التفاصيل البيبلوغرافية
| العنوان: |
Day-and-Night Hybrid Closed-Loop Insulin Delivery in Adolescents With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial. |
| المؤلفون: |
Tauschmann, Martin1,2, Allen, Janet M.1,2, Wilinska, Malgorzata E.1,2, Thabit, Hood1, Stewart, Zoë1, Peiyao Cheng3, Kollman, Craig3, Acerini, Carlo L.2, Dunger, David B.1,2, Hovorka, Roman1,2 rh347@cam.ac.uk, Cheng, Peiyao3 (AUTHOR) |
| المصدر: |
Diabetes Care. Jul2016, Vol. 39 Issue 7, p1168-1174. 7p. 2 Charts, 2 Graphs. |
| مصطلحات موضوعية: |
*CLOSED loop systems, *INSULIN therapy, *PHYSIOLOGICAL effects of insulin, *DRUG delivery systems, *TYPE 1 diabetes, *TREATMENT of diabetes, *HYPERINSULINISM, *ALGORITHMS, *BLOOD sugar, *COMPARATIVE studies, *CROSSOVER trials, *HYPOGLYCEMIA, *HYPOGLYCEMIC agents, *INSULIN, *INSULIN pumps, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *RESEARCH, *RESEARCH funding, *EVALUATION research, *RELATIVE medical risk, *DIAGNOSIS |
| مستخلص: |
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. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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