Optimizing insulin pump therapy: the potential advantages of using a structured diabetes management program

Use of continuous subcutaneous insulin infusion (CSII) therapy improves glycemic control, reduces hypoglycemia and increases treatment satisfaction in individuals with diabetes. As a number of patient- and clinician-related factors can hinder the effectiveness and optimal usage of CSII therapy, new approaches are needed to address these obstacles.

Ceriello and colleagues recently proposed a model of care that incorporates the collaborative use of structured SMBG into a formal approach to personalized diabetes management within all diabetes populations. We adapted this model for use in CSII-treated patients in order to enable the implementation of a workflow structure that enhances patient–physician communication and supports patients’ diabetes self-management skills.

We recognize that time constraints and current reimbursement policies pose significant challenges to healthcare providers integrating the Personalised Diabetes Management (PDM) process into clinical practice. We believe, however, that the time invested in modifying practice workflow and learning to apply the various steps of the PDM process will be offset by improved workflow and more effective patient consultations. This article describes how to implement PDM into clinical practice as a systematic, standardized process that can optimize CSII therapy.     

Rate and Predictors of Ineffective HIV Protection in African Men Who Have Sex with Men Taking Pre-Exposure Prophylaxis

AIDS and Behavior - We investigated the rate and predictors of ineffective HIV protection in men who have sex with men (MSM) taking pre-exposure prophylaxis (PrEP) in a prospective cohort study...     

Swa: a Subdivision

For some time, anomalous serological reactions have been observed when the same anti-Swa sera are tested against red cells from different individuals reported as Sw(a+). A comparative collaborative study using the same collection of Sw(a+) cells and anti-Swa sera was undertaken by 4 reference laboratories, and it was found that Swa represents a heterogeneous group of antigens that can be subdivided into two categories. Both categories, Sw(a+) 700:41 and Sw(a+) 700:-41, were shown to be inherited.     

A Glucose-Dependent Panhemagglutinin

Abstract. An agglutinin was identified in the serum of a non-transfused primiparous patient that reacted with all commercial red blood cells regardless of their antigenic makeup. The autologous control was negative. The agglutinin was directed against human red blood cells that had been incubated in media containing glucose and washed prior to testing. Red blood cells incubated in 2% glucose solution became agglutinable after 6 days at 4°C or after 2h at 37°C. These red blood cells gradually became non-reactive when washed and incubated in saline at 37 or 4°C. At 22°C the titer of the agglutinin was 128 (score 64) in LISS and 64 (score 56) in saline. The agglutinin was denatured by 2-mercaptoethanol, but remained active after 30 min of heating at 56°C. Among various mono- and disaccharides tested, glucose was the only sugar that selectively inhibited the reaction. The presence of such an agglutinin may cause confusion in a transfusion service laboratory by mimicking an antibody directed against a high incidence antigen.