المؤلفون: Tauschmann, Martin

مرشدي الرسالة: Hovorka, Roman

مصطلحات موضوعية: type 1 diabetes, closed-loop insulin delivery, artificial pancreas, continuous glucose monitoring, insulin pump therapy, children and adolescents

الوصف: Type 1 diabetes is one of the most common chronic conditions in childhood and adolescence. Despite ongoing development of more physiological insulin preparations, recent advancements in insulin pump technology and more accurate blood glucose monitoring, in clinical practice it remains challenging to achieve normoglycaemia whilst reducing the risk of hypoglycaemia, particularly in young people with type 1 diabetes. Closed-loop insulin delivery (the artificial pancreas) is an emerging technology gradually progressing from bench to clinical practice. Closed-loop systems combine glucose sensing with computer-based algorithm informed insulin delivery to provide real-time glucose-responsive insulin administration. The key objective of my thesis is to evaluate the safety, efficacy and utility of closed-loop insulin delivery in children and adolescents with type 1 diabetes outside of the research facility setting. Results of five clinical trials are presented in the main chapters of this thesis. In a mechanistic study, the impact of glucose sensor operation duration on efficacy of overnight closed-loop was investigated comparing closed-loop performance on day 1 of sensor insertion to day 3 to 4 of sensor. Twelve adolescents with type 1 diabetes attended the research facility for two overnight visits. The sequence of the interventions was random. Despite differences in sensor accuracy, overnight CL glucose control informed by sensor glucose on day 1 or day 3-4 after sensor insertion was comparable. The model predictive controller appears to mitigate against sensor inaccuracies. In home settings, overnight closed-loop application was evaluated over three months in 25 children and adolescents with type 1 diabetes aged six to 18 years. The study was conducted at three centres in the UK and adopted a randomised cross-over design. Compared to sensor-augmented pump therapy, overnight home use of closed-loop increased the proportion of time sensor glucose was in target, and reduced mean glucose and hypoglycaemia. Two randomised crossover studies evaluated the safety and efficacy of day-and-night hybrid closed-loop insulin delivery in young people with type 1 diabetes aged 10 to 18 years over seven days, and 21 days, respectively. A total of 24 subjects were enrolled in this single centre trial. Free-living home use of day-and-night closed-loop in suboptimally controlled adolescents with type 1 diabetes was safe, and improved glucose control without increasing the risk of hypoglycaemia. Finally, closed-loop technology was assessed in five very young children (aged one to seven years) with type 1 diabetes in a two-period, crossover study. Closed-loop was used during both 3-week intervention periods, either with standard strength insulin (U100), or with diluted insulin (U20). The order of intervention was random. Free-living home use of day-and-night hybrid closed-loop in very young children with type 1 diabetes was feasible and safe. Glucose control was comparable during both intervention periods. Thus, use of diluted insulin during closed-loop insulin delivery might not be of additional benefit in this population. In conclusion, studies conducted as part of my thesis demonstrate that use of hybrid closed-loop insulin delivery systems in children and adolescents aged one to 18 years in free daily living without remote monitoring or supervision is feasible, safe and effective. My work supports the progression of this technology from research to mainstream clinical practice.

الإتاحة: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.767783Test

المؤلفون: Alwan, Heba, Ware, Julia, Boughton, Charlotte K, Wilinska, Malgorzata E, Allen, Janet M, Lakshman, Rama, Nwokolo, Munachiso, Hartnell, Sara, Bally, Lia, de Beaufort, Carine, Besser, Rachel EJ, Campbell, Fiona M, Davis, Nikki, Denvir, Louise, Evans, Mark L, Fröhlich-Reiterer, Elke, Ghatak, Atrayee, Hofer, Sabine E, Kapellen, Thomas M, Leelarathna, Lalantha, Mader, Julia K, Narendran, Parth, Rami-Mehrar, Birgit, Tauschmann, Martin, Thabit, Hood, Thankamony, Ajay, Hovorka, Roman

مصطلحات موضوعية: Artificial pancreas, Closed-loop insulin delivery, Insulin pump therapy, Randomized trial, Type 1 diabetes, Adolescent, Aged, Child, Preschool, Humans, Blood Glucose, Cross-Over Studies, Diabetes Mellitus, Type 1, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Regular, Human, Retrospective Studies, Treatment Outcome, Young Adult, Adult, Middle Aged

الوصف: Objective: We aimed to assess whether percentage of time spent in hypoglycemia during closed-loop insulin delivery differs by age group and time of day. Methods: We retrospectively analyzed data from hybrid closed-loop studies involving young children (2-7 years), children and adolescents (8-18 years), adults (19-59 years), and older adults (≥60 years) with type 1 diabetes. Main outcome was time spent in hypoglycemia <3.9 mmol/L (<70 mg/dL). Eight weeks of data for 88 participants were analyzed. Results: Median time spent in hypoglycemia over the 24-h period was highest in children and adolescents (4.4% [interquartile range 2.4-5.0]) and very young children (4.0% [3.4-5.2]), followed by adults (2.7% [1.7-4.0]), and older adults (1.8% [1.2-2.2]); P < 0.001 for difference between age groups. Time spent in hypoglycemia during nighttime (midnight-05:59) was lower than during daytime (06:00-23:59) across all age groups. Conclusion: Time in hypoglycemia was highest in the pediatric age group during closed-loop insulin delivery. Hypoglycemia burden was lowest overnight across all age groups.

وصف الملف: application/msword

العلاقة: https://www.repository.cam.ac.uk/handle/1810/350613Test; https://doi.org/10.17863/CAM.97045Test

الإتاحة: https://doi.org/10.17863/CAM.97045Test
https://www.repository.cam.ac.uk/handle/1810/350613Test

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

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.

وصف الملف: Print-Electronic; application/pdf

العلاقة: https://www.repository.cam.ac.uk/handle/1810/346173Test

الإتاحة: https://doi.org/10.17863/CAM.93599Test
https://www.repository.cam.ac.uk/handle/1810/346173Test

المؤلفون: Rami-Merhar, Birgit, Schütz-Fuhrmann, Ingrid, Fröhlich-Reiterer, Elke, Hofer, Sabine E., Tauschmann, Martin, Mader, Julia K., Resl, Michael, Kautzky-Willer, Alexandra, Winhofer-Stöckl, Yvonne, Laimer, Markus, Zlamal-Fortunat, Sandra, Weitgasser, Raimund

مصطلحات موضوعية: Diabetes Technologie, Insulinpumpentherapie, Kontinuierliche Glukose Messung, Automatisierte Insulin Abgabe Systeme, Closed-Loop, Künstliches Pankreas, Mobile Apps, Telemedizin, Diabetes technology, Insulin pump therapy, CGM, Threshold-suspension, AID, Artificial pancreas, Telemedicine

جغرافية الموضوع: UMW:17631, UMW:14638

الوصف: Diese Leitlinie repräsentiert die Empfehlungen der Österreichischen Diabetes Gesellschaft (ÖDG) zur Nutzung von Diabetes-Technologie (Insulinpumpentherapie; kontinuierliche Glukosemesssysteme, CGM; Hybrid Closed Loop Systeme, HCL; Automated Insulin Delivery Systeme, AID, Diabetes-Apps) und den Zugang zu diesen technologischen Innovationen für Menschen mit Diabetes mellitus. Die Leitlinie wurde basierend auf aktueller wissenschaftlicher Evidenz erstellt. ; This Guideline represents the recommendations of the Austrian Diabetes Association (ÖDG) on the use of diabetes technology (insulin pump therapy; continuous glucose monitoring, CGM; hybrid closed-loop systems, HCL; diabetes apps) and access to these technological innovations for people with diabetes mellitus based on current scientific evidence.

وصف الملف: text/html

العلاقة: vignette : https://repositorium.meduniwien.ac.at/titlepage/urn/urn:nbn:at:at-ubmuw:3-76554/128Test; urn:nbn:at:at-ubmuw:3-76554; https://resolver.obvsg.at/urn:nbn:at:at-ubmuw:3-76554Test; local:99147472135803331; system:AC16899299

الإتاحة: https://doi.org/10.1007/s00508-023-02165-9Test
https://resolver.obvsg.at/urn:nbn:at:at-ubmuw:3-76554Test

المؤلفون: Boughton, Charlotte, Allen, Janet M, Tauschmann, Martin, Hartnell, Sara, Wilinska, Malgorzata E, Musolino, Gianluca, Acerini, Carlo L, Dunger, Professor David, Campbell, Fiona, Ghatak, Atrayee, Randell, Tabitha, Besser, Rachel, Trevelyan, Nicola, Elleri, Daniela, Northam, Elizabeth, Hood, Korey, Scott, Eleanor, Lawton, Julia, Roze, Stephane, Sibayan, Judy, Kollman, Craig, Cohen, Nate, Todd, John, Hovorka, Roman

مصطلحات موضوعية: Diabetes and endocrinology, type 1 diabetes, closed-loop, artificial pancreas

الوقت: 1506, 1843

الوصف: Introduction: Management of newly diagnosed type 1 diabetes (T1D) in children and adolescents is challenging for patients, families and healthcare professionals. The objective of this study is to determine whether continued intensive metabolic control using hybrid closed-loop (CL) insulin delivery following diagnosis of T1D can preserve C-peptide secretion, a marker of residual beta-cell function, compared with standard multiple daily injections (MDI) therapy. Methods and analysis: The study adopts an open-label, multicentre, randomised, parallel design, and aims to randomise 96 participants aged 10–16.9 years, recruited within 21 days of diagnosis with T1D. Following a baseline mixed meal tolerance test (MMTT), participants will be randomised to receive 24 months treatment with conventional MDI therapy or with CL insulin delivery. A further 24-month optional extension phase will be offered to all participants to continue with the allocated treatment. The primary outcome is the between group difference in area under the stimulated C-peptide curve (AUC) of the MMTT at 12 months post diagnosis. Analyses will be conducted on an intention-to-treat basis. Key secondary outcomes are between group differences in time spent in target glucose range (3.9–10 mmol/L), glycated haemoglobin (HbA1c) and time spent in hypoglycaemia (<3.9 mmol/L) at 12 months. Secondary efficacy outcomes include between group differences in stimulated C-peptide AUC at 24 months, time spent in target glucose range, glucose variability, hypoglycaemia and hyperglycaemia as recorded by periodically applied masked continuous glucose monitoring devices, total, basal and bolus insulin dose, and change in body weight. Cognitive, emotional and behavioural characteristics of participants and parents will be evaluated, and a cost–utility analysis performed to support adoption of CL as a standard treatment modality following diagnosis of T1D. Ethics and dissemination: Ethics approval has been obtained from Cambridge East Research Ethics Committee. The ...

وصف الملف: application/pdf; text/xml

العلاقة: https://www.repository.cam.ac.uk/handle/1810/303388Test

الإتاحة: https://doi.org/10.17863/CAM.50476Test
https://www.repository.cam.ac.uk/handle/1810/303388Test

المؤلفون: Lawton, Julia, Blackburn, Maxine, Rankin, David, Allen, Janet M, Campbell, Fiona M, Leelarathna, Lalantha, Tauschmann, Martin, Thabit, Hood, Wilinska, Malgorzata E, Elleri, Daniela, Hovorka, Roman

المصدر: Lawton , J , Blackburn , M , Rankin , D , Allen , J M , Campbell , F M , Leelarathna , L , Tauschmann , M , Thabit , H , Wilinska , M E , Elleri , D & Hovorka , R 2019 , ' Participants' Experiences of, and Views About, Daytime Use of a Day-and-Night Hybrid Closed-Loop System in Real Life Settings : Longitudinal Qualitative Study ' , Diabetes technology & therapeutics , vol. 21 , no. 3 , pp. 119-127 . https://doi.org/10.1089/dia.2018.0306Test

مصطلحات موضوعية: Type 1 diabetes, Closed-loop system, Artificial pancreas, Medical device, User experience, Qualitative research

الوصف: OBJECTIVE: To explore individuals' experiences of daytime use of a day-and-night hybrid closed-loop system, their information and support needs, and their views about how future systems could be improved. RESEARCH DESIGN AND METHODS: Twenty-four adults, adolescents, and parents were interviewed before using a hybrid day-and-night closed-loop system and 3 months later, data were analyzed thematically. RESULTS: Participants praised the closed loop's ability to respond to high and low blood glucose in ways which extended beyond their own capabilities and to act as a safety net and mop up errors, such as when a mealtime bolus was forgotten or unplanned activity was undertaken. Participants also described feeling less burdened by diabetes as a consequence and more able to lead flexible, spontaneous lives. Contrary to their initial expectations, and after trust in the system had been established, most individuals wanted opportunities to collaborate with the closed loop to optimize its effectiveness. Such individuals expressed a need to communicate information, such as when routines changed or to indicate different intensities of physical activity. While individuals valued frequent contact with staff in the initial month of use, most felt that their long-term support needs would be no greater than when using an insulin pump. CONCLUSIONS: While participants reported substantial benefits to using the closed loop during the day, they also identified ways in which the technology could be refined and education and training tailored to optimize effective use. Our findings suggest that mainstreaming this technology will not necessarily lead to increased demands on clinical staff.

الإتاحة: https://doi.org/10.1089/dia.2018.0306Test
https://research.manchester.ac.uk/en/publications/50cccb28-efb5-488f-9181-1b15cba25a27Test

المؤلفون: Hovorka, Roman, Musolino, Gianluca, Dovc, Klemen, Boughton, Charlotte K., Tauschmann, Martin, Allen, Janet M., Nagl, Katrin, Fritsch, Maria, Yong, James, Metcalfe, Emily, Schaeffer, Dominique, Fichelle, Muriel, Schierloh, Ulrike, Thiele, Alena G., Abt, Daniela, Kojzar, Harald, Mader, Julia K., Slegtenhorst, Sonja, Ashcroft, Nicole, Wilinska, Malgorzata E., Sibayan, Judy, Cohen, Nathan, Kollman, Craig, Hofer, Sabine E., Fröhlich-Reiterer, Elke

مصطلحات موضوعية: artificial pancreas, closed‐loop insulin delivery, type 1 diabetes, very young children

جغرافية الموضوع: UMW:14638

الوصف: Objective To evaluate the experiences of families with very young children aged 1 to 7 years (inclusive) with type 1 diabetes using day‐and‐night hybrid closed‐loop insulin delivery. Methods Parents/caregivers of 20 children aged 1 to 7 years with type 1 diabetes completed a closed‐loop experience survey following two 3‐week periods of unrestricted day‐and‐night hybrid closed‐loop insulin therapy using Cambridge FlorenceM system at home. Benefits, limitations, and improvements of closed‐loop technology were explored. Results Responders reported reduced burden of diabetes management, less time spent managing diabetes, and improved quality of sleep with closed‐loop. Ninety percent of the responders felt less worried about their child's glucose control using closed‐loop. Size of study devices, battery performance and connectivity issues were identified as areas for improvement. Parents/caregivers wished for more options to input information to the system such as temporary glucose targets. Conclusions Parents/caregivers of very young children reported important quality of life benefits associated with using closed‐loop, supporting adoption of this technology in this population.

وصف الملف: text/html

العلاقة: vignette : https://repositorium.meduniwien.ac.at/titlepage/urn/urn:nbn:at:at-ubmuw:3-34629/128Test; urn:nbn:at:at-ubmuw:3-34629; https://resolver.obvsg.at/urn:nbn:at:at-ubmuw:3-34629Test; local:99145832359703331; system:AC16138783

الإتاحة: https://doi.org/10.1111/pedi.12872Test
https://resolver.obvsg.at/urn:nbn:at:at-ubmuw:3-34629Test

المؤلفون: Musolino, Gianluca, Allen, Janet M., Hartnell, Sara, Wilinska, Malgorzata E., Tauschmann, Martin, Boughton, Charlotte, Campbell, Fiona, Denvir, Louise, Trevelyan, Nicola, Wadwa, Paul, DiMeglio, Linda, Buckingham, Bruce A., Weinzimer, Stuart, Acerini, Carlo L., Hood, Korey, Fox, Steven, Kollman, Craig, Sibayan, Judy, Borgman, Sarah, Cheng, Peiyao, Hovorka, Roman

المساهمون: Pediatrics, School of Medicine

المصدر: PMC

مصطلحات موضوعية: Type 1 diabetes, Closed-loop, Artificial pancreas

الوصف: INTRODUCTION: Closed-loop systems titrate insulin based on sensor glucose levels, providing novel means to reduce the risk of hypoglycaemia while improving glycaemic control. We will assess effectiveness of 6-month day-and-night closed-loop insulin delivery compared with usual care (conventional or sensor-augmented pump therapy) in children and adolescents with type 1 diabetes. METHODS AND ANALYSIS: The trial adopts an open-label, multicentre, multinational (UK and USA), randomised, single-period, parallel design. Participants (n=130) are children and adolescents (aged ≥6 and <19 years) with type 1 diabetes for at least 1 year, and insulin pump use for at least 3 months with suboptimal glycaemic control (glycated haemoglobin ≥58 mmol/mol (7.5%) and ≤86 mmol/mol (10%)). After a 2-3 week run-in period, participants will be randomised to 6-month use of hybrid closed-loop insulin delivery, or to usual care. Analyses will be conducted on an intention-to-treat basis. The primary outcome is glycated haemoglobin at 6 months. Other key endpoints include time in the target glucose range (3.9-10 mmol/L, 70-180 mg/dL), mean sensor glucose and time spent above and below target. Secondary outcomes include SD and coefficient of variation of sensor glucose levels, time with sensor glucose levels <3.5 mmol/L (63 mg/dL) and <3.0 mmol/L (54 mg/dL), area under the curve of glucose <3.5 mmol/L (63 mg/dL), time with glucose levels >16.7 mmol/L (300 mg/dL), area under the curve of glucose >10.0 mmol/L (180 mg/dL), total, basal and bolus insulin dose, body mass index z-score and blood pressure. Cognitive, emotional and behavioural characteristics of participants and caregivers and their responses to the closed-loop and clinical trial will be assessed. An incremental cost-effectiveness ratio for closed-loop will be estimated. ETHICS AND DISSEMINATION: Cambridge South Research Ethics Committee and Jaeb Center for Health Research Institutional Review Office approved the study. The findings will be disseminated by ...

وصف الملف: application/pdf

العلاقة: BMJ Open; Musolino, G., Allen, J. M., Hartnell, S., Wilinska, M. E., Tauschmann, M., Boughton, C., … Hovorka, R. (2019). Assessing the efficacy, safety and utility of 6-month day-and-night automated closed-loop insulin delivery under free-living conditions compared with insulin pump therapy in children and adolescents with type 1 diabetes: an open-label, multicentre, multinational, single-period, randomised, parallel group study protocol. BMJ open, 9(6), e027856. doi:10.1136/bmjopen-2018-027856; https://hdl.handle.net/1805/20612Test

الإتاحة: https://doi.org/10.1136/bmjopen-2018-027856Test
https://hdl.handle.net/1805/20612Test

العنوان البديل: Insulin pump therapy and continuous glucose monitoring. (English)

المؤلفون: Schütz-Fuhrmann, Ingrid, Rami-Merhar, Birgit, Fröhlich-Reiterer, Elke, Hofer, Sabine E., Tauschmann, Martin, Mader, Julia K., Resl, Michael, Kautzky-Willer, Alexandra, Winhofer-Stöckl, Yvonne, Laimer, Markus, Zlamal-Fortunat, Sandra, Weitgasser, Raimund

المصدر: Wiener Klinische Wochenschrift; Jan2023 Suppl 1, Vol. 135 Issue 1, p53-61, 9p

الملخص (بالإنجليزية): Summary: This Guideline represents the recommendations of the Austrian Diabetes Association (ÖDG) on the use of diabetes technology (insulin pump therapy; continuous glucose monitoring, CGM; hybrid closed-loop systems, HCL; diabetes apps) and access to these technological innovations for people with diabetes mellitus based on current scientific evidence. [ABSTRACT FROM AUTHOR]

Abstract (German): Zusammenfassung: Diese Leitlinie repräsentiert die Empfehlungen der Österreichischen Diabetes Gesellschaft (ÖDG) zur Nutzung von Diabetes-Technologie (Insulinpumpentherapie; kontinuierliche Glukosemesssysteme, CGM; Hybrid Closed Loop Systeme, HCL; Automated Insulin Delivery Systeme, AID, Diabetes-Apps) und den Zugang zu diesen technologischen Innovationen für Menschen mit Diabetes mellitus. Die Leitlinie wurde basierend auf aktueller wissenschaftlicher Evidenz erstellt. [ABSTRACT FROM AUTHOR]

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المؤلفون: Elleri, Daniela, Allen, Janet M, Tauschmann, Martin, El-Khairi, Ranna, Benitez-Aguirre, Paul, Acerini, Carlo L, Dunger, David B, Hovorka, Roman

مصطلحات موضوعية: Artificial Pancreas, Child, Type 1

الوصف: OBJECTIVE: To assess feasibility of overnight closed-loop therapy in young children with type 1 diabetes and contrast closed loop using diluted versus standard insulin strength. RESEARCH DESIGN AND METHODS: Eleven children (male 6; age range 3.75-6.96 years; glycated hemoglobin 60 (14) mmol/mol; body mass index SD score 1.0 (0.8); diabetes duration 2.2 (1.0) years, mean (SD); total daily dose 12.9 (10.6, 16.5) IU/day, median (IQR)) were studied at a clinical research facility on two occasions. In random order, participants received closed loop with diluted insulin aspart (CL_Dil; 20 IU/mL) or closed loop with standard aspart (CL_Std; 100 IU/mL) from 17:00 until 8:00 the following morning. Children consumed an evening meal at 17:00 (44 (12) gCHO) and an optional bedtime snack (6 (7) gCHO) identical on both occasions. Meal insulin boluses were calculated by standard pump bolus calculators. Basal rates on insulin pump were adjusted every 15 min as directed by a model-predictive-control algorithm informed by a real-time glucose sensor values. RESULTS: Mean plasma glucose was 122 (24) mg/dL during CL_Dil vs 122 (23) mg/dL during CL_Std (p=0.993). The time spent in the target glucose range 70-145 mg/dL was 83 (70, 100)% vs 72 (54, 81)% (p=0.328). Time above 145 mg/dL was 13 (0, 27)% vs 19 (10, 45)% (p=0.477) and time spent below 70 mg/dL was 0.0 (0.0, 1.4)% vs 1.4 (0.0, 11.6)% (p=0.161). One asymptomatic hypoglycemia below 63 mg/dL occurred in one participant during CL_Dil versus six episodes in five participants during CL_Std (p=0.09). Glucose variability measured by CV of plasma glucose tended to be reduced during CL_Dil (20% (13, 31) vs 32% (24, 42), p=0.075). CONCLUSIONS: In this feasibility study, closed-loop therapy maintained good overnight glucose control with tendency towards reduced hypoglycemia and reduced glucose variability using diluted insulin. TRIAL REGISTRATION NUMBER: clinicaltrials.gov Identifier: NCT01557634. ; This work was funded by the Juvenile Diabetes Research Foundation (JDRF Grant Number: ...

وصف الملف: application/pdf

العلاقة: https://www.repository.cam.ac.uk/handle/1810/246292Test

الإتاحة: https://www.repository.cam.ac.uk/handle/1810/246292Test