A5091225335- Diabetes Management and Research
- Pancreatic function and diabetes
- Diabetes and associated disorders
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Mobile Health and mHealth Applications
- Diabetes Management and Education
- Spine and Intervertebral Disc Pathology
- Spinal Fractures and Fixation Techniques
- Chronic Disease Management Strategies
- Artificial Intelligence in Healthcare
- Wireless Body Area Networks
- Adolescent and Pediatric Healthcare
- Diabetes Treatment and Management
- Sleep and related disorders
- Renal function and acid-base balance
- Electrolyte and hormonal disorders
- Zebrafish Biomedical Research Applications
- Angiogenesis and VEGF in Cancer
- Erythrocyte Function and Pathophysiology
- Scoliosis diagnosis and treatment
- Medication Adherence and Compliance
- Phagocytosis and Immune Regulation
- Renal cell carcinoma treatment
- Pituitary Gland Disorders and Treatments
- Adrenal and Paraganglionic Tumors
University of Virginia
2013-2024
Dexcom (United States)
2020-2024
Charlottesville Medical Research
2019-2020
University of Colorado Anschutz Medical Campus
2020
National Transportation Safety Board
2020
Jaeb Center for Health Research
2020
National Institute of Diabetes and Digestive and Kidney Diseases
2020
Stanford University
2020
University of Minnesota
2020
Yale University
2020
A closed-loop system of insulin delivery (also called an artificial pancreas) may improve glycemic outcomes in children with type 1 diabetes.
We have used homologous recombination to disrupt the mouse gene coding for NaK2Cl cotransporter (NKCC2) expressed in kidney epithelial cells of thick ascending limb and macula densa. This is one several that when mutated causes Bartter's syndrome humans, a characterized by severe polyuria electrolyte imbalance. Homozygous NKCC2-/- pups were born expected numbers appeared normal. However, day 1 they showed signs extracellular volume depletion (hematocrit 51%; wild type 37%). They subsequently...
OBJECTIVE To evaluate the feasibility of a wearable artificial pancreas system, Diabetes Assistant (DiAs), which uses smart phone as closed-loop control platform. RESEARCH DESIGN AND METHODS Twenty patients with type 1 diabetes were enrolled at Universities Padova, Montpellier, and Virginia Sansum Research Institute. Each trial continued for 42 h. The United States studies conducted entirely in outpatient setting (e.g., hotel or guest house); Italy France hybrid hospital–hotel admissions. A...
OBJECTIVE We estimate the effect size of hypoglycemia risk reduction on closed-loop control (CLC) versus open-loop (OL) sensor-augmented insulin pump therapy in supervised outpatient setting. RESEARCH DESIGN AND METHODS Twenty patients with type 1 diabetes initiated study at Universities Virginia, Padova, and Montpellier Sansum Diabetes Research Institute; 18 completed entire protocol. Each patient participated two 40-h sessions, CLC OL, randomized order. Sensor (Dexcom G4) (Tandem t:slim)...
Intense exercise is a major challenge to the management of type 1 diabetes (T1D). Closed-loop control (CLC) systems (artificial pancreas) improve glycemic during limited intensity and short duration physical activity (PA). However, CLC has not been tested extended vigorous outdoor common among adolescents.Skiing presents unique metabolic challenges: intense prolonged PA, cold, altitude, stress/fear/excitement. In randomized controlled trial, 32 adolescents with T1D (ages 10-16 years)...
Background: In the past few years, artificial pancreas—the commonly accepted term for closed-loop control (CLC) of blood glucose in diabetes—has become a hot topic research and technology development. summer 2014, we initiated 6-month trial evaluating safety 24/7 CLC during free-living conditions. Research Design Methods: Following an initial 1-month Phase 1, 14 individuals (10 males/4 females) with type 1 diabetes at three clinical centers United States one Italy continued 5-month 2, which...
To determine the safety and efficacy of an automated unified system (USS) in providing overnight closed-loop (OCL) control children adolescents with type 1 diabetes attending summer camps.The Diabetes Assistant (DIAS) USS used Dexcom G4 Platinum glucose sensor (Dexcom) t:slim insulin pump (Tandem Care). An initial inpatient study was completed for 12 participants to evaluate safety. For main camp study, 20 were randomized either OCL or sensor-augmented therapy (control conditions) per night...
OBJECTIVE To evaluate the efficacy of a portable, wearable, wireless artificial pancreas system (the Diabetes Assistant [DiAs] running Unified Safety System) on glucose control at home in overnight-only and 24/7 closed-loop (CLC) modes patients with type 1 diabetes. RESEARCH DESIGN AND METHODS At six clinical centers four countries, 30 participants 18–66 years old diabetes (43% female, 96% non-Hispanic white, median duration 19 years, A1C 7.3%) completed study. The protocol included 2-week...
Hybrid closed-loop (HCL) artificial pancreas (AP) systems are now moving from research settings to widespread clinical use. In this study, the inControl algorithm developed by TypeZero Technologies was embedded a commercial Tandem t:slim X2 insulin pump, called Control-IQ, paired with Dexcom G6 continuous glucose monitor and tested for superiority against sensor augmented pump (SAP) therapy. Both groups were physician-monitored throughout trial.In randomized controlled trial, 24 school-aged...
OBJECTIVE The Pediatric Artificial Pancreas (PedArPan) project tested a children-specific version of the modular model predictive control (MMPC) algorithm in 5- to 9-year-old children during camp. RESEARCH DESIGN AND METHODS A total 30 children, 9-years old, with type 1 diabetes completed an outpatient, open-label, randomized, crossover trial. Three days artificial pancreas (AP) were compared three parent-managed sensor-augmented pump (SAP). RESULTS Overnight time-in-hypoglycemia was reduced...
Background: Glucose variability (GV) remains a key limiting factor in the success of diabetes management. While new technologies, for example, accurate continuous glucose monitoring (CGM) and connected insulin delivery devices, are now available, current treatment standards fail to leverage wealth information generated. Expert systems, from automated advisory missing element richer, more personalized, management diabetes. Methods: Twenty four subjects with type 1 mellitus (T1DM), 15 women,...
Background: Older adults with type 1 diabetes (≥65 years) are often under-represented in clinical trials of automated insulin delivery (AID) systems. We sought to test the efficacy a recently FDA-approved AID system this population. Methods: Participants used sensor-augmented pump (SAP) therapy for four weeks and then an (Control-IQ) weeks. In addition glucose control variables, patient-reported outcomes (PRO) were assessed questionnaires sleep parameters by actigraphy. Results: Fifteen...
An error grid compares measured versus reference glucose concentrations to assign clinical risk values observed errors. Widely used grids for blood monitors (BGMs) have limited value because they do not also reflect accuracy of continuous (CGMs).
Objective Artificial pancreas (AP) systems have been shown to improve glycemic control throughout the day and night in adults, adolescents, children. However, AP testing remains limited during intense prolonged exercise adolescents We present performance of Tandem Control-IQ system children a winter ski camp study, where high altitude, low temperature, activity, stress challenged control. Methods In randomized controlled trial, 24 (ages 13-18 years) school-aged (6-12 with Type 1 diabetes...
Background: Studies of closed-loop control (CLC) in patients with type 1 diabetes (T1D) consistently demonstrate improvements glycemic as measured by increased time-in-range (TIR) 70-180 mg/dL. However, clinical predictors TIR users CLC systems are needed. Materials and Methods: We analyzed data from 100 children aged 6-13 years T1D using the Tandem Control-IQ system during a randomized trial or subsequent extension phase. Continuous glucose monitor were collected at baseline 12-16 weeks...
Introduction: Hybrid closed-loop systems increase time-in-range (TIR) and reduce glycemic variability. Person-reported outcomes (PROs) are essential to assess the utility of new devices their impact on quality life. This article focuses PROs for pediatric participants (ages 6-13 years) with type 1 diabetes (T1D) parents during a trial using Tandem Control-IQ system, which was shown TIR improve other metrics. Research Design Methods: One hundred one children 6 13 years old T1D were randomly...
ABSTRACT. Vascular endothelial growth factor (VEGF) is transcribed in the VEGF120, VEGF164, or VEGF188 isoforms, which differ receptor binding, matrix association, and angiogenic activity. This vascular has been implicated development of renal vasculature, but role distinct VEGF isoforms remains unknown. In present report, angiogenesis arteriogenesis were studied VEGF120/120 mice, expressing only short VEGF120 isoform. ingrowth survival capillaries glomeruli, remodeling peritubular...
Management approaches for adult scoliosis are primarily based on adults with idiopathic and extrapolated to degenerative scoliosis. However, the often substantially, but poorly defined, greater changes present in impact management of these patients.To assess prevalence, severity, canal foraminal stenosis seeking operative treatment.A prospectively collected database patients deformity was reviewed consecutive surgical treatment, without prior corrective surgery. Patients completed Oswestry...
Objective The objective of this study was to evaluate the safety and performance artificial pancreas (AP) in adolescents with type 1 diabetes (T1D) following insulin omission for food. Research design methods In a randomized, cross-over trial, T1D aged 13–18 yr were enrolled trial. On separate days, received either usual care (UC) through their home pump or used an AP system (Diabetes Assistant platform, continuous glucose monitor, pump). Approximately h after admission, participants both...
Objective To evaluate the safety and performance of using a heart rate (HR) monitor to inform an artificial pancreas (AP) system during exercise among adolescents with type 1 diabetes (T1D). Materials Methods In randomized, cross-over trial, T1D age 13 - 18 years were enrolled receive on separate days either unmodified UVa AP (stdAP) or connected portable HR (AP-HR) that triggered algorithm for blood glucose (BG) control. During admissions participants underwent structured regimen....
Background Data on the use of Control-IQ, latest FDA-approved automated insulin delivery (AID) system for people with T1D 6 years age or older is still scarce, particularly regarding nonglycemic outcomes. Children and their parents are at higher risk sleep disturbances. This study assesses sleep, psycho-behavioral glycemic outcomes AID compared to sensor-augmented pump therapy (SAP) in young children parents. Methods Thirteen (ages 7–10) were enrolled. completed an initial 4-week SAP using...
Patients with adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas may require a bilateral adrenalectomy to treat their Cushing's disease. Approximately one third of these patients, however, will experience progressive enlargement the residual adenoma, develop hyperpigmentation, and have an elevated level serum ACTH. These patients Nelson's syndrome can be treated Gamma Knife surgery (GKS).The prospectively collected University Virginia database was reviewed identify all...
Young children 5-8 years old with type 1 diabetes (T1D) exhibit clear needs for improved glycemic control but may be limited in their ability to safely interact an artificial pancreas system. Our goal was evaluate the safety and performance of (AP) system among young T1D.In a randomized, crossover trial, T1D age were enrolled receive on separate study periods (in random order) either UVa AP using DiAs Control Platform software child-resistant lock-out screens (followed as out-patient...