Author Interviews, Diabetes, JAMA / 17.06.2020

MedicalResearch.com Interview with: Richard E. Pratley, MD AdventHealth Samuel E. Crockett Chair in Diabetes Research Medical Director | AdventHealth Diabetes Institute Senior Investigator and Diabetes Program Lead AdventHealth Translational Research Institute  MedicalResearch.com: What is the background for this study? Response: Historically, older individuals with T1D have been underrepresented or excluded from clinical trials. Older individuals with T1D are at particularly high risk for hypoglycemia. Because of their long duration of diabetes, they often have impaired counterregulatory responses and hypoglycemia unawareness. Hypoglycemia in older individuals is particularly dangerous because it can lead to falls and fractures, cognitive impairment and cardiovascular events, including death. There has been the misperception that older individuals are less able to use technology to manage their diabetes.  This study dispelled that notion.   (more…)
Author Interviews, Diabetes, JAMA, Technology / 23.01.2017

MedicalResearch.com Interview with: Dr Marcus Lind Associate Professor of Diabetology at the University of Gothenburg Gothenburg, Sweden Chief Physician of Diabetology, Uddevalla Hospital Uddevalla, Sweden MedicalResearch.com: What is the background for this study? Response: This was a randomized trial over 16 months (cross-over study with 26 weeks of each treatment and a between wash-out period of 17 weeks) of 161 persons with type 1 diabetes. The main purpose was to evaluate whether a “diabetes tool”, denoted continuous glucose monitoring improves the glycaemic control, known to be essential to lower risks for diabetic complications such as injuries on eyes, kidneys, nerves and the cardiovascular system. The study also evaluated whether the glucose could be stabalised, i.e. having less fluctutations (beside the average level per se) and whether well-being, treatment satisfaction and feeling more confident in the daily living to avoid low glucose values which lead influence the cognitive function and can lead to unconciousness. Earlier trials exist of this therapy in connection to insulin pumps. But it has not been tested in randomized trials with persons only using multiple daily insulin injections to administer insulin which is the most common therapy among adults with type 1 diabetes. Another novelty is that the current CGM-system (DexCom G4) has earlier shown a high accuracy and positive treatment experience among persons with type 1 diabetes, but it has not been tested in long-term randomized trials. Of note this trial was performed among adults with type 1 diabetes. Continuous glucose monitoring (CGM) is a system where the patient has a sensor subcutaneously that he/she easily can change every week. It estimates the glucose level every minute and shows values on a hand-held small monitor (size of a small cell-phone) and whether the glucose levels are rising or declining. The hypothesis with the study is that if the patient has continuous information of the glucose level and trends it will improve treatment variables. The comparison group was that patients got information of their glucose control via capillary finger sticks which has been the general treatment for a long time period but can only be made at certain occasions since a procedure where blood must be taken from the finger tips. (more…)