Ware, Julia [0000-0002-4497-0979], Boughton, Charlotte K [0000-0003-3272-9544], Besser, Rachel EJ [0000-0002-4645-6324], Evans, Mark L [0000-0001-8122-8987], Leelarathna, Lalantha [0000-0001-9602-1962], Mader, Julia K [0000-0001-7854-4233], Thabit, Hood [0000-0001-6076-6997], Hovorka, Roman [0000-0003-2901-461X], Apollo - University of Cambridge Repository
المصدر:
Ware, Julia; Wilinska, Malgorzata E; Ruan, Yue; Allen, Janet M; Boughton, Charlotte K; Hartnell, Sara; Bally, Lia; de Beaufort, Carine; Besser, Rachel E J; Campbell, Fiona M; Draxlbauer, Katharine; Elleri, Daniela; Evans, Mark L; Fröhlich-Reiterer, Elke; Ghatak, Atrayee; Hofer, Sabine E; Kapellen, Thomas M; Leelarathna, Lalantha; Mader, Julia K; Mubita, Womba M; ... (2022). Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm. (In Press). Journal of diabetes science and technology, p. 19322968221141924. Diabetes Technology Society 10.1177/19322968221141924 <http://dx.doi.org/10.1177/19322968221141924Test>
Objective: Many hybrid closed-loop (HCL) systems struggle to manage unusually high glucose levels as experienced with intercurrent illness or pre-menstrually. Manual correction boluses may be needed, increasing hypoglycemia risk with overcorrection. The Cambridge HCL system includes a user-initiated algorithm intensification mode (“Boost”), activation of which increases automated insulin delivery by approximately 35%, while remaining glucose-responsive. In this analysis, we assessed the safety of “Boost” mode. Methods: We retrospectively analyzed data from closed-loop studies involving young children (1-7 years, n = 24), children and adolescents (10-17 years, n = 19), adults (≥24 years, n = 13), and older adults (≥60 years, n = 20) with type 1 diabetes. Outcomes were calculated per participant for days with ≥30 minutes of “Boost” use versus days with no “Boost” use. Participants with Results: Eight weeks of data for 76 participants were analyzed. There was no difference in time spent 300 mg/dL was 1.39 percentage points (1.01 to 1.77; P < .001) higher on “Boost” days, with higher mean glucose and lower time in target range ( P < .001). Conclusions: Use of an algorithm intensification mode in HCL therapy is safe across all age groups with type 1 diabetes. The higher time in hyperglycemia observed on “Boost” days suggests that users are more likely to use algorithm intensification on days with extreme hyperglycemic excursions.
