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provides coniferyl ferulate(CAS#:899789-51-6) MSDS, density, melting point, boiling point, structure, formula, molecular weight etc. Articles of coniferyl ferulate are included as well.>> amp version: coniferyl ferulate
Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person’s blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down.
We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes.
Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0-11.2) to 10.0% (95% confidence interval 6.75-13.25) and decreased the number of severe hypoglycemic events.
Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring interventions to usual care. However, the uncertainty around the ICERs was large. The net budget impact of publicly funding continuous glucose monitoring assuming a 20% annual increase in adoption of continuous glucose monitoring would range from $8.5 million in year 1 to $16.2 million in year 5.
Patient engagement surrounding the topic of continuous glucose monitoring was robust. Patients perceived that these devices provided important social, emotional, and medical and safety benefits in managing type 1 diabetes, especially in children.
Continuous glucose monitoring was more effective than self-monitoring of blood glucose in managing type 1 diabetes for some outcomes, such as time spent in the target glucose range and time spent outside the target glucose range (moderate certainty in this evidence). We were less certain that continuous glucose monitoring would reduce the number of severe hypoglycemic events. Compared with self-monitoring of blood glucose, the costs of continuous glucose monitoring were higher, with only small increases in health benefits. Publicly funding continuous glucose monitoring for the type 1 diabetes population in Ontario would result in additional costs to the health system over the next 5 years. Adult patients and parents of children with type 1 diabetes reported very positive experiences with continuous glucose monitoring. The high ongoing cost of continuous glucose monitoring devices was seen as the greatest barrier to their widespread use.
Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment
Health Quality Ontario
The title compound, C35H27ClN4O3, crystallized with two independent molecules (A and B) in the asymmetric unit. In both molecules, the pyran and pyridine rings adopt envelope and chair conformations, respectively. The conformation of the pyrrolidine and cyclopentene rings differ in the two molecules; twisted and flat, respectively, in molecule A, but envelope and twisted, respectively, in molecule B. In both molecules, there is a C—H⋯N intramolecular hydrogen bond present. In both molecules, the oxygen atoms of the nitro groups are disordered as is the chlorine atom in molecule B. In the crystal, the B molecules are linked by C—H⋯O hydrogen bonds, forming -B-B-B- chains along , and by C—H⋯π interactions. The A and B molecules are also linked by a number of C—H⋯π interactions, resulting in the formation a supramolecular three-dimensional structure. In molecule A, the nitro group oxygen atoms are disordered over two positions with refined occupancy ratios of the nitro group oxygen atoms O3A and O4A in 0.59 (2):0.41 (2) while in molecule B one of the nitro O atoms is disordered over two positions with a refined occupancy ratio of 0.686 (13):0.314 (13) and the chlorine atoms is disordered over two positions with a refined occupancy ratio of 0.72 (3):0.28 (3).
crystal structure, spiro compounds, cycloaddition, piperidine, pyran, pyrrolidine, cyclopentene, hydrogen bonding, C—H⋯π interactions
Crystal structure of 6-(4-chlorophenyl)-6a-nitro-6a,6b,8,9,10,12a-hexahydro-6H,7H-spiro[chromeno[3,4-a]indolizine-12,11′-indeno[1,2-b]quinoxaline]
S. Syed Abuthahir,a M. NizamMohideen,a,* V. Viswanathan,b D. Velmurugan,c and J. Nagasivaraod
2019 Feb 1;