19 results found
Saadane I, Ali T, El-Laboudi A, et al., 2021, Ramadan fasting in insulin-treated patients is associated with potentially unfavourable changes in glucose metrics: A flash glucose monitoring (FGM) study, DIABETES RESEARCH AND CLINICAL PRACTICE, Vol: 172, ISSN: 0168-8227
Crabtree TSJ, Rowles S, Tarpey S, et al., 2019, Reductions in alanine aminotransferase levels with liraglutide treatment are greatest in those with raised baseline levels and are independent of weight loss: real-world outcome data from the ABCD Nationwide Liraglutide Audit, BRITISH JOURNAL OF DIABETES, Vol: 19, Pages: 118-+, ISSN: 2397-6233
Sharma S, El-Laboudi A, Reddy M, et al., 2018, A pilot study in humans of microneedle sensor arrays for continuous glucose monitoring, Analytical Methods, Vol: 10, Pages: 2088-2095, ISSN: 1759-9660
Although subcutaneously implanted continuous glucose monitoring (CGM) devices have been shown to support diabetes self-management, their uptake remains low due to a combination of high manufacturing cost and limited accuracy and precision arising from their invasiveness. To address these points, minimally invasive, a solid microneedle array-based sensor for continuous glucose monitoring is reported here. These intradermal solid microneedle CGM sensors are designed for low cost manufacturing. The tolerability and performance of these devices is demonstrated through clinical studies, both in healthy volunteers and participants with type 1 diabetes (T1D). The geometry of these solid microneedles allows them to penetrate dermal tissue without the need for an applicator. The outer surface of these solid microneedles are modified as glucose biosensors. The microneedles sit in the interstitial fluid of the skin compartment and monitor real-time changes in glucose concentration. Optical coherence tomography measurements revealed no major axial movement of the microneedles in the tissue. No significant adverse events were observed and low pain scores were reported when compared to catheter insertion, deeming it safe for clinical studies in T1D. These amperometric sensors also yielded currents that tracked venous blood glucose concentrations, showing a clinically acceptable correlation. Studies in people with T1D gave a mean absolute relative difference (MARD) of 9% (with respect to venous blood glucose) with over 94% of the data points in the A and B zones of the Clarke error grid. These findings provide baseline data for further device development and a larger clinical efficacy and acceptability study of this microneedle intradermal glucose sensor in T1D.
Reddy M, Jugnee N, El Laboudi A, et al., 2018, A randomized controlled pilot study of continuous glucose monitoring and flash glucose monitoring in people with Type 1 diabetes and impaired awareness of hypoglycaemia, Diabetic Medicine, Vol: 35, Pages: 483-490, ISSN: 0742-3071
AIM: Hypoglycaemia in Type 1 diabetes is associated with mortality and morbidity, especially where awareness of hypoglycaemia is impaired. Clinical pathways for access to continuous glucose monitoring (CGM) and flash glucose monitoring technologies are unclear. We assessed the impact of CGM and flash glucose monitoring in a high-risk group of people with Type 1 diabetes. METHODS: A randomized, non-masked parallel group study was undertaken. Adults with Type 1 diabetes using a multiple-dose insulin-injection regimen with a Gold score of ≥ 4 or recent severe hypoglycaemia were recruited. Following 2 weeks of blinded CGM, they were randomly assigned to CGM (Dexcom G5) or flash glucose monitoring (Abbott Freestyle Libre) for 8 weeks. The primary outcome was the difference in time spent in hypoglycaemia (below 3.3 mmol/l) from baseline to endpoint with CGM versus flash glucose monitoring. RESULTS: Some 40 participants were randomized to CGM (n = 20) or flash glucose monitoring (n = 20). The participants (24 men, 16 women) had a median (IQR) age of 49.6 (37.5-63.5) years, duration of diabetes of 30.0 (21.0-36.5) years and HbA1c of 56 (48-63) mmol/mol [7.3 (6.5-7.8)%]. The baseline median percentage time < 3.3 mmol/l was 4.5% in the CGM group and 6.7% in the flash glucose monitoring. At the end-point the percentage time < 3.3 mmol/l was 2.4%, and 6.8% respectively (median between group difference -4.3%, P = 0.006). Time spent in hypoglycaemia at all thresholds, and hypoglycaemia fear, were different between groups, favouring CGM. CONCLUSION: CGM more effectively reduces time spent in hypoglycaemia in people with Type 1 diabetes and impaired awareness of hypoglycaemia compared with flash glucose monitoring. (Clinical Trial Registry No: NCT03028220).
El-Laboudi AH, Godsland I, Johnston D, et al., 2016, Measures of Glycemic Variability In Type 1 Diabetes and the Effect of Real-Time Continuous Glucose Monitoring, Diabetes Technology & Therapeutics, Vol: 18, Pages: 806-812, ISSN: 1557-8593
Objective: To report the impact of continuous glucose monitoring (CGM) onglycemic variability (GV) indices, factors predictive of change and to correlatevariability with conventional markers of glycaemia.Methods: Data from the JDRF study of CGM in participants with type 1 diabeteswere used. Participants were randomised to CGM or self-monitored blood glucose(SMBG). GV indices at baseline, at 26 weeks in both groups, and at 52 weeks in thecontrol group were analysed. The associations of demographic and clinical factorswith change in GV indices from baseline to 26 weeks were evaluated.Results: Baseline data were available for 448 subjects. GV indices were all outsidenormative ranges (P<0.001). Inter-correlation between GV indices was common and,apart from coefficient of variation (CV), low blood glucose index (LBGI) andpercentage of glycemic risk assessment diabetes equation score attributable tohypoglycaemia (%GRADEhypoglycaemia), all indices correlate positively with HbA1c.There was strong correlation between time spent in hypoglycaemia, and CV, LBGIand %GRADEhypoglycaemia, but not with HbA1c. A significant reduction in all GVindices, except lability index and mean absolute glucose change per unit time (MAG),was demonstrated in the intervention group at 26 weeks compared with the controlgroup. Baseline factors predicting a change in GV with CGM include baselineHbA1c, baseline GV, frequency of daily SMBG and insulin pump use.Conclusions: CGM reduces most GV indices compared with SMBG in people withtype 1 diabetes. The strong correlation between time spent in hypoglycaemia and CV,LBGI and %GRADEhypoglycaemia highlights the value of these metrics in assessinghypoglycaemia as an adjunct to HbA1c in overall assessment of glycaemia.
Sharma S, El-Laboudi A, Oliver N, et al., 2016, Chemical cross talk studies on a microprobe array based continuous glucose monitoring sensor, ATTD 2016, Publisher: Mary Ann Liebert, ISSN: 1557-8593
El-Laboudi A, Neal D, Oliver N, 2016, CONTINUOUS GLUCOSE MONITORING: PATIENTS' PERCEPTION AND BARRIERS TO ADHERENCE, DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 18, Pages: A71-A72, ISSN: 1520-9156
El-Laboudi A, Oliver N, 2016, AGREEMENT BETWEEN GLYCAEMIC VARIABILITY CALCULATORS: ANOTHER LIMITATION IN MEASURING GLYCAEMIC VARIABILITY, DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 18, Pages: A90-A90, ISSN: 1520-9156
El-Laboudi AH, Oliver N, 2015, Towards a Physiological Prandial Insulin Profile: Enhancement of Subcutaneously Injected Prandial Insulin Using Local Warming Devices, Diabetes Therapy, Vol: 6, Pages: 257-272, ISSN: 1869-6961
The need to develop an insulin delivery system that can closely mimic physiologically induced changes in prandial insulin release has been a major research target since the discovery of insulin. The challenges facing existing insulin delivery systems, related to relatively slow pharmacokinetics and pharmacodynamics, have been further highlighted by rapid advances in diabetes technology and progress in artificial pancreas research. Despite the growing interest in alternative routes of insulin administration, the subcutaneous route remains—at least for now—the preferred route for insulin administration. In this article, we review efforts aimed at developing subcutaneously injected ultrafast-acting insulin and measures aimed at enhancing insulin absorption, focusing on local warming devices.
Sharma S, El-Laboudi A, Oliver N, et al., 2015, EVALUATION AND IMPROVEMENT OF EPOXY POLYURETHANE MEMBRANE FOR A MICROPROBE ARRAY BASED CONTINUOUS GLUCOSE SENSOR, DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 17, Pages: A90-A91, ISSN: 1520-9156
El-Laboudi A, Godsland I, Johnston D, et al., 2015, EFFECT OF REAL-TIME CONTINUOUS GLUCOSE MONITORING ON MEASURES OF GLYCEMIC VARIABILITY AND QUALITY OF GLYCEMIC CONTROL IN TYPE 1 DIABETES, Publisher: MARY ANN LIEBERT, INC, Pages: A76-A76, ISSN: 1520-9156
El-Laboudi A, Godsland I, Johnston D, et al., 2015, FACTORS PREDICTIVE OF EFFECT OF REAL-TIME CONTINUOUS GLUCOSE MONITORING ON MEASURES OF GLYCEMIC VARIABILITY AND QUALITY OF GLYCEMIC CONTROL IN TYPE 1 DIABETES, Publisher: MARY ANN LIEBERT, INC, Pages: A76-A77, ISSN: 1520-9156
El-Laboudi A, Misra S, Martineau M, et al., 2015, INTENTIONAL LARGE INSULIN OVERDOSE CAPTURED ON A CONTINUOUS GLUCOSE MONITOR: A NOVEL CASE REPORT, DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 17, Pages: A75-A76, ISSN: 1520-9156
El-Laboudi A, Sharma S, Oliver N, et al., 2014, DEVELOPMENT OF A NOVEL MICROPROBE ARRAY CONTINUOUS GLUCOSE SENSOR FOR TYPE 1 DIABETES: INTERFERENCE STUDIES, DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 16, Pages: A65-A66, ISSN: 1520-9156
El- Laboudi A, Sharma S, Santhanam H, et al., 2013, Development Of A Novel Microprobe Array Continuous Glucose Monitor: Preclinical Validation, EASD
Background and aim: Despite clinical benefits, continuous glucose monitoring (CGM) devices are invasive and can be uncomfortable, negatively affecting concordance and effectiveness. In addition, CGM sensor accuracy is suboptimal in the critical hypoglycaemic range. To overcome these challenges, a novel continuous glucose sensor has been developed based on microprobe technology. It consists of a small, wearable patch containing several microscopic projections (microprobes) that penetrate the stratum corneum to access interstitial fluid. Aim: Mechanical and functional validation of the sensor prior to in vivo clinical studies. Mechanical validation assesses the ability to penetrate the stratum corneum without mechanical failure, while functional validation assesses the current produced in response to changing glucose concentration and the effects of sterilisation and insertion. Materials and methods: Each array had 64 microprobes arranged 8x8. Microprobe height is 1000 μm and tip diameter is 15 μm. Insertion tests were performed ex vivo in full thickness human skin. An Instron compression system was used to press the device into skin using forces of 7, 10, 15, 20 and 25 Newton. Skin penetration was confirmed by applying methylene blue dye to visualize created micropores and by histological examination. Fracture tests were performed in vitro using the Instron system to exert axial pressure against a metal probe using forces of 50, 100, 200, 300 and 400 Newton. Microprobes were examined using scanning electron microscopy before and after testing to detect failure and measure height reduction. To assess transverse fracture force, transverse pressure was exerted against one row of 8 microprobes till they fractured. Functional evaluation tests were performed in vitro by measuring the current generated in response to changing glucose concentration before and after gamma ray radiation and ex vivo skin insertion. Results: Insertion tests (n=10) demonstrated successful p
El-Laboudi A, Sharma S, Oliver N, et al., 2013, DEVELOPMENT OF A NOVEL MICROPROBE ARRAY CONTINUOUS GLUCOSE MONITOR: MECHANICAL CHARACTERIZATION, Advanced Technologies and Treatments for Diabetes, Publisher: Mary Ann Liebert, Inc., Publishers
El-Laboudi A, Oliver NS, Cass A, et al., 2013, Use of Microneedle Array Devices for Continuous Glucose Monitoring: A Review, DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 15, Pages: 101-115, ISSN: 1520-9156
Hall PS, Lord SR, El-Laboudi A, et al., 2010, Non-cancer medications for patients with incurable cancer: time to stop and think?, BRITISH JOURNAL OF GENERAL PRACTICE, Vol: 60, Pages: 243-244, ISSN: 0960-1643
El-Laboudi AH, Etherington C, Whitaker P, et al., 2009, Acute Burkholderia cenocepacia pyomyositis in a patient with cystic fibrosis, JOURNAL OF CYSTIC FIBROSIS, Vol: 8, Pages: 273-275, ISSN: 1569-1993
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