Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study
| العنوان: | Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study |
|---|---|
| المؤلفون: | Thomas R. Pieber, Janet M. Allen, Malgorzata E Wilinska, Mark L. Evans, Harald Kojzar, Martin Tauschmann, Julia K. Mader, Jehona Qerimi-Hyseni, Lia Bally, Roman Hovorka, Hood Thabit, Sara Hartnell |
| المساهمون: | Tauschmann, Martin [0000-0002-2305-2490], Wilinska, Gosia [0000-0003-2739-1753], Evans, Mark [0000-0001-8122-8987], Hovorka, Roman [0000-0003-2901-461X], Apollo - University of Cambridge Repository |
| المصدر: | The Lancet Diabetes & Endocrinology Bally, Lia; Thabit, Hood; Kojzar, Harald; Mader, Julia K; Qerimi-Hyseni, Jehona; Hartnell, Sara; Tauschmann, Martin; Allen, Janet M; Wilinska, Malgorzata E; Pieber, Thomas R; Evans, Mark L; Hovorka, Roman (2017). Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study. The lancet. Diabetes & endocrinology, 5(4), pp. 261-270. Elsevier 10.1016/S2213-8587(17)30001-3 <http://dx.doi.org/10.1016/S2213-8587Test(17)30001-3> The Lancet. Diabetes & Endocrinology |
| بيانات النشر: | Elsevier BV, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Pancreas, Artificial, Adult, Male, Insulin pump, medicine.medical_specialty, Time Factors, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 610 Medicine & health, 030209 endocrinology & metabolism, law.invention, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Endocrinology, Bolus (medicine), Randomized controlled trial, law, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Type 1 diabetes, Cross-Over Studies, Intention-to-treat analysis, business.industry, Articles, Infusion Pumps, Implantable, Middle Aged, medicine.disease, Crossover study, Hypoglycemia, 3. Good health, Surgery, Diabetes Mellitus, Type 1, Treatment Outcome, Female, business |
| الوصف: | BACKGROUND Tight control of blood glucose concentration in people with type 1 diabetes predisposes to hypoglycaemia. We aimed to investigate whether day-and-night hybrid closed-loop insulin delivery can improve glucose control while alleviating the risk of hypoglycaemia in adults with HbA1c below 7·5% (58 mmol/mol). METHODS In this open-label, randomised, crossover study, we recruited adults (aged ≥18 years) with type 1 diabetes and HbA1c below 7·5% from Addenbrooke's Hospital (Cambridge, UK) and Medical University of Graz (Graz, Austria). After a 2-4 week run-in period, participants were randomly assigned (1:1), using web-based randomly permuted blocks of four, to receive insulin via the day-and-night hybrid closed-loop system or usual pump therapy for 4 weeks, followed by a 2-4 week washout period and then the other intervention for 4 weeks. Treatment interventions were unsupervised and done under free-living conditions. During the closed-loop period, a model-predictive control algorithm directed insulin delivery, and prandial insulin delivery was calculated with a standard bolus wizard. The primary outcome was the proportion of time when sensor glucose concentration was in target range (3·9-10·0 mmol/L) over the 4 week study period. Analyses were by intention to treat. This study is registered with ClinicalTrials.gov, number NCT02727231, and is completed. FINDINGS Between March 21 and June 24, 2016, we recruited 31 participants, of whom 29 were randomised. One participant withdrew during the first closed-loop period because of dissatisfaction with study devices and glucose control. The proportion of time when sensor glucose concentration was in target range was 10·5 percentage points higher (95% CI 7·6-13·4; p |
| وصف الملف: | application/pdf |
| تدمد: | 2213-8587 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::60020a972f8e05d36d58882de4deca4eTest https://doi.org/10.1016/s2213-8587Test(17)30001-3 |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....60020a972f8e05d36d58882de4deca4e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 22138587 |
|---|