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
中山二院糖尿病足中心
一位援疆医生讲述了自己的故事:一天夜里,他接诊了一名遭遇车祸的病人,肝脏破裂,生命垂危。虽经全力抢救,病人终因失血过多而死亡。当医生告诉家属这个坏消息后,家属不仅没有责怪医生,反而向医生道谢,然后要求把切下的破碎肝脏带回去,和死者一起埋葬。丧事办完后,家属又来到医院结清所有费用。此举令这位医生十分感动。从此,每当遇到危重患者,他都没有后顾之忧,总是愿意冒险一搏。
原创: 十六点五 中山二院糖尿病足中心
如果说大拇指占了人手功能的50%以上的功能,那么足的大趾的功能并没有那么大的作用,实际上,为了追求足底的平面,这三个支撑点的功能都非常重要。
足部对于一个人来说最重要的功能就是站立和行走,这些功能对于一个人来说是非常重要的,没有站立和行走的功能,就意味着这个人无法生活自理,无法工作,需要其他人的照顾,生活质量的急剧下降。
有关糖尿病足这个顽疾,国内外学界最近几年出了很多的指南、专家共识,对于几个比较重要的指南(包括对于2019年版IWGDF糖尿病足指南、2015年版IWGDF糖尿病足指南、中华医学会糖尿病分会糖尿病足及周围血管病变学组等)进行研读之后,有这么几个印象。
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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