One Year Clinical Experience of the First Commercial Hybrid Closed-Loop System
| العنوان: | One Year Clinical Experience of the First Commercial Hybrid Closed-Loop System |
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| المؤلفون: | Korey K. Hood, David M. Maahs, Rayhan A. Lal, Darrell M. Wilson, Marina Basina, Bruce A. Buckingham |
| المصدر: | Diabetes Care |
| بيانات النشر: | American Diabetes Association, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Blood Glucose, Male, Research design, Pediatrics, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Hypoglycemia, Young Adult, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Internal Medicine, Humans, Hypoglycemic Agents, Insulin, Medicine, Prospective Studies, 030212 general & internal medicine, Young adult, Child, Prospective cohort study, Glycemic, Glycated Hemoglobin, Advanced and Specialized Nursing, Type 1 diabetes, business.industry, Blood Glucose Self-Monitoring, Clinical Care/Education/Nutrition/Psychosocial Research, Equipment Design, Middle Aged, medicine.disease, United States, Discontinuation, Diabetes Mellitus, Type 1, Treatment Outcome, Female, Observational study, business |
| الوصف: | OBJECTIVE In September 2016, the U.S. Food and Drug Administration approved the Medtronic 670G “hybrid” closed-loop system. In Auto Mode, this system automatically controls basal insulin delivery based on continuous glucose monitoring data but requires users to enter carbohydrates and blood glucose for boluses. To track real-world experience with this first commercial closed-loop device, we prospectively followed pediatric and adult patients starting the 670G system. RESEARCH DESIGN AND METHODS This was a 1-year prospective observational study of patients with type 1 diabetes starting the 670G system between May 2017 and May 2018 in clinic. RESULTS Of the total of 84 patients who received 670G and consented, 5 never returned for follow-up, with 79 (aged 9–61 years) providing data at 1 week and 3, 6, 9, and/or 12 months after Auto Mode initiation. For the 86% (68 out of 79) with 1-week data, 99% (67 out of 68) successfully started. By 3 months, at least 28% (22 out of 79) had stopped using Auto Mode; at 6 months, 34% (27 out of 79); at 9 months, 35% (28 out of 79); and by 12 months, 33% (26 out of 79). The primary reason for continuing Auto Mode was desire for increased time in range. Reasons for discontinuation included sensor issues in 62% (16 out of 26), problems obtaining supplies in 12% (3 out of 26), hypoglycemia fear in 12% (3 out of 26), multiple daily injection preference in 8% (2 out of 26), and sports in 8% (2 out of 26). At all visits, there was a significant correlation between hemoglobin A1c (HbA1c) and Auto Mode utilization. CONCLUSIONS While Auto Mode utilization correlates with improved glycemic control, a focus on usability and human factors is necessary to ensure use of Auto Mode. Alarms and sensor calibration are a major patient concern, which future technology should alleviate. |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2c93ea4e1836d7792fcc0975c5d862d7Test https://doi.org/10.2337/dc19-0855Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....2c93ea4e1836d7792fcc0975c5d862d7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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