Use of Personal Continuous Glucose Monitoring Device Is Associated With Reduced Risk of Hypoglycemia in a 16-Week Clinical Trial of People With Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion

Aims:Continuous glucose monitoring (CGM) has the potential to promote diabetes self-management at home with a better glycemic control as outcome. Investigation of the effect of CGM has typically been carried out based on randomized controlled trials with prespecified CGM devices on CGM-naïve participants. The aim of this study was to investigate the effect on glycemic control in people using their personal CGM before and during the trial.Materials and Methods:Data from the Onset 5 trial of 472 people with type 1 diabetes using either their personal CGM (n = 117) or no CGM (n = 355) and continuous subcutaneous insulin infusion in a 16-week treatment period were extracted. Change from baseline in glycated hemoglobin A1c (HbA_1c), number of hypoglycemic episodes, and CGM metrics at the end of treatment were analyzed with analysis of variance repeated-measures models.Results:Use of personal CGM compared with no CGM was associated with a reduction in risk of documented symptomatic hypoglycemia (event rate ratio: 0.82; 95% CI: 0.69-0.97) and asymptomatic hypoglycemia (event rate ratio: 0.72; 95% CI: 0.53-0.97), reduced time spent in hypoglycemia (P = .0070), and less glycemic variability (P = .0043) without a statistically significant increase in HbA_1c (P = .2028).Conclusions:Results indicate that use of personal CGM compared with no CGM in a population of type 1 diabetes is associated with a safer glycemic control without a statistically significantly deteriorated effect on HbA_1c, which adds to the evidence about the real-world use of CGM, where device type is not prespecified, and users are not CGM naïve.     

A retrospective analysis of cardiovascular outcomes in patients treated with ASV

Objectives. The effect of long-term adaptive servo-ventilation (ASV) on cardiovascular mortality and admission rates in patients with chronic heart failure (CHF) and Cheyne–Stokes respiration (CSR) has not been much studied. The aim of this study was primarily to investigate whether ASV therapy significantly reduced these parameters. Design. We included 75 CHF patients on optimal medication and CSR?≥25% of sleeping time, in New York Heart Association (NYHA) classes II–IV and left ventricular ejection fraction (LVEF)?≤?45%. Thirty-one patients were treated with ASV for >3–18 months and 44 patients served as a control group. Results. Seven deaths (16%) in the control group and one death (3%) in the ASV treatment group had cardiovascular etiology. There was no significant difference between the two groups regarding cardiovascular death (log rank p?=?0.07; HR 0.18 (95% CI 0.02-1.44), p?=?0.11) and combined cardiovascular death or readmissions, but there was a trend toward better outcome regarding cardiovascular event-free survival (log rank p?=?0.06; HR 0.53 (95% CI 0.27–1.05). Conclusions. In CHF patients with CSR, 18 months ASV treatment did not significantly affect cardiovascular death or combined cardiovascular death or hospital admissions. But there was a trend toward better combined outcome.     

Use of the flexible bronchoscope and Infrared Red Intubation System in a known difficult airway in the intensive care unit

This case report describes a patient in the ICU in need of urgent intubation, for whom video laryngoscope‐guided intubation had previously failed. The Infrared Red Intubation System (IRRIS) may enhance the chance of successful flexible bronchoscope intubation, especially when performed by non‐expert anesthesiologists.     

Tyre-pulling as concurrent training

Sport Sciences for Health - Concurrent training has gained popularity as a health-promoting activity. The focus of this study was to investigate the feasibility of tyre-pulling as a strength and...