Peter Beck Design of a mobile, safety-critical in-hospital glucose management system
|
|
|
- Andra Tucker
- 5 years ago
- Views:
Transcription
1 Peter Beck Design of a mobile, safety-critical in-hospital glucose management system European Health Forum Gastein, 3 rd October, 2013
2 2 Setting the scene: Diabetes Care Primary Care In-Hospital Care Critically ill Intensive Care (ICU) Non-critically ill General Ward
3 3 Glycaemic control in hospitals is not satisfactory in England! Diabetes patients on insulin had poor glucose control! Medication errors are worryingly common and associated with poorer outcomes! There is cause for concern about the care of inpatients with diabetes in most hospitals in Graz/Austria Source: National Diabetes Inpatient Audit (NaDIA), 2010, 2011 Neubauer et al. 2013
4 4 Motivation! Glucose management is currently often regarded as secondary in clinical wards! Hyperglycaemia in hospital is an important marker for poor clinical outcome! Intensive treatment of diabetes/hyperglycaemia shows positive results concerning reduced mortality and morbidity rates and length of stay! Well established glucose management with close blood glucose control and appropriate medication is required J Clin Endocrinol Metab 97:16-38, 2012 Diabetes Care, 27, 2: , 2004
5 Introduction of a Clinical Protocol is effective! Basal-Bolus vs. Sliding Scale in inpatient management of patients with type 2 diabetes (RABBIT 2 Trial)! BG target <140 mg/dl achieved in 66% of patients in basal-bolus group ( ) and 38% in the sliding scale insulin (SSI) group (o) (*P < 0.01; P < 0.05) Umpierrez et al., Diabetes Care 30, 2007
6 6 Medication Errors Technical Solutions CPOE, CDSS, eprescribing! Medication errors in hospitals are common, expensive, and sometimes harmful to patients! Recommended by the Institute of Medicine as one way to reduce medication errors and patient harm! Technical solutions to support process of ordering medications CPOE, CDSS and eprescribing! The evidence on these topics is only modest at best.! Systems demonstrate improved practitioner performance (more optimal prescribing, reduction of medication errors) and improve patient surrogate outcomes.! However, there is far less evidence on patient-level outcomes.
7 7 Compliance with European Medical Device Directive! GlucoTab provides Clinical Decision Support! Classified as medical device according to MDD! Considered standards! IEC Medical device software - Software life cycle processes! ISO Application of risk management to medical devices! ISO Quality management systems! IEC Application of usability engineering to medical devices! EN Application of risk management for IT-networks incorporating medical devices
8 8 Clinical Workflow Bolus Insulin (Supplement) Bolus Insulin (Nutrition) DSS DSS DSS DSS Basal Insulin Insulin Total Daily Dose Blood Glucose Measurement DSS Insulin Administration Physician Activity Morning Midday Evening Night DSS
9 9 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters
10 10 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters
11 11 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters! Automated decision support for insulin dosage (based on 3-4 BG measurements/day, SC insulin delivery)! Total Daily Dose (physician directed)
12 12 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters! Automated decision support for insulin dosage (based on 3-4 BG measurements/day, SC insulin delivery)! Total Daily Dose (physician directed)
13 13 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters! Automated decision support for insulin dosage (based on 3-4 BG measurements/day, SC insulin delivery)! Total Daily Dose (physician directed)! Individual insulin delivery (nurse directed)
14 14 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters! Automated decision support for insulin dosage (based on 3-4 BG measurements/day, SC insulin delivery)! Total Daily Dose (physician directed)! Individual insulin delivery (nurse directed)
15 15 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters! Automated decision support for insulin dosage (based on 3-4 BG measurements/day, SC insulin delivery)! Total Daily Dose (physician directed)! Individual insulin delivery (nurse directed)
16 16 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters! Automated decision support for insulin dosage (based on 3-4 BG measurements/day, SC insulin delivery)! Total Daily Dose (physician directed)! Individual insulin delivery (nurse directed)! Workflow support and reminder for open tasks! Sequence of operation! measurements as prerequisite for dose recommendation
17 17 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters! Automated decision support for insulin dosage (based on 3-4 BG measurements/day, SC insulin delivery)! Total Daily Dose (physician directed)! Individual insulin delivery (nurse directed)! Workflow support and reminder for open tasks! Sequence of operation! measurements as prerequisite for dose recommendation
18 18 Main Features! Provide glucose management directly at the point of care Documentation and visualization of relevant parameters! Automated decision support for insulin dosage (based on 3-4 BG measurements/day, SC insulin delivery)! Total Daily Dose (physician directed)! Individual insulin delivery (nurse directed)! Workflow support and reminder for open tasks! Sequence of operation! measurements as prerequisite for dose recommendation! Avoidance of manual/multiple data inputs (HIS interfaces)! Time and location independent access
19 19 Development Methods! Evolutionary development approach! Interdisciplinary group! Usability testing, user-centred design approach! Mock-ups and early prototypes: triggers for clinical personnel! Continuous risk management
20 GlucoTab Evolution
21 GlucoTab Evolution
22 GlucoTab Evolution
23 GlucoTab Evolution
24 GlucoTab Evolution
25 GlucoTab Evolution
26 GlucoTab Evolution
27 Conclusion! End-users were involved in main decisions on functionality and design! Use of triggers (mock-ups/prototypes)! end-users got a better idea of design possibilities/functionality! base for decisions and compromises between users! base for further development and/or changes! Different points of view! Clinicians focus on key functionality, ease of use, workflow, integration! Technicians tend to gather as much functionality as possible! User-centred approach is important to meet regulatory requirements
28 28 Discussion! Even if computerized insulin orders are medically accurate, if systems are not built and designed well, they may fail in their purpose.! Usability and user involvement were an important part of the GlucoTab development! BUT: Technical issues still could become barriers! Education as a key element of the introduction of a glucose management system is repeatedly mentioned in clinical studies! Education is a factor of cost and effort! Concern about causing hypoglycaemia most important barrier to implementation of glycemic control programs! Clinical studies will have to demonstrate good results
29 Clinical Evaluation
30 30 Clinical Evaluation analysis of glycaemic management REACTION - algorithm paper-based tablet-based one ward tablet-based several wards Glucose Cardio Endo Cardio Endo Endo clinical wards clinical wards ClinDiab01 ClinDiab02 ClinDiab03 ClinDiab04 Project
31 31 Mader JK, Neubauer KM, Schaupp L, Augustin T, Beck P, Spat S, Höll B, Treiber GM, Fruhwald FM, Pieber TR, Plank J Efficacy, usability and sequence of operations of a workflowintegrated algorithm for basal-bolus insulin therapy in hospitalized type 2 diabetes patients. Diabetes, Obesity & Metabolism. 2013, E-Pub ahead of print.
32 32 Glycaemic control! Open, single-centre controlled trial! Algorithm treatment, n=37 patients Endocrinology department! Standard treatment, n=37 patients Cardiology department
33 33 Nurses questionnaire! Glucose control with algorithm is more efficient as compared to standard routine care?! Do you think that the algorithm will help to prevent errors in the glycaemic management process?! Did you feel confident using the algorithm based therapy?
34 34 ClinDiab02 Summary! Recommended glycaemic target could be achieved in 46% of the data with the REACTION algorithm! no serious adverse events (i.e. severe hypohyper glycaemia)! increased rate of mild hypoglycaemic events in the afternoon! paper based REACTION algorithm has been very well accepted by staff
35 35 Next Step analysis of glycaemic management REACTION algorithm paper-based tablet-based one ward tablet-based several wards tablet-based multicenter Glucose Cardio Endo Cardio Endo Endo clinical wards clinical wards ClinDiab01 ClinDiab02 ClinDiab03 ClinDiab04 ClinDiab05 Project
36 36 Outlook! Application outside the hospital! in nursing homes! mobile care at home! Challenges! Full mobility! More independence of network connectivity! Algorithm modification! Dose adjustments less frequently! More flexibility
37 Dr. Peter Beck JOANNEUM RESEARCH Forschungsgesellschaft mbh HEALTH Institute for Biomedicine and Health Sciences Elisabethstraße 11a, 8010 Graz
Diabetes Management in hospital care: GlucoTab - A medical device to improve insulin treatment of patients with diabetes type 2
Diabetes Management in hospital care: GlucoTab - A medical device to improve insulin treatment of patients with diabetes type 2 JOANNEUM RESEARCH Forschungsgesellschaft mbh HEALTH Institute for Biomedicine
A toolbox to improve algorithms for insulin-dosing decision support
548 A toolbox to improve algorithms for insulin-dosing decision support K. Donsa 1 ; P. Beck 1 ; J. Plank 2 ; L. Schaupp 2 ; J. K. Mader 2 ; T. Truskaller 1 ; B. Tschapeller 1 ; B. Höll 1 ; S. Spat 1 ;
Accurate Timing of Insulin Administration.
Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing Accurate Timing of Insulin Administration. Elizabeth Ajamu BSN, RN Lehigh Valley Health Network, elizabeth_o.ajamu@lvhn.org
A Children s Bedtime Story
A Children s Bedtime Story Setting: University Medical Center, Big Town, USA Scenario: 0500, last admission of the night, 10 previous admissions, all tucked in for the night Patient: 75 year old male with
National Diabetes Inpatient Audit (NaDIA) 2016
National Diabetes Inpatient Audit (NaDIA) 2016 DIABETES A summary report for people with diabetes and anyone interested in the quality of care for people with diabetes when they stay in hospital. Based
Basal Bolus Insulin Therapy Frequently Asked Questions
1. What is Basal Bolus Insulin Therapy (BBIT)? 2. What evidence supports the use of subcutaneous Basal Bolus Insulin Therapy? 3. Does Basal Bolus Insulin Therapy apply to all patients? 4. What s wrong
In - Hospital Diabetes Care. A review and personal experience
In - Hospital Diabetes Care A review and personal experience Hyperglycemia in the Hospital The Problem Hospitalizations with Diabetes http://www.cdc.gov/diabetes/statistics/dmany/fig1.htm Prevalence of
Insulin pumps (CSII): Using Modern technology to communicate with families of children with type 1 diabetes
Insulin pumps (CSII): Using Modern technology to communicate with families of children with type 1 diabetes Grace Harris and Rita Sigley Paediatric Diabetes Nurse Specialists Starship children s Health
Meeting the Challenge of Inpatient Glycemic Management in the Non-Critical Care Setting
Meeting the Challenge of Inpatient Glycemic Management in the Non-Critical Care Setting Jane Jeffrie Seley, DNP, MPH, GNP, BC-ADM, CDE, CDTC, FAAN, FAADE Diabetes Nurse Practitioner, Inpatient Diabetes
Self-assessment checklist
Self-assessment checklist 1 1 All hospitals should have a fully staffed diabetes inpatient team, made up of the following 1 : consultant. Sufficient diabetes inpatient specialist nurses to run a daily
15 th Annual DAFNE collaborative meeting Tuesday 28 th June 2016
15 th Annual DAFNE collaborative meeting Tuesday 28 th June 2016 Sponsored by: Abbott Diabetes Care and Lilly Diabetes Type 1 and exercise Royal Berkshire Hospital Centre for Diabetes and Endocrinology
GLOOKO DREAMED FOR ANDROID USER GUIDE
GLOOKO DREAMED FOR ANDROID USER GUIDE November 2018 IFU-0017 02 TABLE OF CONTENTS TABLE OF CONTENTS GENERAL INFORMATION... 2 Product Description... 2 Glooko Intended Use... 2 Dreamed Intended Use... 2
Making Foot Surgery Safer for Patients with Diabetes
Making Foot Surgery Safer for Patients with Diabetes Building a New Trust Pathway Patient Safety Briefing The Newcastle Peri-operative Diabetes Pathway Launched 9 May 2016 Aims to join up peri-operative
9 Diabetes care. Back to contents
Back to contents Diabetes is a major risk factor for the development of peripheral vascular disease and 349/628 (55.6%) of the patients in this study had diabetes. Hospital inpatients with diabetes are
In keeping with the Scottish Diabetes Group criteria, use should be restricted to those who:
Advice Statement 009-18 July 2018 Advice Statement What is the clinical and cost effectiveness of Freestyle Libre flash glucose monitoring for patients with diabetes mellitus treated with intensive insulin
Deepika Reddy MD Department of Endocrinology
Deepika Reddy MD Department of Endocrinology Management of hyperglycemic crisis Review need for inpatient glycemic control Brief overview of relevant trials Case based review of diabetes management strategies/review
APPENDIX American Diabetes Association. Published online at
APPENDIX 1 INPATIENT MANAGEMENT OF TYPE 2 DIABETES No algorithm applies to all patients with diabetes. These guidelines apply to patients with type 2 diabetes who are not on glucocorticoids, have no
UNCOVERING THE BENEFITS OF THE ACCU- CHEK BOLUS ADVISOR MICHAEL PORTER CDE
UNCOVERING THE BENEFITS OF THE ACCU- CHEK BOLUS ADVISOR MICHAEL PORTER CDE 1 LEARNING OBJECTIVES By the end of this session participants should be able to understand: The benefits of bolus advisors The
Kylie Murray, Ann Ainsworth. Maggie Hammersley. 28 th November 2008
ABCD Pilot Audit of Hyperglycaemia Management in ACS East & North Herts Norwich Oxford Portsmouth Peter Winocour, Debbie Stannistreet, Kylie Murray, Ann Ainsworth Ketan Dhatariya Maggie Hammersley Ken
GLYCEMIC CONTROL SURVEY
GLYCEMIC CONTROL SURVEY Objective: To gain an understanding of the current state of glycemic control (ie, intensive insulin therapy and frequent blood glucose testing) protocol use in hospital inpatients.
Study Participants HbA1c (%, mean and SD) Duration of diabetes (years, mean and SD) Age (years, mean and SD) Type 1 diabetes
Supplementary Table 1. Baseline characteristics of the included studies and participants Name (year) Type 1 diabetes Length (mths) (2013) 14 6 I:63 C:64 (2010) 15 6 I:67 C:63 Charpentier et al. (2013)
What is the role of insulin pumps in the modern day care of patients with Type 1 diabetes?
What is the role of insulin pumps in the modern day care of patients with Type 1 diabetes? Dr. Fiona Wotherspoon Consultant in Diabetes and Endocrinology Dorset County Hospital Fiona.Wotherspoon@dchft.nhs.uk
eprescribing: Implementation reflections Andrew Heed Lead Pharmacist Clinical Informatics The Newcastle upon Tyne Hospitals NHS Foundation Trust
eprescribing: Implementation reflections Andrew Heed Lead Pharmacist Clinical Informatics The Newcastle upon Tyne Hospitals NHS Foundation Trust 3 Reflections eprescribing is: Simple, complicated, non-existent,
Hot Topics: The Future of Diabetes Management Cutting Edge Medication and Technology-Based Care
Hot Topics: The Future of Diabetes Management Cutting Edge Medication and Technology-Based Care Mary Jean Christian, MA, MBA, RD, CDE Diabetes Program Coordinator UC Irvine Health Hot Topics: Diabetes
Diabetes Subcommittee of PTAC meeting held 3 March (minutes for web publishing)
Diabetes Subcommittee of PTAC meeting held 3 March 2011 (minutes for web publishing) Diabetes Subcommittee minutes are published in accordance with the Terms of Reference for the Pharmacology and Therapeutics
Managing Hyperglycaemia in Acute (Adult) Inpatients Requiring Enteral Feeding Guidelines
Document Control Title Managing Hyperglycaemia in Acute (Adult) Inpatients Requiring Author Author s job title Specialist Nurse Consultant Physician Department Directorate Unscheduled Care Version Date
Developing a pathway of. and care planning for people with diabetes
Developing a pathway of preoperative assessment and care planning for people with diabetes Louise Hilton, Marie Digner Diabetes is a common endocrine condition affecting 1.4 million people in the UK, with
Welcome Everyone. Monitoring, Sick Days, Inpatient Management - Objectives. Mrs. Jones has new diabetes. She asks you: Page 1
Welcome Everyone Sign-In Enjoy Breakfast Meet someone new Enter Raffle Pick a team name Please silence phones We start at 8:00am Monitoring, Sick Days, Inpatient Management - Objectives Objectives: Strategies
HAP PA-HEN Achieving More Together
HAP PA-HEN Achieving More Together Managing Hyperglycemia in the Hospital: Strategies for Safe and Effective Care Pennsylvania Patient Safety Authority Managing Hyperglycemia in the Hospital: Strategies
UvA-DARE (Digital Academic Repository) The artificial pancreas Kropff, J. Link to publication
UvA-DARE (Digital Academic Repository) The artificial pancreas Kropff, J. Link to publication Citation for published version (APA): Kropff, J. (2017). The artificial pancreas: From logic to life General
1. Continuous Glucose Monitoring
1. Continuous Glucose Monitoring 1. Physiology of interstitial fluid glucose 2. Comparison of CGM and self-monitored blood glucose (SMBG) data 3. Insulin dosing indication in BGM vs. CGM & the FDA 4. Protection
Long-term effects of continuous glucose monitoring on HbA 1c levels: An audit
Long-term effects of continuous glucose monitoring on Julie Brake Continuous glucose monitoring (CGM) has become a common and useful tool in diabetes care. To understand whether a 72-hour glucose profile
Managing Diabetes and Hyperglycemia Safely in the Complex Hospital Setting
Managing Diabetes and Hyperglycemia Safely in the Complex Hospital Setting Greg Maynard MD, MSc Clinical Professor of Medicine and CQO, UC Davis Medical Center Sacramento, CA Greg Maynard Disclosure SHM
Faculty. Disclosures. Prescribing. A Multidisciplinary Approach to Preventing Medication Errors Associated with Insulin Therapy. Learning Objectives
A Multidisciplinary Approach to Preventing Medication Errors Associated with Insulin Therapy Faculty Matthew Grissinger, RPh, FISMP, FASCP Director, Error Reporting Programs Institute for Safe Medication
Approach to the Young child & Parent with Child with DM Best Structure for Continued Care
Approach to the Young child & Parent with Child with DM Best Structure for Continued Care M.S. Limbe MD Paediatric Endcocrinologist Aga Khan University Hospital, Nairobi Approach to the Young Child & Parent
Diabetes is a lifelong, chronic. Survey on the quality of diabetes care in prison settings across the UK. Keith Booles
Survey on the quality of diabetes care in prison settings across the UK Article points 1. The Royal College of Nursing Diabetes Forum conducted an audit of prisons within the UK to determine the level
In Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus
In Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus This procedural document supersedes any previous guidelines in relation to this subject: PAT/T 49 v.2 In Hospital Management of
Endocrine Update Mary T. Korytkowski MD Division of Endocrinology University of Pittsburgh
Endocrine Update 2016 Mary T. Korytkowski MD Division of Endocrinology University of Pittsburgh Disclosure of Financial Relationships Mary Korytkowski MD Honoraria British Medical Journal Diabetes Research
Hypoglyceamia and Exercise
Hypoglyceamia and Exercise Noreen Barker Diabetes Specialist Nurse May 2016 Hypoglyceamia What is a hypo? Why are we concerned? Signs and symptoms Treatments Causes Hypo unawareness Managing diabetes and
BEST 4 Diabetes. Optimisation of insulin module
BEST 4 Diabetes Optimisation of insulin module Confidence and competence Where would you rate yourself? Why do all of our patient not achieve optimal blood glucose control? Insulin Therapy Goals and Purpose
Diabetes group education classes
These group education classes are available for patients who: have newly diagnosed type 2 diabetes have type 2 diabetes and are on insulin, or starting on insulin use an insulin pump or are starting to
Counting the Carbs, Fat and Protein in Type 1 Diabetes Translating the Research into Clinical Practice
Welcome to Allied Health Telehealth Virtual Education Counting the Carbs, Fats and Protein in Type 1 Diabetes Translating the Research into Clinical Practice Dr Carmel Smart, PhD Senior Specialist Paediatric
Endoscopy or colonoscopy guidelines
Endoscopy or colonoscopy guidelines for patients with diabetes The development and audit of local pilot guidelines for patients with diabetes undergoing an endoscopy or colonoscopy as an out-patient D
Management of Inpatient Hyperglycemia: 2011 Endocrine Society Meeting Hyperglycemia in Critically ill patients in ICU Settings.
Management of Inpatient Hyperglycemia: 2011 Endocrine Society Meeting Guillermo E. Umpierrez, MD, Emory University School of Medicine and Jack Leahy, MD, University of Connecticut Hyperglycemia in Critically
National Diabetes Treatment and Care Programme
National Diabetes Treatment and Care Programme Introduction to and supporting documentation for VALUE BASED TRANSFORMATION FUNDING SITE SELECTION December 2016 1 Introduction and Contents The Planning
Improving Glycemic Control and Insulin Ordering Efficiency for Hospitalized Patients With Diabetes Through Carbohydrate Counting
e1 Improving Glycemic Control and Insulin Ordering Efficiency for Hospitalized Patients With Diabetes Through Carbohydrate Counting Kristina K. Pearson, Sarah A. Reiland, John G. O Meara, Julie K. Brown,
Introduction. Guidelines for patient involvement in the administration of insulin under supervision in hospital (Adult patients)
Guidelines for patient involvement in the administration of insulin under supervision in hospital (Adult patients) Introduction This guideline is designed to provide a framework for patients to administer
Insulin Pump Therapy. WakeMed Children s Endocrinology & Diabetes WakeMed Health & Hospitals Version 1.3, rev 5/21/13 MP
Insulin Pump Therapy WakeMed Children s Endocrinology & Diabetes Overview What is an insulin pump? What are the advantages and disadvantages of an insulin pump? Lifestyle Changes Food Management Exercise
Policy for the Provision of Insulin Pumps for Patients with Diabetes Mellitus
Policy for the Provision of Insulin Pumps for Patients with Diabetes Mellitus Version No. Changes Made Version of July 2018 V0.5 Changes made to the policy following patient engagement including: - the
Olympic diabetes What have we learned over the last decade? Ian Gallen Jephcott Symposium 9 th May 2012
Olympic diabetes What have we learned over the last decade? Ian Gallen Jephcott Symposium 9 th May 2012 Diabetes and exercise Ian Gallen Challenges in the management SR s diabetes prior to 2000 Olympic
SIMULATIONS OF A MODEL-BASED FUZZY CONTROL SYSTEM FOR GLYCEMIC CONTROL IN DIABETES
Bulletin of the Transilvania University of Braşov Vol. 8 (57) No. 2-2015 Series I: Engineering Sciences SIMULATIONS OF A MODEL-BASED FUZZY CONTROL SYSTEM FOR GLYCEMIC CONTROL IN DIABETES C. BOLDIȘOR 1
magic DRAGONS: A Protocol for Accurate Glycaemic Control in General Wards
Preprints of the 19th World Congress The International Federation of Automatic Control magic DRAGONS: A Protocol for Accurate Glycaemic Control in General Wards Felicity Thomas,* Hamish Tomlinson,* Angus
Transition of Care in Hospitalized Patients with Hyperglycemia and Diabetes
Transition of Care in Hospitalized Patients with Hyperglycemia and Diabetes Critically ill patients in the ICU Hospital Non-ICU Settings Home Guillermo E Umpierrez, MD, FACP, FACE Professor of Medicine
Procedure for the prescribing and administration of insulin
Procedure for the prescribing and administration of insulin Author: Lilian Baxendale and Heather Beadle Designation: Clinical Governance Pharmacists Version: Version 3 Date: December 2016 Date Approved:
Medication management at the Valenciennes General Hospital
Medication management at the Valenciennes General Hospital Etienne Cousein Chief Pharmacist Pharmacy Medication Department cousein-e@ch-valenciennes.fr Valenciennes General Hospital 1800 beds facility
THE ONLY SYSTEM^ CLINICALLY PROVEN TO REDUCE HYPOGLYCAEMIA
THE ONLY SYSTEM^ CLINICALLY PROVEN TO REDUCE HYPOGLYCAEMIA MINIMED 640G system^ with SmartGuard technology HYPOGLYCAEMIA IS CHALLENGING FOR GLYCAEMIC CONTROL 1 AND quality of life 2 Achieving good glucose
NHS GG&C Introduction of Freestyle Libre flash glucose monitoring system
NHS GG&C Introduction of Freestyle Libre flash glucose monitoring system The Freestyle Libre flash glucose monitoring system is a sensor based, factory-calibrated system that measures interstitial fluid
Αναγκαιότητα και τρόπος ρύθμισης του διαβήτη στους νοσηλευόμενους ασθενείς
Αναγκαιότητα και τρόπος ρύθμισης του διαβήτη στους νοσηλευόμενους ασθενείς Αναστασία Θανοπούλου Επίκουρη Καθηγήτρια Β Παθολογικής Κλινικής Πανεπιστημίου Αθηνών Διαβητολογικό Κέντρο, Ιπποκράτειο Νοσοκομείο
Hypoglycemia a barrier to normoglycemia Are long acting analogues and pumps the answer to the barrier??
Hypoglycemia a barrier to normoglycemia Are long acting analogues and pumps the answer to the barrier?? Moshe Phillip Institute of Endocrinology and Diabetes National Center of Childhood Diabetes Schneider
ClinicalTrials.gov Identifier: sanofi-aventis. Sponsor/company:
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription Sponsor/company: sanofi-aventis ClinicalTrials.gov
Insulin sensitivity, its variability and glycaemic outcome:
MCBMS 2009 Insulin sensitivity, its variability and glycaemic outcome: A model-based analysis of the difficulty in achieving tight glycaemic control in critical care JG Chase et al Dept of Mechanical Engineering
Diabetes Medical Management Plan
MADISON CONSOLIDATED SCHOOLS Diabetes Medical Management Plan Date of Plan: Effective Dates : The student s personal health care team and parents/guardian should complete this plan. It should be reviewed
Final publishable summary report
Final publishable summary report The aim of PCDIAB was to bring a portable bihormonal artificial pancreas to the patients home to improve diabetes care and quality of life, eventually diminishing societal
Anneli, Martina s daughter In better control with her pump since 2011 MY CHILD HAS TYPE 1 DIABETES
Anneli, Martina s daughter In better control with her pump since 2011 MY CHILD HAS TYPE 1 DIABETES Many parents whose child is diagnosed with Type 1 diabetes wonder: Why is this happening to my child?
BEST 4 Diabetes. Optimisation of insulin module
BEST 4 Diabetes Optimisation of insulin module Confidence and competence Where would you rate yourself? Why do all of our patient not achieve optimal blood glucose control? Insulin Therapy Goals and Purpose
Guide to Finding Your Hospital s Adverse Drug Event (ADE) Rates. Step-by-Step Data Collection Guide for Collecting the Six ADE Measures
Guide to Finding Your Hospital s Adverse Drug Event (ADE) Rates Step-by-Step Data Collection Guide for Collecting the Six ADE Measures 1 Anticoagulation Outcome Measure International Normalized Ratio (INR)
Closed-loop insulin delivery in inpatients with type 2 diabetes: a randomised, parallel-group trial
Closed-loop insulin delivery in inpatients with type 2 diabetes: a randomised, parallel-group trial Hood Thabit, Sara Hartnell, Janet M Allen, Andrea Lake, Malgorzata E Wilinska, Yue Ruan, Mark L Evans,
April Dear (Editor):
April 2014 Dear (Editor): Registered Dietitians (RD) play an integral role in patient care in the medical intensive care unit. RD s have increased knowledge in blood glucose control and reducing adverse
JDRF RESEARCH UPDATE. Daniel Finan, Ph.D. Research Director
JDRF RESEARCH UPDATE Daniel Finan, Ph.D. Research Director March 10, 2018 PRESENTER Daniel Finan Biomedical engineer B.S. Chemical Engineering University of Colorado, 2003 Ph.D. Chemical Engineering UC
Glucose Concentration Simulation for Closed-Loop Treatment in Type 1 Diabetes
American Society for Engineering Education (ASEE), Northeast Section Annual Conference, April 27-28, 208 Glucose Concentration Simulation for Closed-Loop Treatment in Type Diabetes Marilyn Urrea, Nora
Learning Objectives. Impact of Diabetes II UPDATES IN TYPE 2 DIABETES. David Doriguzzi, PA-C
UPDATES IN TYPE 2 DIABETES David Doriguzzi, PA-C Learning Objectives Upon completion of this educational activity, the participant should be able to: Overcome barriers and attitudes that limit Clinician/Patient
NOT-SO-SWEET! THE STRAIGHT SCOOP ON DIABETES IN THE HOSPITAL SETTING
Sharp HealthCare s 2016 Diabetes Conference November 11, 2016 NOT-SO-SWEET! THE STRAIGHT SCOOP ON DIABETES IN THE HOSPITAL SETTING Tamara Swigert, MSN, RN, CDE Speaker Disclosure Tammy Swigert has no conflicts
Parenteral Nutrition The Sweet and Sour Truth. From: Division of Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai
ENDOCRINE PRACTICE Rapid Electronic Article in Press Rapid Electronic Articles in Press are preprinted manuscripts that have been reviewed and accepted for publication, but have yet to be edited, typeset
Sponsor / Company: Sanofi Drug substance(s): Insulin Glargine. Study Identifiers: NCT
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription. Sponsor / Company: Sanofi Drug substance(s):
Control of Glycemic Variability for Reducing Hypoglycemia Jae Hyeon Kim
Control of Glycemic Variability for Reducing Hypoglycemia Jae Hyeon Kim Division of Endocrinology and Metabolism, Samsung Medical Center, Sungkyunkwan University School of Medicine Conflict of interest
GLOOKO FOR ios MIDS USER GUIDE
GLOOKO FOR ios MIDS USER GUIDE October 2018 IFU-0001 13 Glooko MIDS is cleared for US only Rx only TABLE OF CONTENTS TABLE OF CONTENTS MOBILE INSULIN DOSING SYSTEM (MIDS)... 2 Intended Use... 2 Warnings...
Objectives. Key Elements. ICAHN Targeted Focus Area: Drug Information and Drug Standardization and Distribution 3/24/2014
ICAHN Targeted Focus Area: Drug Information and Drug Standardization and Distribution Matthew Fricker, RPh, MS, FASHP Program Director, ISMP Rebecca Lamis, PharmD, FISMP Medication Safety Analyst, ISMP
Standard Operating Procedure 11. Completion of DAFNE Data Collection: Full Post Course Form F04.010, Version 8
Standard Operating Procedure 11 Completion of DAFNE Data Collection: Full Post Course Form F04.010, Version 8 Date Version Issue Review Contact Approved Date Date Person October 2013 9 October 2013 March
Topics in Inpatient Glycemic Control
Topics in Inpatient Glycemic Control Jane Jeffrie Seley DNP MPH MSN GNP BC-ADM CDE CDTC FAADE FAAN Diabetes Nurse Practitioner Program Manager, Inpatient Glycemic Control Program NewYork-Presbyterian/
P R O J E C T B U L L E T I N - F A L L I N T H I S I S S U E U P D A T E S F O R
D I A B E T E S O B E S I T Y & N U T R I T I O N S T R A T E G I C C L I N I C A L N E T W O R K ( D O N S C N ) I N T H I S I S S U E U P D A T E S F O R P R O V I N C I A L D I A B E T E S I N P A T
Inpatient Management of Hyperglycemia Guillermo Umpierrez, MD, CDE Saturday, February 10, :30 a.m. 11:15 a.m.
Inpatient Management of Hyperglycemia Guillermo Umpierrez, MD, CDE Saturday, February 10, 2018 10:30 a.m. 11:15 a.m. There are over 7.5 million hospital admissions for patients with diabetes in the US.
WOULD YOU LIKE TO REDUCE THE FEAR OF HYPOGLYCAEMIA FOR YOUR PATIENTS?
WOULD YOU LIKE TO REDUCE THE FEAR OF HYPOGLYCAEMIA FOR YOUR PATIENTS? THE ONLY SYSTEM CLINICALLY PROVEN TO REDUCE HYPOGLYCAEMIA MINIMED 640G SYSTEM WITH SMARTGUARD TECHNOLOGY 1 HYPOGLYCAEMIA IS CHALLENGING
Section of Endocrinology, Rush University Medical Center, Chicago, Illinois.
ORIGINAL RESEARCH Treatment of Inpatient Hyperglycemia Beginning in the Emergency Department: A Randomized Trial Using Insulins Aspart and Detemir Compared With Usual Care Jennifer B. Bernard, MD Christina
Updates in Diabetes Technology
Updates in Diabetes Technology Jessica Kirk, MSN, RN, CPN, CDE Nurse Manager, Endo ECHO No disclosures Disclosures 1 Objectives Distinguish patients appropriate for continuous glucose monitoring and insulin
[Frida Svendsen and Jennifer Southern] University of Oxford
![[Frida Svendsen and Jennifer Southern] University of Oxford](/thumbs/95/124874384.jpg "[Frida Svendsen and Jennifer Southern] University of Oxford")
In adolescents with poorly controlled type 1 diabetes mellitus, could a bionic, bihormonal pancreas provide better blood glucose control than continuous subcutaneous insulin infusion therapy? [Frida Svendsen
The Practice of Delivering Diabetes Medicines Optimisation. Elizabeth Hackett Principal Pharmacist for Diabetes
The Practice of Delivering Diabetes Medicines Optimisation Elizabeth Hackett Principal Pharmacist for Diabetes University i Hospitals Leicester Agenda Background (NaDIA and local data) Challenges facing
DIAGNOSIS OF DIABETES NOW WHAT?
DIAGNOSIS OF DIABETES NOW WHAT? DISCUSS GOALS FOR DIABETES CARE IDENTIFY COMMON COMPLIANCE- ADHERENCE ISSUES DESCRIBE TECHNOLOGY TO ASSIST AND / OR IMPROVE DIABETES CARE WHAT DO WE WANT OUR PATIENTS TO
GUIDELINE FOR ENTERAL TUBE FEEDING (NASOGASTRIC OR PEG) IN PATIENTS WITH DIABETES MELLITUS TREATED WITH INSULIN
GUIDELINE FOR ENTERAL TUBE FEEDING (NASOGASTRIC OR PEG) IN PATIENTS WITH DIABETES MELLITUS TREATED WITH INSULIN This guidance does not override the individual responsibility of health professionals to
Diabetes in obstetric patients
Diabetes in obstetric patients Swedish Society of Obstetric Anaesthesia & Intensive Care Anita Banerjee Obstetric Physician Diabetes & Endocrinology Consultant Outline Scope of the problem Diabetes and
Diabetes Medical Management Plan
Date of Plan: Diabetes Medical Management Plan This plan should be completed by the student s personal health care team and parents/guardian. It should be reviewed with relevant school staff and copies
The most recent estimates suggest that. A study of inpatient diabetes care on medical wards. Saqib Javed, Yaser Javed, Kate Barnabas, Kalpana Kaushal
A study of inpatient diabetes care on medical wards Saqib Javed, Yaser Javed, Kate Barnabas, Kalpana Kaushal Article points 1. It is well established that poor glycaemic control is associated with increased
Glycemic Control IU Health Diabetes Centers
Glycemic Control IU Health Diabetes Centers Central Nursing Orientation 3/10/2014 1 Objectives Identify laboratory results that diagnosis diabetes and reflect glycemic control Describe glycemic control
Management of adults with diabetes undergoing surgery and elective procedures: Improving standards
Management of adults with diabetes undergoing surgery and elective procedures: Improving standards Revised September 2015 Changes in the second edition of the peri-operative document Preoperative pathway
An Audit of Hypoglycaemia Management in Adult Inpatients with Diabetes
An Audit of Hypoglycaemia Management in Adult Inpatients with Diabetes Presented by: Brett Fenton, NUM Diabetes Services Prepared with: Julie Droguett, CNS 2 Diabetes Services Background and Rationale
Diabetes Medical Management Plan
of Plan: School year: Diabetes Medical Management Plan This plan should be completed by the student s personal health care team and parents/guardian. It should be reviewed with relevant school staff and
CLINICAL DECISION SUPPORT FOR ME/ADE PREVENTION
CLINICAL DECISION SUPPORT FOR ME/ADE PREVENTION Sandra Kane-Gill, PharmD, MSc, FCCP, FCCM Associate Professor of Pharmacy, Critical Care Medicine and the Clinical Translational Science Institute, University
Improved IPGM: Demonstrating the Value to both Patients and Hospitals
Improved IPGM: Demonstrating the Value to both Patients and Hospitals Osama Hamdy, MD, PhD, FACE Medical Director, Inpatient Diabetes Program Joslin Diabetes Center Harvard Medical School, Boston, MA Cost
Slide 1. Slide 2. Slide 3. Objectives. Reminders and Alerts. Decision Support for Quality Improvement. Unit 6.3: Alerts and Clinical Reminders
Slide 1 Decision Support for Quality Improvement Unit 6.3: Alerts and Clinical Reminders 1 Slide 2 Objectives Analyze the benefits and shortfalls of alerts and clinical reminders 2 Slide 3 Reminders and
Inpatient Diabetes Management: The Slippery Slope of Sliding Scale Insulin
Inpatient Diabetes Management: The Slippery Slope of Sliding Scale Insulin David Newman, MD University of North Dakota School of Medicine Sanford Health Big Sky Conference 2017 Dr. David Newman, Personal/Professional