Day-and-night closed-loop glucose control in patients with type 1 diabetes under free-living conditions:results of a single-arm 1-month experience compared with a previously reported feasibility study of evening and night at home
| العنوان: | Day-and-night closed-loop glucose control in patients with type 1 diabetes under free-living conditions:results of a single-arm 1-month experience compared with a previously reported feasibility study of evening and night at home |
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| المؤلفون: | Renard, Eric, Farret, Anne, Kropff, Jort, Bruttomesso, Daniela, Messori, Mirko, Place, Jérôme, Visentin, Roberto, Calore, Roberta, Toffanin, Chiara, Di Palma, Federico, Lanzola, Giordano, Magni, Paolo, Boscari, Federico, Galasso, Silvia, Avogaro, Angelo, Keith-Hynes, Patrick, Kovatchev, Boris, Del Favero, Simone, Cobelli, Claudio, Magni, Lalo, DeVries, J. Hans, consortium, AP@home |
| المساهمون: | 01 Internal and external specialisms, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Endocrinology, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CIC Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS) |
| المصدر: | Diabetes care, 39(7), 1151-1160. American Diabetes Association Inc. Diabetes Care Diabetes Care, American Diabetes Association, 2016, 39 (7), pp.1151-1160. ⟨10.2337/dc16-0008⟩ |
| بيانات النشر: | American Diabetes Association Inc., 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Insulin pump, Adult, Blood Glucose, Male, Pancreas, Artificial, medicine.medical_specialty, Evening, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Artificial pancreas, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Animal science, Insulin Infusion Systems, Endocrinology, Internal medicine, Diabetes mellitus, Internal Medicine, Advanced and Specialized Nursing, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Morning, Glycemic, Type 1 diabetes, Cross-Over Studies, business.industry, Blood Glucose Self-Monitoring, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Middle Aged, medicine.disease, Crossover study, Circadian Rhythm, Diabetes and Metabolism, Diabetes Mellitus, Type 1, Social Conditions, Feasibility Studies, Female, business, Algorithms |
| الوصف: | OBJECTIVE After testing of a wearable artificial pancreas (AP) during evening and night (E/N-AP) under free-living conditions in patients with type 1 diabetes (T1D), we investigated AP during day and night (D/N-AP) for 1 month. RESEARCH DESIGN AND METHODS Twenty adult patients with T1D who completed a previous randomized crossover study comparing 2-month E/N-AP versus 2-month sensor augmented pump (SAP) volunteered for 1-month D/N-AP nonrandomized extension. AP was executed by a model predictive control algorithm run by a modified smartphone wirelessly connected to a continuous glucose monitor (CGM) and insulin pump. CGM data were analyzed by intention-to-treat with percentage time-in-target (3.9–10 mmol/L) over 24 h as the primary end point. RESULTS Time-in-target (mean ± SD, %) was similar over 24 h with D/N-AP versus E/N-AP: 64.7 ± 7.6 vs. 63.6 ± 9.9 (P = 0.79), and both were higher than with SAP: 59.7 ± 9.6 (P = 0.01 and P = 0.06, respectively). Time below 3.9 mmol/L was similarly and significantly reduced by D/N-AP and E/N-AP versus SAP (both P < 0.001). SD of blood glucose concentration (mmol/L) was lower with D/N-AP versus E/N-AP during whole daytime: 3.2 ± 0.6 vs. 3.4 ± 0.7 (P = 0.003), morning: 2.7 ± 0.5 vs. 3.1 ± 0.5 (P = 0.02), and afternoon: 3.3 ± 0.6 vs. 3.5 ± 0.8 (P = 0.07), and was lower with D/N-AP versus SAP over 24 h: 3.1 ± 0.5 vs. 3.3 ± 0.6 (P = 0.049). Insulin delivery (IU) over 24 h was higher with D/N-AP and SAP than with E/N-AP: 40.6 ± 15.5 and 42.3 ± 15.5 vs. 36.6 ± 11.6 (P = 0.03 and P = 0.0004, respectively). CONCLUSIONS D/N-AP and E/N-AP both achieved better glucose control than SAP under free-living conditions. Although time in the different glycemic ranges was similar between D/N-AP and E/N-AP, D/N-AP further reduces glucose variability. |
| اللغة: | English |
| تدمد: | 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::88782e3e74429454fc92fc76a6fd8d97Test http://hdl.handle.net/11577/3211487Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....88782e3e74429454fc92fc76a6fd8d97 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 01495992 |
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