Young Children Have Higher Variability of Insulin Requirements: Observations During Hybrid Closed-Loop Insulin Delivery
| العنوان: | Young Children Have Higher Variability of Insulin Requirements: Observations During Hybrid Closed-Loop Insulin Delivery |
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| المؤلفون: | D. Elleri, Malgorzata E. Wilinska, Sabine E. Hofer, Thomas R. Pieber, Fiona Campbell, Sabine Arnolds, Carine de Beaufort, Amy Criego, David B. Dunger, Thomas Kapellen, Elke Fröhlich-Reiterer, Roman Hovorka, Birgit Rami-Merhar, Martin Tauschmann, KidsAP Consortia, Lalantha Leelarathna, Hood Thabit, Carlo L. Acerini, Klemen Dovc, Viral N. Shah, Mark L. Evans, Charlotte K. Boughton, Richard M. Bergenstal, Janet M. Allen, Judy Sibayan, Lia Bally |
| المصدر: | Diabetes Care APCam11 Consortium, AP@home Consortium & KidsAP Consortia 2019, ' Young Children Have Higher Variability of Insulin Requirements : Observations During Hybrid Closed-Loop Insulin Delivery ', Diabetes Care, vol. 42, no. 7, pp. 1344-1347 . https://doi.org/10.2337/dc18-2625Test |
| بيانات النشر: | American Diabetes Association, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Blood Glucose, Male, Pediatrics, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Individuality, 0302 clinical medicine, Insulin, Multicenter Studies as Topic, 030212 general & internal medicine, Young adult, 610 Medicine & health, Child, Randomized Controlled Trials as Topic, Cross-Over Studies, Age Factors, Percentage point, Middle Aged, Novel Communications in Diabetes, Child, Preschool, Female, Adult, medicine.medical_specialty, Adolescent, Coefficient of variation, 030209 endocrinology & metabolism, Multicenter Studies as Topic/statistics & numerical data, Young Adult, 03 medical and health sciences, Blood Glucose/drug effects, Insulin Infusion Systems, Diabetes management, Diabetes mellitus, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Blood Glucose Self-Monitoring/instrumentation, Aged, Retrospective Studies, Advanced and Specialized Nursing, Type 1 diabetes, Dose-Response Relationship, Drug, business.industry, Randomized Controlled Trials as Topic/statistics & numerical data, Blood Glucose Self-Monitoring, Infant, Diabetes Mellitus, Type 1/blood, Hypoglycemic Agents/administration & dosage, medicine.disease, Crossover study, Diabetes Mellitus, Type 1, business, Insulin/administration & dosage |
| الوصف: | OBJECTIVE: To quantify age-related variability of insulin needs during day and night closed-loop insulin delivery. RESEARCH DESIGN AND METHODS: We retrospectively analyzed data from hybrid closed-loop studies involving young children (1-6 years old, n = 20), children (7-12 years, n = 21), adolescents (13-17 years, n = 15), and adults (>18 years, n = 58) with type 1 diabetes. The coefficient of variation quantified variability of insulin needs during 3 weeks of unrestricted-living hybrid closed-loop use. RESULTS: Data from 2,365 nights and 2,367 days in 114 participants were analyzed. The coefficient of variation of insulin delivery was higher in young children compared with adults (mean difference at nighttime 10.7 percentage points [95% CI 2.9-18.4], P = 0.003; daytime 6.4 percentage points [95% CI 2.0-10.9], P = 0.002) and compared with adolescents (mean difference at nighttime 10.2 percentage points [95% CI 0.0-20.4], P = 0.049; daytime 7.0 percentage points [95% CI 1.1-12.8], P = 0.014). CONCLUSIONS: Diabetes management in young children is complicated by higher variability in insulin requirements, supporting fast-track clinical practice adoption of closed-loop in this vulnerable population. With increasing application of insulin pump therapy and continuous glucose monitors, hybrid closed-loop has become a feasible treatment modality for people with type 1 diabetes (1,2). Apart from manual meal-time boluses, insulin delivery is autonomously modulated by a control algorithm based on real-time sensor glucose values. Insulin delivery may vary considerably from day to day and night to night due to varying activity levels, insulin set-changes, meal timings and composition, and other factors(3,4).Todate,theassociationbetweenageandinsulinvariabilityhasnotbeen assessed.Inthepresentanalysis,weinvestigatewhetherinsulinrequirementsmaybe more variable in younger age. |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a432b3d3cb4aa049461d91ac8f227e58Test https://doi.org/10.2337/dc18-2625Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....a432b3d3cb4aa049461d91ac8f227e58 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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