دورية أكاديمية
Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm.
| العنوان: | Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm. |
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| المؤلفون: | Ware, Julia, Wilinska, Malgorzata E, Ruan, Yue, Allen, Janet M, Boughton, Charlotte K, Hartnell, Sara, Bally, Lia, de Beaufort, Carine, Besser, Rachel EJ, 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, Narendran, Parth, Poettler, Tina, Rami-Merhar, Birgit, Tauschmann, Martin, Randell, Tabitha, Thabit, Hood, Thankamony, Ajay, Trevelyan, Nicola, Hovorka, Roman |
| بيانات النشر: | SAGE Publications Department of Clinical Biochemistry Department of Medicine Department of Paediatrics //dx.doi.org/10.1177/19322968221141924 J Diabetes Sci Technol |
| سنة النشر: | 2023 |
| المجموعة: | Apollo - University of Cambridge Repository |
| مصطلحات موضوعية: | artificial pancreas, automated insulin delivery, closed-loop, hypoglycemia, personalized medicine, type 1 diabetes |
| الوصف: | 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 <10 "Boost" days were excluded. The main outcome was time spent in hypoglycemia <70 and <54 mg/dL. RESULTS: Eight weeks of data for 76 participants were analyzed. There was no difference in time spent <70 and <54 mg/dL between "Boost" days and "non-Boost" days; mean difference: -0.10% (95% confidence interval [CI] -0.28 to 0.07; P = .249) time <70 mg/dL, and 0.03 (-0.04 to 0.09; P = .416) time < 54 mg/dL. Time in significant hyperglycemia >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. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | Print-Electronic; application/pdf |
| اللغة: | English |
| العلاقة: | https://www.repository.cam.ac.uk/handle/1810/346173Test |
| DOI: | 10.17863/CAM.93599 |
| الإتاحة: | https://doi.org/10.17863/CAM.93599Test https://www.repository.cam.ac.uk/handle/1810/346173Test |
| حقوق: | Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: | edsbas.DC58ED3F |
| قاعدة البيانات: | BASE |
| DOI: | 10.17863/CAM.93599 |
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