Welcome to Journal of Diabetes Science and Technology (DST) (www.journalofdst.org). This bimonthly peer reviewed electronic journal closely covers the field of diabetes technology. DST is published by Diabetes Technology Society, a non-profit organization, based in Foster City, California. The mission of DST is to produce a high quality journal that is: 1) the meeting ground between the science and practice of diabetes and technology; 2) the premiere source of information focused on diabetes and technology; and 3) the catalyst to advance development and utilization of new technologies to help people with diabetes. Journal of Diabetes Science and Technology is backed by an outstanding Editorial Board of scientists, clinicians, and government regulators to review articles and advise the editorial staff. It is noteworthy that such major United States government agencies as the Army, Centers for Disease Control and Prevention (CDC), Department of Veterans Affairs (VA), Food and Drug Administration (FDA), National Aeronautics and Space Administration (NASA), National Institutes of Health (NIH), National Space Biomedical Research Institute (NSBRI), and National Science Foundation (NSF) are all represented on the Editorial Board. Each of these agencies or organizations deals with maintaining health or developing technology for their constituents. The technologies that are being closely covered by DST relate to the 21 million Americans, and the 250 million people worldwide with diabetes. When administrators of these agencies or organizations look to acquire improved metabolic monitoring, physiologic modeling, or remote data transmission capabilities, they are increasingly turning to the diabetes technology community, and DST presents the advances that are emerging from this scientific community. Journal of Diabetes Science and Technology is supported by a Clinical Advisory Board, as well. This group of international experts in clinical applications of diabetes technology, based in the US, Europe, and Australia, reviews clinical articles and advises the editorial staff. This Board will be particularly active in identifying topics for the journal's regular section on “Clinical Applications of Diabetes Technology.” DST presents the latest information about developments in diabetes technology from basic science to clinical applications. Diabetes science refers to performing research or making observations to understand the abnormal physiology of diabetes and discover opportunities for treating this disease Diabetes technology refers to applying scientific principles or utilizing practical experience to create tools for people with diabetes and develop products for fighting this disease. DST emphasizes the spectrum of technologic applications derived from the physical sciences, which can be used to treat, monitor, diagnose, or prevent diabetes. At one end of the journal's spectrum are basic science articles written by engineers, chemists, physicists, and other physical scientists. These scientific articles cover physical principles and relationships that can be utilized to develop products. At the other end of the journal's spectrum are clinical trial articles written by physicians, nurses, pharmacists, and other healthcare providers. These articles cover the outcomes and potential benefits of investigational devices and drugs that can mimic or improve upon natural systems to compensate for the abnormal metabolic pathways that characterize diabetes. DST covers all forms of diabetes technology including: glucose monitoring; insulin and metabolic peptide delivery; artificial and bioartificial closed-loop control systems, telemedicine; software for modeling; physiologic monitoring; technology for managing obesity; diagnostic tests of glycation; and the use of bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors and actuators to be applied to diabetes. DST supports the mission of Diabetes Technology Society, which is to promote the use of science and engineering in the fight against diabetes. In DST, peer review of original articles and review articles is conducted by leaders in the field from academia, government, the non-profit sector, and industry. Commentary articles are published to express opinions about problems in diabetes technology, and their general format is to describe where we are, where we are going, and how we need to get there. Authors are asked to disclose potential financial conflicts of interest. DST contains a regular section on scientific and clinical developments in Obesity Technology, co-edited by Karl Friedl, Ph.D. from US Army TATRC, Fort Detrick, Maryland (Scientific Editor) and Frank Greenway, M.D., from Pennington Biomedical Research Institute of Louisiana State University (Clinical Editor). Diabetes Technology Society believes that technology will play an important role in reversing the global trend toward obesity and resultant type 2 diabetes. In the first issue of DST, this section contains a report about the NSF/NIH Workshop on Engineering Approaches to Energy Balance and Obesity: Opportunities for Novel Collaborations and Research, which took place in June, 2006 in Virginia. DST includes a section entitled, “Clinical Applications of Diabetes Technology.” In the journal's first issue, David Rodbard, M.D. has launched this section with an article entitled “Optimizing Display, Analysis, Interpretation and Utility of Self-Monitoring of Blood Glucose (SMBG) Data for Management of Patients with Diabetes.” DST includes a section entitled, “Controversies in Continuous Glucose Monitoring” to highlight the scientific, clinical, and economic growing pains that are accompanying the adoption of continuous glucose monitoring, which promises to revolutionize diabetes management. This section is co-edited by Bruce Buckingham, M.D. from Stanford University and Stuart Weinzimer, M.D. from Yale University. In the journal's first issue, James Nichols, Ph.D. and David Klonoff, M.D. have launched this section with an article entitled “The Need for Performance Standards for Continuous Glucose Monitors.” DST features a column entitled “Diabetes Computing & Internet Watch,” which is edited by Eldon Lehmann, M.D., Ph.D. from University of Toronto. This column alternates with a section entitled, “Diabetes Vascular and Neurologic Technology,” which is edited by Thomas Forst, M.D. from University of Mainz. DST will publish the Proceedings of the world's two most important meetings devoted to diabetes technology, the Diabetes Technology Meeting every Fall and the Clinical Diabetes Technology Meeting every Spring, as well as reports from meetings around the world. Journal of Diabetes Science and Technology is the world's first completely electronic journal devoted to diabetes. To provide quick access to back articles, DST sends subscribers a CD-ROM with the Table of Contents printed on the jacket for each issue of the journal. In this way, DST offers both the rapid turnaround time of a completely electronic journal as well as the archiving capability of a print journal. By publishing in an electronic format, it is possible to present letters to the editor online on the journal website with very little delay. We expect that DST will be occasionally controversial, frequently enlightening, and often entertaining. We hope that you will enjoy DST and will read it regularly. We invite you to submit an original article, a review article, a Commentary article, or a letter to the editor on a topic of diabetes science or technology. Journal of Diabetes Science and Technology is an electronic meeting place for the ever-expanding diabetes technology community. Together with our authors and readers we will advance the field of Diabetes Technology.
When I began working as managing editor of Journal of Diabetes Science and Technology (JDST) in August 2011, I was not quite sure what this meant in reality. With each day, I realized that it involves a good number of emails, increasing each and every day, and a lot of things to learn. It also means fun. For example, you read the (detailed) response letters of authors who write many sentences as to why this or that comment of a reviewer is wrong or right but at the same time, are very reluctant to change a single sentence in their manuscript—more about this a little later. Sometimes, I also get shocked when I encounter clear cases of plagiarism. But at first, you have to see and accept how many “stories” are going on in an active journal/editorial office. The truth is that each and every manuscript has its own story. Almost always, there are some special issues here or some trouble there. It takes some time to learn this game, and it requires highly efficient handling in the editorial office not to get lost. On the other side, it is as a big honor to work with David Klonoff and the editorial team of JDST (mainly, Vanessa Ta, Jiji Reyes, and Yoram Tamir), and my hope is that my efforts will somehow contribute to improving the quality and acceptance of our journal even further over the coming years. This might be an unusual editorial, but having been onboard this ship for several months now allows me to reflect on some aspects I believe might be of interest to our readers. With this opinion piece (the true meaning of an editorial), I also hope to clarify some topics in the interest of our journal. As a scientist, I will bring some data to the table as well. The source of these data is a well-maintained database in which each and every bit of email from the editorial office is documented along with each reviewer, deadline information, and the topics of manuscripts. There is room for a more in-depth analysis of the database in order for us all to learn some lessons, including those of us at the editorial office.
Cyberpsychology, Behavior, and Social NetworkingVol. 23, No. 7 EditorialConnecting Through Technology During the Coronavirus Disease 2019 Pandemic: Avoiding “Zoom Fatigue”Brenda K. WiederholdBrenda K. WiederholdBrenda K. Wiederhold, Editor-in-Chief Search for more papers by this authorPublished Online:10 Jul 2020https://doi.org/10.1089/cyber.2020.29188.bkwAboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail View article"Connecting Through Technology During the Coronavirus Disease 2019 Pandemic: Avoiding “Zoom Fatigue”." Cyberpsychology, Behavior, and Social Networking, 23(7), pp. 437–438FiguresReferencesRelatedDetailsCited byQuantitative analysis of communication changes in online medication counseling using the Roter Interaction SystemResearch in Social and Administrative Pharmacy, Vol. 20, No. 1“Who Said That?” Applying the Situation Awareness Global Assessment Technique to Social Telepresence13 December 2023 | ACM Transactions on Human-Robot Interaction, Vol. 12, No. 4The good and bad of an online asynchronous general education course: Students’ perceptions18 December 2023 | Psychology Teaching Review, Vol. 29, No. 2Face-to-face more important than digital communication for mental health during the pandemic17 May 2023 | Scientific Reports, Vol. 13, No. 1Videoconference fatigue from a neurophysiological perspective: experimental evidence based on electroencephalography (EEG) and electrocardiography (ECG)26 October 2023 | Scientific Reports, Vol. 13, No. 1The ‘Zoomification’ of Collaboration: How 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and Psychology of the Pandemic November Through the October 2021 | Education, Vol. No. Practice During COVID-19 to and of November 2021 | Vol. 36, No. as the of Exploring and Perspectives of of Telehealth by a Australian Service during COVID-19 October 2021 | International Journal of Environmental Research and Public Health, Vol. 18, No. with The of technology and consumer July 2021 | International Journal of Consumer Studies, Vol. 45, No. of June 2021 | Annals of Surgery, Vol. No. and of Virtual in Video and Effects on of the ACM on Human-Computer Interaction, Vol. 5, No. How a Virtual Network during the COVID-19 of the ACM on Human-Computer Interaction, Vol. 5, No. May 2021 | American Journal of Clinical Vol. No. to and Education in the of December 2021 | Journal of Education, Vol. No. between social communication and during the early of September 2021 | Journal of Social and Vol. No. September 2021 | Vol. 11, No. Bir September 2021 | Vol. 5, No. of During the COVID-19 Pandemic by the of Medical of A Survey September 2021 | Frontiers in Medicine, Vol. student under remote learning using digital A June 2021 | Education and Information Vol. No. of the COVID-19 Pandemic on Higher Education: the
No AccessStand Alone Books1 Feb 2013Air pollution from motor vehiclesStandards and technologies for controlling emissionsAuthors/Editors: Asif Faiz, Christopher S. Weaver, and Michael P. WalshAsif Faiz, Christopher S. Weaver, and Michael P. Walshhttps://doi.org/10.1596/0-8213-3444-1SectionsAboutPDF (1.9 MB) ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinked In Abstract:This handbook presents a state-of-the-art review of vehicle emission standards and testing procedures and attempts to synthesize worldwide experience with vehicle emission control technologies and their applications in both industrialized and developing countries. It is one in a series of publications on vehicle-related pollution and control measures prepared by the World Bank in collaboration with the United Nations Environment Programme to underpin the Bank ' s overall objective of promoting transport development that is environmentally sustainable and least damaging to human health and welfare. Chapter 1 surveys vehicle emission standards adopted in various countries, emphasizing the international system of standards employed in North America and Europe. Chapter 2 discusses the test procedures used to quantify vehicle emissions in order to verify compliance and estimate emissions actually used. Chapter 3 describes the engine and aftertreatment technologies developed to enable new vehicles to comply with emission standards, as well as the costs and other impacts of these technologies. That measures to control emissions from in-use vehicles are an essential complement to emission standards for new vehicles is the subject explored in Chapter 4. Lastly, the role of fuels in reducing emissions is reviewed in Chapter 5, which discusses both the benefits of reformulating conventional gasoline and diesel fuels and the potential benefits of alternative cleaner fuels. 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No AccessEducationJul 2010Design Thinking for Social InnovationAuthors/Editors: Tim Brown, Jocelyn WyattTim BrownSearch for more papers by this author, Jocelyn WyattSearch for more papers by this authorhttps://doi.org/10.1596/1020-797X_12_1_29SectionsAboutView ChaptersPDF (0.2 MB) ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinked In Designers have traditionally focused on enchancing the look and functionality of products. 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Innovation and Development, Vol.13, August the of service in tourism and Vol.31, August Research A Design Thinking Approach to on Journal of Environmental Research and Public Health, Vol.18, September Innovation Design and Sustainability of in Vol.13, No.173 September of in the design thinking of a Skills and Creativity, Sosyal August 2021Design thinking and innovation: the of Business July 2020Design thinking approach to for the Journal of August Uygulamaları Bilimler August 2021Innovating for through collaborative innovation of Cleaner Production, OF DESIGN AND OF AND of the Design Society, July of Social Innovation through The Case of in Vol.13, August COVID-19 as a for public and The need for robust governance to turbulent Management Review, Vol.23, September and practice of Design Thinking: of and business Journal of Design Creativity and Innovation, Vol.9, May Learning to Support Decision-Making and Creative in Instructional Design Vol.65, No.46 April in Learning through the of Design Thinking in a Vol.13, July methodology design: participatory processes for of Research, a approach to food as in Student case of using a to support Technology as an The and of in Regional Open Innovation Vol.13, June Services during the in of Design, December 2022Supporting and Living through Journal of Environmental Research and Public Health, Vol.18, April de Vol.26, the new on the in public & a April of Design Thinking to in a Vol.13, April Courses of Design on the Light on to Social and Vol.13, April 2021Using human-centred design to develop an female Vol.7, January case study of an of Business No.214 May Innovation in Education and Social Service and Approaches to Social in Education, March Design Thinking Approach for March to the of energy in Research & Social Science, A Conceptual Framework for the and of Youth of and Health, Vol.18, evaluation of innovation: A case of for in Journal of Science, Technology, Innovation and Development, Vol.13, July Novel for Digital Assessment Using A Human-Centered Design Approach (Preprint)JMIR February mental health and in and mental framework for in of Cleaner Production, to Design Thinking to Creative and in Journal of & Design Education, August Theory in An Journal, March 2021Designing and for with January with design thinking: a case study from Journal of Environmental Education, Vol.52, January and the of Design: of Design and Design in No.122 May to Design with A for Design and July Case and the of Design Thinking in Public Education in August to Co-Created Digital to Support Activities for Socially Youth in February Innovation and Exchange a Lessons Learned from a Design Thinking Challenge in May October Sustainable Business and January Analysis of Agile Development Methodology Through Design June Sustainable Design to Environmental of Design November Case for Design May Learning in Design Thinking to April 2021Design Thinking as a Strategy to Learning in Education Across South April Inspection Management with October design methodology for A to community health and health in the Health of and Science, Vol.5, February 2021Using Design Thinking to the Educational of August factors of service design methodology for manufacturing Business & Management, Vol.8, February 2021Design and of an app for September 2021Design Innovation Methodology – Design in Journal, of the Health Mental Health Intervention for in and for a Research Vol.10, June Design Approach to Social a of Public and October Design Thinking in an Interdisciplinary Learning December Design Thinking to Design Thinking to Food Innovation for January of Design Thinking and to Food and January 2021Design Thinking to Engage in Food The January 2021Systemic and Design Towards Participatory The Journal of Design, and Innovation, Vol.7, Design Thinking October Research and Design Thinking for the Health and Social A para de de Vol.16,
HomeCirculationVol. 83, No. 1An updated coronary risk profile. A statement for health professionals. Free AccessAbstractPDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessAbstractPDF/EPUBAn updated coronary risk profile. A statement for health professionals. K M Anderson, P W Wilson, P M Odell and W B Kannel K M AndersonK M Anderson Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. , P W WilsonP W Wilson Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. , P M OdellP M Odell Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. and W B KannelW B Kannel Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. Originally published1 Jan 1991https://doi.org/10.1161/01.CIR.83.1.356Circulation. 1991;83:356–362 Previous Back to top Next FiguresReferencesRelatedDetailsCited By Hespe C, Giskes K, Harris M and Peiris D (2022) Findings and lessons learnt implementing a cardiovascular disease quality improvement program in Australian primary care: a mixed method evaluation, BMC Health Services Research, 10.1186/s12913-021-07310-6, 22:1, Online publication date: 1-Dec-2022. Lemke E, Vetter V, Berger N, Banszerus V, König M and Demuth I (2022) Cardiovascular health is associated with the epigenetic clock in the Berlin Aging Study II (BASE-II), Mechanisms of Ageing and Development, 10.1016/j.mad.2021.111616, 201, (111616), Online publication date: 1-Jan-2022. 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No AccessHealth, Nutrition, and Population1 Feb 2013Better Health Systems for India's PoorFindings, Analysis, and OptionsAuthors/Editors: David H. Peters, Abdo S. Yazbeck, Rashmi R. Sharma, G. N. V. Ramana, Lant H. Pritchett, Adam WagstaffDavid H. Peters, Abdo S. Yazbeck, Rashmi R. Sharma, G. N. V. Ramana, Lant H. Pritchett, Adam Wagstaffhttps://doi.org/10.1596/0-8213-5029-3SectionsAboutPDF (1.3 MB) ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinked In Abstract:This report focuses on four areas of the health system in which reforms, and innovations would make the most difference to the future of the Indian health system: oversight, public health service delivery, ambulatory curative care, and inpatient care (together with health insurance). Part 1 of the report contains four chapters that discuss current conditions, and policy options. Part 2 presents the theory, and evidence to support the policy choices. The general reader may be most interested in the overview chapter, and in the highlights found at the beginning of each of the chapters in part 2. These highlights outline the empirical findings, and the main policy challenges discussed in the chapter. The report does not set out to prescribe detailed answers for India ' s future health system. It does however, have a goal: to support informed debate, and consensus building, and to help shape a health system that continually strives to be more effective, equitable, efficient, and accountable to the Indian people, and particularly to the poor. 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OBJECTIVE: To analyze clinical studies on correlations between Traditional Chinese Medicine (TCM) body constitution types and diseases published in the past 10 years, and to provide an evidence base to support the use of such correlations for health maintenance and disease prevention. METHODS: We searched five databases for the period April 2009 to December 2019: China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, PubMed and Embase. Three types of observational studies on correlation between constitution types and diseases were included: cross-sectional, case-control and cohort studies. Descriptive statistical methods were employed for data analysis. RESULTS: A total of 1639 clinical studies were identified: 1452 (88.59%) cross-sectional studies, 115 (7.02%) case-control studies and 72 (4.39%) cohort studies covering 30 regions of China and five other countries (Malaysia, South Korea, Singapore, Thailand and France). The collection of studies comprised 19 disease categories and 333 different diseases. The 10 most commonly studied diseases were hypertension, diabetes, stroke, coronary atherosclerotic heart disease (CAHD), sleep disorders, neoplasm of the breast, dysmenorrhea, fatty liver disease, chronic viral hepatitis B and dyslipidemia. We found high distributions for each biased constitution type in different patient populations as follows: Qi-deficiency constitution in stroke, diabetes, chronic obstructive pulmonary disease, acquired immunodeficiency syndrome and hypertension; Yang-deficiency constitution in female infertility, osteoporosis, irritable bowel syndrome, gonarthrosis and dysmenorrhea; Yin-deficiency constitution in hypertension, diabetes, constipation, female climacteric states and osteoporosis; phlegm- dampness constitution in hypertension, stroke, fatty liver disease, diabetes and metabolic syndrome; damp-heat constitution in acne, chronic gastritis, chronic viral hepatitis B, human papillomavirus infection and hyperuricemia; blood-stasis constitution in CAHD, endometriosis and stroke; Qi-stagnation constitution in hyperplasia and neoplasms of the breast, insomnia, depression and thyroid nodules; and inherited-special constitution in asthma and allergic rhinitis. CONCLUSION: Eight biased TCM constitutions were closely related to specific diseases, and could be used to guide individualized prevention and treatment. More rigorously designed studies are recommended to further verify the constitution-disease relationship.
BACKGROUND: Diabetes mellitus (DM) is a metabolic disorder that causes abnormal blood glucose (BG) regulation that might result in short and long-term health complications and even death if not properly managed. Currently, there is no cure for diabetes. However, self-management of the disease, especially keeping BG in the recommended range, is central to the treatment. This includes actively tracking BG levels and managing physical activity, diet, and insulin intake. The recent advancements in diabetes technologies and self-management applications have made it easier for patients to have more access to relevant data. In this regard, the development of an artificial pancreas (a closed-loop system), personalized decision systems, and BG event alarms are becoming more apparent than ever. Techniques such as predicting BG (modeling of a personalized profile), and modeling BG dynamics are central to the development of these diabetes management technologies. The increased availability of sufficient patient historical data has paved the way for the introduction of machine learning and its application for intelligent and improved systems for diabetes management. The capability of machine learning to solve complex tasks with dynamic environment and knowledge has contributed to its success in diabetes research. MOTIVATION: Recently, machine learning and data mining have become popular, with their expanding application in diabetes research and within BG prediction services in particular. Despite the increasing and expanding popularity of machine learning applications in BG prediction services, updated reviews that map and materialize the current trends in modeling options and strategies are lacking within the context of BG prediction (modeling of personalized profile) in type 1 diabetes. OBJECTIVE: The objective of this review is to develop a compact guide regarding modeling options and strategies of machine learning and a hybrid system focusing on the prediction of BG dynamics in type 1 diabetes. The review covers machine learning approaches pertinent to the controller of an artificial pancreas (closed-loop systems), modeling of personalized profiles, personalized decision support systems, and BG alarm event applications. Generally, the review will identify, assess, analyze, and discuss the current trends of machine learning applications within these contexts. METHOD: A rigorous literature review was conducted between August 2017 and February 2018 through various online databases, including Google Scholar, PubMed, ScienceDirect, and others. Additionally, peer-reviewed journals and articles were considered. Relevant studies were first identified by reviewing the title, keywords, and abstracts as preliminary filters with our selection criteria, and then we reviewed the full texts of the articles that were found relevant. Information from the selected literature was extracted based on predefined categories, which were based on previous research and further elaborated through brainstorming among the authors. RESULTS: The initial search was done by analyzing the title, abstract, and keywords. A total of 624 papers were retrieved from DBLP Computer Science (25), Diabetes Technology and Therapeutics (31), Google Scholar (193), IEEE (267), Journal of Diabetes Science and Technology (31), PubMed/Medline (27), and ScienceDirect (50). After removing duplicates from the list, 417 records remained. Then, we independently assessed and screened the articles based on the inclusion and exclusion criteria, which eliminated another 204 papers, leaving 213 relevant papers. After a full-text assessment, 55 articles were left, which were critically analyzed. The inter-rater agreement was measured using a Cohen Kappa test, and disagreements were resolved through discussion. CONCLUSION: Due to the complexity of BG dynamics, it remains difficult to achieve a universal model that produces an accurate prediction in every circumstance (i.e., hypo/eu/hyperglycemia events). Recently, machine learning techniques have received wider attention and increased popularity in diabetes research in general and BG prediction in particular, coupled with the ever-growing availability of a self-collected health data. The state-of-the-art demonstrates that various machine learning techniques have been tested to predict BG, such as recurrent neural networks, feed-forward neural networks, support vector machines, self-organizing maps, the Gaussian process, genetic algorithm and programs, deep neural networks, and others, using various group of input parameters and training algorithms. The main limitation of the current approaches is the lack of a well-defined approach to estimate carbohydrate intake, which is mainly done manually by individual users and is prone to an error that can severely affect the predictive performance. Moreover, a universal approach has not been established to estimate and quantify the approximate effect of physical activities, stress, and infections on the BG level. No researchers have assessed model predictive performance during stress and infection incidences in a free-living condition, which should be considered in future studies. Furthermore, a little has been done regarding model portability that can capture inter- and intra-variability among patients. It seems that the effect of time lags between the CGM readings and the actual BG levels is not well covered. However, in general, we foresee that these developments might foster the advancement of next-generation BG prediction algorithms, which will make a great contribution in the effort to develop the long-awaited, so-called artificial pancreas (a closed-loop system).
BACKGROUND: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. METHODS: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. FINDINGS: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. INTERPRETATION: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. FUNDING: Bill & Melinda Gates Foundation.
BACKGROUND: The role of technology in the self-management of type 1 diabetes mellitus (T1DM) among children and young people is not well understood. Interventions should aim to improve key diabetes self-management behaviours (self-management of blood glucose, insulin administration, physical activity and dietary behaviours) and prerequisites (psychological outcomes and HbA1c) highlighted in the UK guidelines of the National Institute for Health and Care Excellence (NICE) for management of T1DM. The purpose was to identify evidence to assess the effectiveness of technological tools in promoting aspects of these guidelines amongst children and young people. METHODS: A systematic review of English language articles was conducted using the following databases: Web of Science, PubMed, Scopus, NUSearch, SAGE Journals, SpringerLink, Google Scholar, Science Direct, Sport Discus, Embase, Psychinfo and Cochrane Trials. Search terms included paediatric, type one diabetes, technology, intervention and various synonyms. Included studies examined interventions which supplemented usual care with a health care strategy primarily delivered through a technology-based medium (e.g. mobile phone, website, activity monitor) with the aim of engaging children and young people with T1DM directly in their diabetes healthcare. Studies did not need to include a comparator condition and could be randomised, non-randomised or cohort studies but not single-case studies. RESULTS: Of 30 included studies (21 RCTs), the majority measured self-monitoring of blood glucose monitoring (SMBG) frequency, clinical indicators of diabetes self-management (e.g. HbA1c) and/or psychological or cognitive outcomes. The most positive findings were associated with technology-based health interventions targeting SMBG as a behavioural outcome, with some benefits found for clinical and/or psychological diabetes self-management outcomes. Technological interventions were well accepted by children and young people. For the majority of included outcomes, clinical relevance was deemed to be little or none. CONCLUSIONS: More research is required to assess which elements of interventions are most likely to produce beneficial behavioural outcomes. To produce clinically relevant outcomes, interventions may need to be delivered for at least 1 year and should consider targeting individuals with poorly managed diabetes. It is not possible to determine the impact of technology-based interventions on insulin administration, dietary habits and/or physical activity behaviour due to lack of evidence.
BACKGROUND: Type 2 diabetes is associated with acute and chronic complications and poses a large economic, social, and medical burden on patients and their families as well as society. OBJECTIVE: This study aims to evaluate the direct economic burden of type 2 diabetes in China. DATA SOURCE: systematic review on cost of illness, health care costs, direct service costs, drug costs, and health expenditures in relation to type 2 diabetes was conducted up to 2014 using databases such as Pubmed; EBSCO; Elsevier ScienceDirect, Web of Science; and a series of Chinese databases, including Wanfang Data, China National Knowledge Infrastructure (CNKI), and the China Science and Technology Journal Database. Factors influencing hospitalization and drug fees were also identified. STUDY ELIGIBILITY CRITERIA: (1) estimation of the direct economic burden including hospitalization and outpatient cost of type 2 diabetes patients in China; (2) evaluation of the factors influencing the direct economic burden. Articles only focusing on the cost-effectiveness analysis of diabetes drugs were excluded. RESULTS: The direct economic burden of type 2 diabetes has increased over time in China, and in 2008, the direct medical cost reached $9.1 billion, Both outpatient and inpatient costs have increased. Income level, type of medical insurance, the level of hospital care, and type and number of complications are primary factors influencing diabetes related hospitalization costs. Compared to urban areas, the direct non-medical cost of type 2 diabetes in rural areas is significantly greater. CONCLUSIONS: The direct economic burden of type 2 diabetes poses a significant challenge to China. To address the economic burden associated with type 2 diabetes, measures need to be taken to reduce prevalence rate and severity of diabetes and hospitalization cost.
Diabetes Technology & TherapeuticsVol. 15, No. 3 CommentariesIt's Time to Move from the A1c to Better Metrics for Diabetes ControlAaron J. Kowalski and Sanjoy DuttaAaron J. KowalskiSearch for more papers by this author and Sanjoy DuttaSearch for more papers by this authorPublished Online:12 Mar 2013https://doi.org/10.1089/dia.2013.0060AboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited byExpert Panel Recommendations for Use of Standardized Glucose Reporting System Based on Standardized Glucometrics Plus Visual Ambulatory Glucose Profile (AGP) Data in Clinical Practice24 January 2022 | Frontiers in Endocrinology, Vol. 12The Correlation between Time in Range and Diabetic Microvascular Complications Utilizing Information Management PlatformInternational Journal of Endocrinology, Vol. 2020Uric acid to HDL cholesterol ratio is a strong predictor of diabetic control in men with type 2 diabetes mellitus16 October 2019 | The Aging Male, Vol. 23, No. 5Navigating Two Roads to Glucose Normalization in Diabetes: Automated Insulin Delivery Devices and Cell TherapyCell Metabolism, Vol. 29, No. 3A randomised, controlled trial of the effects of a mobile telehealth intervention on clinical and patient-reported outcomes in people with poorly controlled diabetes8 July 2016 | Journal of Telemedicine and Telecare, Vol. 23, No. 2Pathway to Artificial Pancreas Systems Revisited: Moving Downstream12 May 2015 | Diabetes Care, Vol. 38, No. 6Frequency of Continuous Glucose Monitoring use and Change in Hemoglobin A1C for Adults With Type 1 Diabetes in a Clinical Practice SettingEndocrine Practice, Vol. 20, No. 10The Right Tool For The JobEndocrine Practice, Vol. 20, No. 10Development of the Likelihood of Low Glucose (LLG) Algorithm for Evaluating Risk of Hypoglycemia17 April 2014 | Journal of Diabetes Science and Technology, Vol. 8, No. 4Closing the Loop Eran Atlas, Andrew Thorne, Kara Lu, Moshe Phillip, and Eyal Dassau30 January 2014 | Diabetes Technology & Therapeutics, Vol. 16, No. S1Standardization Versus Customization of Glucose Reporting David Rodbard1 May 2013 | Diabetes Technology & Therapeutics, Vol. 15, No. 5 Volume 15Issue 3Mar 2013 InformationCopyright 2013, Mary Ann Liebert, Inc.To cite this article:Aaron J. Kowalski and Sanjoy Dutta.It's Time to Move from the A1c to Better Metrics for Diabetes Control.Diabetes Technology & Therapeutics.Mar 2013.194-196.http://doi.org/10.1089/dia.2013.0060Published in Volume: 15 Issue 3: March 12, 2013Online Ahead of Print:March 1, 2013PDF download
Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users.Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement--a reporting guideline published in 1999--there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions.The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
The advent of single-use disposable syringes along with myriad similar products for the health care industry has raised interest in the impact of these devices on the environment. Interest does not stop at impact of the device, but also includes associated pharmaceutical agents. Across the spectrum of health care, providers as well as end users of products are assessing the impact of product design and contents upon land, air, and water. In this issue of Journal of Diabetes Science and Technology, Pfützner and colleagues tackle the issue by focusing on a product for the diabetes patient. As environmental sustainability has become part of the evaluation process of many products, their assessment sheds some interesting light on the impact of a group of devices when compared and contrasted against the ever-popular disposable coffee cup or beer/soda aluminum can. Regional variations in waste disposal practices need to be understood when conducting these types of assessments.
In this issue of Journal of Diabetes Science and Technology, Rao and colleagues present a comparison of three iPhone diabetes data management applications: the Diamedic Diabetes Logbook, Blood Sugar Diabetes Control, and WaveSense Diabetes Manager. These applications provide patients the ability to enter blood glucose readings manually, view graphs and simple statistics, and email data to health care providers. While these applications show promise, they are limited in their current forms. All require manual data entry and none convert insulin-to-carbohydrate ratios to insulin dose. Future development of these types of technology should consider integration with blood glucose meters and expanded calculation capabilities, as well as monitoring of other risk factors, e.g., blood pressure and lipids, and tracking of preventive examinations, e.g., eye, foot, and renal.
In this issue of Journal of Diabetes Science and Technology, Davey and coauthors present encouraging data that even short-term use of a real-time continuous glucose monitor can lead to marked reduction in hypoglycemia exposure. In this analysis, two particular issues will be discussed: the distinction between short- and long-term experiences with sensors and the use of standardized diabetes treatment algorithms for use with continuous glucose monitoring (CGM) devices. An understanding of both of these aspects of CGM devices is necessary for placing clinical diabetes technology products into the context of how they will be used in "real life."
Background: Even though a Clinical and Laboratory Standards Institute proposal exists on the design of studies and performance criteria for continuous glucose monitoring (CGM) systems, it has not yet led to a consistent evaluation of different systems, as no consensus has been reached on the reference method to evaluate them or on acceptance levels. As a consequence, performance assessment of CGM systems tends to be inconclusive, and a comparison of the outcome of different studies is difficult. Materials and Methods: Published information and available data (as presented in this issue of Journal of Diabetes Science and Technology by Freckmann and coauthors) are used to assess the suitability of several frequently used methods [International Organization for Standardization, continuous glucose error grid analysis, mean absolute relative deviation (MARD), precision absolute relative deviation (PARD)] when assessing performance of CGM systems in terms of accuracy and precision. Results: The combined use of MARD and PARD seems to allow for better characterization of sensor performance. The use of different quantities for calibration and evaluation, e.g., capillary blood using a blood glucose (BG) meter versus venous blood using a laboratory measurement, introduces an additional error source. Using BG values measured in more or less large intervals as the only reference leads to a significant loss of information in comparison with the continuous sensor signal and possibly to an erroneous estimation of sensor performance during swings. Both can be improved using data from two identical CGM sensors worn by the same patient in parallel. Conclusions: Evaluation of CGM performance studies should follow an identical study design, including sufficient swings in glycemia. At least a part of the study participants should wear two identical CGM sensors in parallel. All data available should be used for evaluation, both by MARD and PARD, a good PARD value being a precondition to trust a good MARD value. Results should be analyzed and presented separately for clinically different categories, e.g., hypoglycemia, exercise, or night and day.
In an article in this issue of Journal of Diabetes Science and Technology, Sherwyn Schwartz, M.D., presents a study to validate the design of the ClikSTAR® insulin pen from sanofi-aventis and demonstrates that the device can be used correctly by participants with diabetes. Concern with this article lies with the selection of participants, which was meant to reflect the intended audience for the insulin pen device but does not address the inclusion of visually impaired individuals, who comprise over 20% of the adult diabetes population. Visually impaired individuals need to be included as part of the intended audience for insulin administration technology, and manufacturers of these devices need to design their products for safe use by all people, including those who are visually impaired. The study demonstrated successful use of the ClikSTAR insulin pen in a population that did not include subjects with severe visual impairment. We believe that future validation studies for insulin administration technology should also include samples of visually impaired users and that visually impaired patients will embrace the use of insulin pens designed with their needs in mind.
The July 2012 issue of the Journal of Diabetes Science and Technology includes a special symposium called "Serious Games for Diabetes, Obesity, and Healthy Lifestyle." As part of the symposium, this article focuses on health behavior change video games that are designed to improve and support players' diabetes self-management. Other symposium articles include one that recommends theory-based approaches to the design of health games and identifies areas in which additional research is needed, followed by five research articles presenting studies of the design and effectiveness of games and game technologies that require physical activity in order to play. This article briefly describes 14 diabetes self-management video games, and, when available, cites research findings on their effectiveness. The games were found by searching the Health Games Research online searchable database, three bibliographic databases (ACM Digital Library, PubMed, and Social Sciences Databases of CSA Illumina), and the Google search engine, using the search terms "diabetes" and "game." Games were selected if they addressed diabetes self-management skills.