Day-and-Night Hybrid Closed-Loop Insulin Delivery in Adolescents With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial
| العنوان: | Day-and-Night Hybrid Closed-Loop Insulin Delivery in Adolescents With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial |
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| المؤلفون: | Peiyao Cheng, David B. Dunger, Craig Kollman, Zoe A. Stewart, Malgorzata E. Wilinska, Roman Hovorka, Hood Thabit, Janet M. Allen, Martin Tauschmann, Carlo L. Acerini |
| المساهمون: | Tauschmann, Martin [0000-0002-2305-2490], Wilinska, Malgorzata E [0000-0003-2739-1753], Acerini, Carlo Lorenzo [0000-0003-2121-5871], Dunger, David Brian [0000-0002-2566-9304], Hovorka, Roman [0000-0003-2901-461X], Apollo - University of Cambridge Repository, Wilinska, Gosia [0000-0003-2739-1753], Acerini, Carlo [0000-0003-2121-5871], Dunger, David [0000-0002-2566-9304] |
| المصدر: | Diabetes Care Europe PubMed Central |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Insulin pump, Research design, Blood Glucose, Male, Risk, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Hypoglycemia, law.invention, 03 medical and health sciences, 0302 clinical medicine, Bolus (medicine), Insulin Infusion Systems, Randomized controlled trial, law, Diabetes mellitus, Hyperinsulinism, Internal Medicine, Medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Prospective Studies, Child, Advanced and Specialized Nursing, Type 1 diabetes, Cross-Over Studies, business.industry, medicine.disease, Crossover study, Surgery, The Artificial Pancreas in 2016: A Digital Treatment Ecosystem for Diabetes, Diabetes Mellitus, Type 1, Anesthesia, Female, business, Algorithms |
| الوصف: | OBJECTIVE: To evaluate feasibility, safety, and efficacy of day-and-night hybrid closed-loop insulin delivery in adolescents with type 1 diabetes under free-living conditions without remote monitoring or supervision. RESEARCH DESIGN AND METHODS: In an open-label, randomized, free-living, crossover study design, 12 adolescents receiving insulin pump therapy (mean [±SD] age 15.4 ± 2.6 years; HbA1c 8.3 ± 0.9%; duration of diabetes 8.2 ± 3.4 years) underwent two 7-day periods of sensor-augmented insulin pump therapy or hybrid closed-loop insulin delivery without supervision or remote monitoring. During the closed-loop insulin delivery, a model predictive algorithm automatically directed insulin delivery between meals and overnight; prandial boluses were administered by participants using a bolus calculator. RESULTS: The proportion of time when the sensor glucose level was in the target range (3.9-10 mmol/L) was increased during closed-loop insulin delivery compared with sensor-augmented pump therapy (72 vs. 53%, P < 0.001; primary end point), the mean glucose concentration was lowered (8.7 vs. 10.1 mmol/L, P = 0.028), and the time spent above the target level was reduced (P = 0.005) without changing the total daily insulin amount (P = 0.55). The time spent in the hypoglycemic range was low and comparable between interventions. CONCLUSIONS: Unsupervised day-and-night hybrid closed-loop insulin delivery at home is feasible and safe in young people with type 1 diabetes. Compared with sensor-augmented insulin pump therapy, closed-loop insulin delivery may improve glucose control without increasing the risk of hypoglycemia in adolescents with suboptimally controlled type 1 diabetes. This is the author accepted manuscript. The final version is available from the American Diabetes Association via http://dx.doi.org/10.2337/dc15-2078Test |
| وصف الملف: | application/msword; application/pdf |
| تدمد: | 1935-5548 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::88093357fcca7a151ea7d2fa54143e95Test https://pubmed.ncbi.nlm.nih.gov/26740634Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....88093357fcca7a151ea7d2fa54143e95 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 |
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