A5052897654- Diabetes Management and Research
- Pancreatic function and diabetes
- Diabetes and associated disorders
- Diabetes Treatment and Management
- Cardiovascular and exercise physiology
- Muscle metabolism and nutrition
- Heart Rate Variability and Autonomic Control
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Quality and Safety in Healthcare
- Fault Detection and Control Systems
- Liver Disease Diagnosis and Treatment
- Nuts composition and effects
- Diabetes Management and Education
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Cardiovascular Syncope and Autonomic Disorders
- Intravenous Infusion Technology and Safety
- Gestational Diabetes Research and Management
- Diet and metabolism studies
- Vehicle License Plate Recognition
- Cardiovascular Function and Risk Factors
- COVID-19 Clinical Research Studies
- Mobile Health and mHealth Applications
- Metabolism, Diabetes, and Cancer
- Stroke Rehabilitation and Recovery
- Healthcare and Venom Research
The University of Melbourne
2018-2025
St Vincent's Hospital
2018-2024
The Royal Melbourne Hospital
2023
Northridge Hospital Medical Center
2023
Mercy Hospital
2018
Parks Victoria
2018
OBJECTIVE To investigate glycemic and psychosocial outcomes with hybrid closed-loop (HCL) versus user-determined insulin dosing multiple daily injections (MDI) or pump (i.e., standard therapy for most adults type 1 diabetes). RESEARCH DESIGN AND METHODS Adults diabetes using MDI without continuous glucose monitoring (CGM) were randomized to 26 weeks of HCL (Medtronic 670G) continuation current therapy. The primary outcome was masked CGM time in range (TIR; 70–180 mg/dL) during the final 3...
<h3>Importance</h3> Hybrid closed-loop (HCL) therapy has improved glycemic control in children and adolescents with type 1 diabetes; however, the efficacy of HCL on psychosocial outcomes not yet been established a long-term randomized clinical trial. <h3>Objective</h3> To determine percentage time spent target glucose range using vs current conventional therapies continuous subcutaneous insulin infusion or multiple daily injections without monitoring (CGM). <h3>Design, Setting,...
Regular exercise is essential to overall cardiovascular health and well-being in people with type 1 diabetes, but can also lead increased glycemic disturbances. Automated insulin delivery (AID) technology has been shown modestly improve time range (TIR) adults diabetes significantly TIR youth diabetes. Available AID systems still require some user-initiated changes the settings and, cases, significant pre-planning for exercise. Many recommendations were developed initially using multiple...
OBJECTIVE To compare glucose control with hybrid closed-loop (HCL) when challenged by high intensity exercise (HIE), moderate (MIE), and resistance (RE) while profiling counterregulatory hormones, lactate, ketones, kinetic data in adults type 1 diabetes. RESEARCH DESIGN AND METHODS This study was an open-label multisite randomized crossover trial. Adults diabetes undertook 40 min of HIE, MIE, RE random order using HCL (Medtronic MiniMed 670G) a temporary target set 2 h prior to during 15 g...
OBJECTIVE To evaluate glucose control using fast-acting insulin aspart (faster aspart) compared with (IAsp) delivered by the MiniMed Advanced Hybrid Closed-Loop (AHCL) system in adults type 1 diabetes. RESEARCH DESIGN AND METHODS In this randomized, open-label, crossover study, participants were assigned to receive faster or IAsp random order. Stages and 2 comprised of 6 weeks closed loop, preceded open loop. This was followed stage 3, whereby changed directly back formulation used for week...
To determine feasibility and compare acceptance of an investigational Medtronic enhanced advanced hybrid closed-loop (e-AHCL) system in adults with type 1 diabetes earlier iterations.
Introduction Manual determination of insulin dosing largely fails to optimise glucose control in type 1 diabetes. Automated delivery via closed-loop systems has improved short-term studies. The objective the present study is determine effectiveness 6 months’ compared with manually determined on time-in-target range adults Methods and analysis This open-label, seven-centre, randomised controlled parallel group clinical trial will compare home-based hybrid versus standard diabetes therapy...
Background: Experience from first-generation closed-loop (CL) systems informs refinements to enhance glucose control and user acceptance. A next-generation prototype enhanced-hybrid CL (E-HCL) system incorporates iterative changes the Medtronic MiniMed 670G system, including automated correction boluses, lower target level, enhancements. The aim was explore safety, performance, using E-HCL in adults with type 1 diabetes. Methods: Twelve underwent this first in-human feasibility study. After...
To evaluate exercise-related glucose and counterregulatory responses (CRR) in adults with type 1 diabetes impaired awareness of hypoglycemia (IAH) using hybrid closed-loop (HCL) insulin delivery to maintain homeostasis.Twelve participants undertook 45-min high-intensity intermittent exercise (HIIE) moderate-intensity (MIE) random order. The primary outcome was continuous monitoring (CGM) time range (70-180 mg/dL) for 24-h post-exercise commencement.CGM similar HIIE MIE (median 79.5%...
Hybrid closed loop (HCL) insulin delivery with the Medtronic Minimed 670G system is effective and safe in people type 1 diabetes (T1D). This study compared glucose control, (CL) exits, alarm frequency standard HCL (s-HCL) versus enhanced (e-HCL) system. Pump-experienced T1D adults (n = 11; 9 female; mean [SD] age: 51 years [15 years]; HbA1c 7.5% [1.0%] or 58 mmol/mol [7.7 mmol/mol]) were assigned, random order, s-HCL e-HCL for week each a supervised live-in setting. incorporated bolus...
Background: This study compared glucose control with fast-acting insulin aspart (FiAsp) versus following moderate-intensity exercise (MIE) and high-intensity (HIE) using a second-generation closed-loop (CL) system in people type 1 diabetes. Materials Methods: randomized crossover FiAsp over four sessions during MIE HIE CL delivery by the MiniMed™ Advanced hybrid system. Participants were randomly assigned each for 6 weeks within period performed, random order, 40 min (∼50% VO2max) (6 × 2...
Exercise has many physical and psychological benefits is recommended for people with type 1 diabetes; however, there are barriers to exercise, including glycemic instability fear of hypoglycemia. Closed-loop (CL) systems have shown benefit in the overall management diabetes, improving HbA1c levels reducing incidence nocturnal hypoglycemia; these challenged by rapidly changing insulin needs exercise. This commentary focuses on principles, strengths, challenges CL discusses potential...
Aim: To compare evening and overnight hypoglycemia risk after late afternoon exercise with a nonexercise control day in adults type 1 diabetes using automated insulin delivery (AID). Methods: Thirty AID (Minimed 670G) performed random order 40 min high intensity interval aerobic (HIE), resistance (RE), moderate (MIE) each separated by >1 week. The closed-loop set-point was temporarily increased 2 h pre-exercise snack eaten if plasma glucose ≤126 mg/dL pre-exercise. Exercise commenced at...
Closed loop (CL) systems deliver insulin with a rapid onset and offset in action. Although favorable overall, the absence of long-acting increases risk diabetic ketoacidosis (DKA) which can occur delivery failure, acute illness, low carbohydrate diets, sodium glucose-linked transporter inhibitors, high intensity exercise. A CL system relying entirely on interstitial glucose measurements may not provide an alert for DKA many people type 1 diabetes (T1D) do carry blood ketone meter...
Background: Benefits of hybrid closed-loop (HCL) systems in a high-risk group with type 1 diabetes and impaired awareness hypoglycemia (IAH) have not been well-explored. Methods: Adults Edmonton HYPO scores ≥1047 were randomized to 26-weeks HCL (MiniMed™ 670G) vs standard therapy (multiple daily injections or insulin pump) without continuous glucose monitoring (CGM) (control). Primary outcome was percentage CGM time-in-range (TIR; 70-180 mg/dL) at 23 26 weeks post-randomization. Major...
Background: Gestational diabetes mellitus (GDM) management using self-monitoring blood glucose (SMBG) does not normalize pregnancy outcomes. Objective: We aimed to conduct an observational study explore if continuous monitoring (CGM) could identify elevated levels apparent in women with GDM managed SMBG. Study Design: A 7-day masked-CGM (iPro; Medtronic) was performed within 2 weeks of diagnosis, immediately post-GDM education, but before insulin commencement as determined by CGM data...
Background: This prerandomization analysis from the Australian HCL-Adult trial (registration number: ACTRN12617000520336) compared masked continuous glucose monitoring (CGM) metrics among adults using insulin pumps versus multiple daily injections (MDIs), who were all self-monitoring blood (SMBG). Methods: Adults with type 1 diabetes, an pump or MDIs without real-time CGM (and entering a of closed-loop technology), eligible. MDI users given dosage calculator. All participants received...
Aim: To assess relationships between continuous glucose monitoring (CGM) time in range (TIR), 70–180 mg/dL, below (TBR), <70 above (TAR), >180 and coefficient of variation (CV) relation to currently recommended clinical CGM targets for older people, which recommend reduced TIR TBR relative the general type 1 diabetes population. Methods: We conducted a post hoc analysis using JDRF Australia Adult Hybrid Closed Loop trial database examining correlations 120 adults with 3 weeks masked...