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Digital Health Technologies and Innovations
Published in Kelly H. Zou, Lobna A. Salem, Amrit Ray, Real-World Evidence in a Patient-Centric Digital Era, 2023
Kelly H. Zou, Mina B. Riad, Shaantanu Donde, Joan van der Horn, Tarek A. Hassan
Combining wearables and sensors together allows researchers to reach new heights of digital innovations, from sensing patients’ biological data and monitoring them, to conducting real-time analysis. Patients can now monitor their heart rate, ECG, blood oxygen saturation all in one device. Diabetic patients can have continuous glucose monitoring with real-time data via medical charts for analysis (Ray et al., 2020). The future and the competition in smart healthcare are on combining sensors and wearables in one device. Doctors and nurses will have real-time data in high frequencies, without extensive research or diagnosis. Patients with Parkinsonism can have real time brain stimulation, pacemakers will protect from heart attacks. Patients will be warned about a danger from any health issue happening to their hearts or brains and these devices can even seek help for them (Hagargi and Kumbhar, 2020).
Pathophysiology of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Treatment goals are to restore blood glucose levels to between 4.4 and 5.6 mmol/L (80 and 100 mg/dL) and to prevent recurrent episodes. When not severe, the patient needs immediate oral intake of simple carbohydrates that can be quickly absorbed. If severe, IV dextrose or IM glucagon is required. It is of the most importance to determine the causative factors. Causative comorbidities include Addison’s disease and celiac disease. Continuous glucose monitoring is sometimes needed.
Gestational Diabetes
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
A. Dhanya Mackeen, Richard S. Vigh, Kajal Angras
Using a glucometer, four glucose values are recorded daily: fasting as well as 1-hour or 2-hour postprandial measurements after meals. Although not in widespread use, continuous glucose monitoring reveals more postprandial hyperglycemia than just checking 2-hour postprandial values [98, 99]. Target goals (euglycemia) are fasting glucose values between 60 and 95 mg/dL and postprandial values at 1-hour <120 mg/dL or 2-hour <140 mg/dL (we use fasting and 2-hour values) [1]. No trial has shown clear superiority of 1-hour compared to 2-hour postprandial monitoring [1]. If diet and exercise interventions are sufficient, a 1–2 week period of glucose monitoring should demonstrate all glucose values to be within target limits. If, during the 2-week monitoring period, 1 or 2 measurements are above limits, pharmacologic therapy should be initiated [100].
Point of care blood glucose devices in the hospital setting
Published in Critical Reviews in Clinical Laboratory Sciences, 2023
Nam K. Tran, Clayton LaValley, Berit Bagley, John Rodrigo
Continuous glucose monitoring has significant potential for hospitalized patients [57]. At present, CGM is used predominantly for managing patients with diabetes in the ambulatory environment [58]. While ambulatory CGM biosensors utilize the same analytical techniques as their blood glucose counterparts, they usually sample blood subcutaneously to provide continuous measurements. Sensor calibration is often required at regular intervals and is accomplished by performing a paired measurement with a blood glucose meter; however, several newer platforms do not require calibration. Thus, the accuracy of the blood glucose calibration measurement could also influence CGM values. Continuous glucose monitoring sensors also have a preset lifespan following placement. Subcutaneous sensors are intended to measure glucose for up to 3 days before being replaced. Some studies have suggested subcutaneous CGM sensors may function correctly for months, but this practice is considered off-label use [59].
Poorly Controlled Diabetes Mellitus Increases the Risk of Deaths and Castration-Resistance in Locally Advanced Prostate Cancer Patients
Published in Cancer Investigation, 2023
Cheng Ma, Di Cui, Bangmin Han, Mao Ding, Jiahao Zhang, Shiyun Liu, Yingli Gao, Shujie Xia
There are some limitations to our study. Firstly, this is a single-center retrospective study, which may have some biases. Secondly, HbA1c only shows the 3-month average glycemic level, so it cannot reflect short-term (intraday or intra-week) glycemic fluctuation. A more accurate indicator called continuous glucose monitoring can better demonstrate the variability of glycemic control, but it is not widely used. A well-designed prospective study with better glycemic monitoring tools is needed to better identify how glycemic control affects the prognosis of locally advanced prostate cancer patients. Thirdly, treatments for DM, like medications, nutrition therapies, etc., should have considered in the study, but due to the incomplete DM therapy data, especially for nutrition therapies and physical activity patients, the treatments of DM were not included in the analysis. It should be analyzed in a prospective study in the future.
Evaluation of the cost and medical resource use outcomes associated with nasal glucagon versus injectable glucagon for treatment of severe hypoglycemia in people with diabetes in Canada: a modeling analysis
Published in Journal of Medical Economics, 2022
Jean-François Yale, Beatrice Osumili, Beth D. Mitchell, Barnaby Hunt, Gurjeev Sohi, Mark Jeddi, Donna Mojdami, William J. Valentine
The use of continuous glucose monitoring and flash glucose monitoring may provide opportunities for patients, particularly those receiving intensive insulin therapy, to reduce the frequency of severe hypoglycemia, but technology use does not eliminate the risk entirely7–9. Severe hypoglycemia represents a barrier to achieving good glycemic control in patients with diabetes, as in an effort to avoid hypoglycemia, patients may target higher blood glucose levels and thereby increase their risk of related complications10,11. Severe hypoglycemic events can result in significant medical resource use, such as emergency medical services (EMS) and treatment in the emergency room, and therefore an economic burden to healthcare payers12,13. The majority of severe hypoglycemic events occur outside of a healthcare setting. A survey conducted in 184 people with diabetes and 140 caregivers found that 87.1 and 87.7% of severe hypoglycemic events occurred at home in people with type 1 and type 2 diabetes, respectively14.