected during the 2012 Big Blue Test.
Our Big Blue Test scientific poster was awarded a big blue 1st place ribbon for “Immediate Impact of Exercise on Blood Glucose in People with Diabetes.”
Cocktails & Carbs Chicago: an introduction to Diabetes Hands Foundation durin...Diabetes Hands Foundation
Loneliness and social isolation are significant health risks according to recent research. Studies have shown that emotional isolation has similar health risks as smoking and increases the likelihood of early mortality. Additionally, research funding for conditions like Parkinson's disease receives far less funding per patient compared to other high profile diseases like breast cancer and HIV/AIDS. Maintaining social connections and reducing loneliness can positively impact both mental and physical health.
Diabetes Online Communities (DOCs) allow people with diabetes to connect, support each other, and share information free from outside influence. Key features of DOCs include member profiles, forums for discussions, private groups, and educational content. When evaluating a DOC, it is important to consider the size, rules around safety and conduct, the DOC's reputation, and whether it follows established codes of ethics. Popular and trusted DOCs provide identity, social connections, moderated discussions, and focus on supporting both patients and healthcare professionals.
This document provides an overview of a presentation on using social media for diabetes. It includes:
1) An agenda for the presentation that covers introductions, presentations, breakout sessions, and Q&A.
2) Biographies of the presenters, Amy Tenderich and Manny Hernandez, who are diabetes advocates and social media experts.
3) A discussion of the value of social media and technology for diabetes care and management. Research is accumulating that social media can help improve outcomes.
4) Guidance on developing a social media strategy and engaging ethically and legally online as a diabetes educator or provider. Concerns around patient privacy, confidentiality and representing your employer must be addressed
Social Media for Diabetes: Step Up to the Genius Bar
Fran Kaufman TuDiabetes CGM
1. The Use and Future Use of
Continuous Glucose Monitoring
Francine Ratner Kaufman, M.D.
Distinguished Professor Emerita of Pediatrics and Communications,
The Keck School of Medicine of the University of Southern California
Center for Diabetes and Endocrinology, Children’s Hospital Los Angeles
Chief Medical Officer of Medtronic Diabetes
Los Angeles, CA
•Medtronic
1
Diabetes
2. Meet Dr. Kaufman
To register for a free copy of Insulin
Pumps and Continuous Glucose
Monitoring: A User’s Guide to
Diabetes Management, visit:
http://info.medtronicdiabetes.com/
2013-tudiabetes.html
•Medtronic
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Diabetes
4. More Information – MORE DATA
with Continuous Glucose Monitoring
NUMBER OF
CONTINUOUS
GLUCOSE
READINGS PER
105,120 YEAR
(288 per day x 365
days)
NUMBER OF FINGERSTICK
MEASUREMENTS PER
1,460 YEAR
(4 per day x 365 days) •Medtronic
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Diabetes
5. Continuous Glucose Monitoring Technology: Personal Use
Personal CGM
Paradigm and Guardian
• For use by people with insulin-dependent
diabetes
• Real time displays of glucose values and
trend graphs Allows You to Proactively
• Retrospective data through CareLink
Respond to Changes in
Your Glucose Levels to
Improve Control
Real time CGM reveals fluctuations in your glucose levels that you can’t
see through A1C tests alone*. •Medtronic
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Levetan C, et al. Diabetes Care 2003; 26:1-8 Diabetes
6. Site Differences in Glucose Testing:
Interstitial Versus Capillary
Meter Sensor mirrors its
Sensor and meter are
reading to match
testing at different
meter: a process called
Sensor sites
calibration
Skin
Interstitial Space
Cells
Capillary
Medtronic illustration: not to scale.
•Medtronic
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Diabetes
7. Continuous Glucose Monitoring Technology
Glucose sensor readings
300 every 5 minutes (288/day)
REAL-Time Trend Graphs
reveal glucose patterns over
time
Glucose – mg/dL
200
REAL-Time Trend Arrows
show the direction and rate
of glucose level changes
100 Target REAL-Time Alerts can be
Zone customized to let people
with diabetes know when
they are out of range.
0 Offer’s three layers of
protection:
– Rate-of-Change Alerts
3AM 6AM 9AM 12PM 3PM 6PM 9PM
– Predictive Alerts
Time of Day
– Low and High Alerts
•Medtronic
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* Levetan C, et al. Diabetes Care 2003; 26:1-8 Diabetes
8. Personal CGM Alerts Patients to Intervene to
Avoid Dangerous High and Low Blood Glucose
Fewer highs = less complications
Alert Alert
Alert
Fewer lows = less accidents, coma, death
•Medtronic
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Diabetes
10. Safety and Comfort: Key Concepts for Success
Most important for success.
•Medtronic
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Diabetes
11. Step 1: Set Low Sensor Glucose Alert
Low SG Alert ONLY
High SG Alert is OFF
60
Alert sounds when Sensor
Glucose is 60 mg/dl
•Medtronic
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Diabetes
12. Step 2: Set High Sensor Glucose Alert
Turn on High SG Alert
300
60
•Range between High and Low Alerts
is WIDE.
•Focus on safety, while learning how
to understand CGM trends.
•Medtronic
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Diabetes
13. Step 3: Tighten the Sensor Glucose Alerts
Low SG Alert is 70 mg/dl
High SG Alert is 250 mg/dl
250
70
• High and Low Sensor Glucose Alert
thresholds are now closer to target
range.
• Adjust based on individual needs.
•Medtronic
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Diabetes
14. Step #4: Add High and Low Predictive Alerts
Predictive Alerts occur
BEFORE the threshold.
250
70
• Optional Alert setting.
1:33P HIGH
PREDICTED • Start with 10 minutes
for Predictive
Alerts, then adjust as
needed. •Medtronic
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Diabetes
15. Integrated Insulin Pump with Built-In CGM is the Platform
Upon Which the Artificial Pancreas Will Be Built
A All Subjects 204
MDI MDI
8.5
216
SAPSAP
*
* 8.1% *
* 8.0% 8.0%
7.9%
8.0
A1C (%)
†
** †
**
7.6%
7.6%
7.4% 7.4% 7.4%
7.5
7.3%
7.5% 7.5%
Study Phase Continuation Phase
7.0
0 3 6 9 12 15 18
Month
•Medtronic
*, P<0.001 for between-groups comparison; †, P<0.001 and ‡, P<0.05 for within-group
comparison using the crossover group’s 12-month A1C value as the comparator.
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Diabetes
16. Next Step: Threshold Suspend Automation
How it Works:
• User settable: On/Off 200
• Threshold range: 60 - 90 mg/dL
Sensor Glucose Values
160
• Suspends at threshold for 2
hours 120 Resumes after 2 hours
• During suspend:
80
• Patient can resume insulin
delivery at any time
40
• No bolus ability
• If sensor glucose value is below 0
threshold at 4 hrs after 30 90 150 210
resume, pump re-suspends Minutes
insulin delivery
•Medtronic
Not approved in the U.S. Currently under FDA review.
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Diabetes
17. The Steps to the Artificial Pancreas
Combines hardware, software and algorithms to shift control
from patient and lessen variability of glucose
Treat to Range
Closed Loop
Out of Range
Closed Loop
Closed Loop
at Night
Threshold Suspend
Automation
•Medtronic
Predicted Low Glucose
Future Product Concepts Not approved in the U.S.
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Management Diabetes
18. And Around the World – What are we doing?
Kazakhstan
•Medtronic
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Diabetes
19. And Around the World – What are we doing?
Haiti
•Medtronic
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21. Conclusions
Integrated Insulin Pump with Built-In CGM
– Providing a wealth of data and personalized alerts and alarms
can help you prevent dangerous highs and lows
The Iterative Steps to the Artificial Pancreas
– CGM is the foundation upon which the artificial pancreas will be
built
– Medtronic is taking iterative steps of automation to work toward
the ultimate goal of bringing to market a fully automated artificial
pancreas
Advocating for the Global Diabetes Community
– We can help by contributing our time, money and talents to
organizations that work to improve education, understanding
and resources for people living with diabetes around the globe
•Medtronic
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Diabetes
Benefit of pump + CGM (not just CGM)This is the foundation for an artificial pancreas
Here’s how the feature works:User settable: On/OffLGS setting range: 40-110 mg/dL, default: 60 mg/dLWhen triggered, the feature suspends insulin infusion for up to 2 hours:Continuous audible alarm and continuous display of an emergency messageCan resume insulin delivery and cancel LGS at any timeCannot deliver a bolus when suspendedAfter 2 hours, pump resumes basal insulin delivery for 4 hours The 6-hour cycle will continue until LGS is cancelled or current calibration expires(Note: if asked about the 2 hour resume, it came from 23 million pump days analyzed in CareLink from 1/1/04-8/23/09. This was equal to 9,634,009 suspends with (281,270 for 2-3 hours and 270,454 for 3-5+ hours)