Nicolò Diego Borella1 · Antonio Ferramosca2 · Giona Castagna1 · Silvia Ippolito1 · Sara Ceresoli2 · Antonio Taverna1 · Beatrice Sonzogni2 · Roberto Trevisan1,3 · Giuseppe Lepore1
Received: 6 March 2024 / Accepted: 15 October 2024 / Published online: 22 November 2024 © The Author(s) 2024
Abstract
Context Advanced hybrid closed loop (AHCL) systems currently represent the most advanced modality of insulin therapy.
Aim To compare the night-time (from 00 to 07 a.m.) effectiveness in achieving recommended glycemic targets of three dif-ferent AHCL systems in adults with type 1 diabetes (T1D).
Methods We retrospectively evaluated 55 adults with T1D (mean age 41±16 years, male 40%, diabetes duration 19.4±11.4 years, BMI 24.1±4.1 kg/m2 ) with similar glycemic control (GMI 7.0–7.4%). Twenty-two participants were using the Minimed 780G system, 18 the Tandem t:slim X2 with Control-IQ system and 15 the DBLG1 system. Continuous glucose monitoring derived metrics and insulin requirement of 14 consecutive nights were
Results All three groups achieved the recommended mean TIR>70%, mean TBR<4%, and mean CV<36% with a similar insulin requirement (Minimed 780G system: TIR 73.9±11.2%, TBR 0.9±1.2%, CV 29±6.7%; Tandem t:slim X2 with Con-trol-IQ system: TIR 74.1±11.1%, TBR 1.1±1.0%, CV 34.5±6.6%; DBLG1 System TIR 71.7±11.3%, TBR 1.4±3.7%, CV 32.4±7.1%). Tight TIR% (70–140 mg/dl) was significantly higher (p<0.01) in the Tandem t:slim X2 with Control-IQ group (51.5±9.8%) when compared to Minimed 780G group (42.1±13.7%) and DBLG1 System (40.1±10.5%). In all three groups the insulin infusion similarly decreased from midnight to 05.00 am and then increased.
Conclusions All the three AHCL systems achieved the recommended TIR, TBR and CV without difference in insulin requirement. The Tandem Control-IQ system obtained a higher tight TIR.
Oliver Kuss1,2,3 · Michael Roden3,4,5 · Sabrina Schlesinger1,3 · Annika Hoyer6
Received: 27 May 2024 / Accepted: 23 November 2024 / Published online: 12 December 2024 © The Author(s) 2024
Aims Two prerequisites must be met for the precision treatment approach to be beneficial for treated individuals. First, there must be treatment heterogeneity; second, in case of treatment heterogeneity, clinical predictors to identify people who would benefit from one treatment more than from others must be available. There is an established meta-regression approach to assess these two prerequisites that relies on measuring the variability of a clinical outcome after treatment in placebo-controlled randomised trials. We recently applied this approach to the treatment of type 2 diabetes for the clinical outcomes of glycaemic control and body weight and repeat it for the clinical outcome of all-cause mortality.
Methods We performed a meta-regression analysis using digitalized individual participant information on time to death from 10 large cardiovascular outcome trials (7563 deaths from 99,746 participants) on DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors with respect to the variability of all-cause mortality and its potential predictors after treatment.
Results The adjusted difference in log(SD) values of time to death between the verum and placebo arms was −0.036 (95%- CI: −0.059; −0.013), showing larger variability of time to death in the placebo arms. No clinical predictors were found to explain treatment heterogeneity.
Conclusions This analysis suggests that the potential of the precision treatment approach in type 2 diabetes is low, at least with regard to improvement of all-cause mortality in population with high cardiovascular risk. This extends our previous findings for the clinical outcomes of glycaemic control and body weight.
Keywords Dipeptidyl peptidase-4 inhibitors · Glucagon-like peptide 1 · HbA1c · Meta-regression · Precision medicine · Sodium–glucose transporter 2 inhibitors · Type 2 diabetes mellitus
原创：伤口治疗及造口护理中心
糖尿病足是糖尿病后期最严重的并发症之一，据文献统计，糖尿病足的发病率在糖尿病住院病人中约占15%的比例，糖尿病鞋是针对糖尿病足的保护专门研发设计的新型健康鞋，其合适的选材与科学的做工，可有效保护糖尿病足的患者。
足部是糖尿病这个多系统疾病的一个复杂的靶器官。糖尿病患者因周围神经病变与外周血管疾病合并过高的机械压力，可引起足部软组织及骨关节系统的破坏与畸形形成，进而引发一系列足部问题，从轻度的神经症状到严重的溃疡、感染、血管疾病、Charcot关节病和神经病变性骨折。如果积极治疗不能充分解决下肢出现的症状和并发症，则会造成灾难性的后果。因此，在糖尿病患者中开展对足部问题的早期预防和治疗将有重要的意义。
随着现在人们生活水平的逐渐提高，有一种“富贵病”在生活中逐渐出现，渐渐地已经成为生活中的常见病，它就是我们常说的糖尿病。而今天小编不给大家讲糖尿病的相关知识，而是讲一种因糖尿病而引起的一种并发症，它的名字叫糖尿病足！
下肢静脉溃疡
下肢静脉性溃疡，俗称“老烂腿”，是下肢静脉疾病的常见临床表现。下肢静脉性溃疡常常反复发作，溃疡久治不愈，严重影响患者的正常生活，因此一旦出现下肢静脉性溃疡的现象，患者应该及时到正规医院的血管外科就医，以查清病因，对症下药。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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