Intraperitoneal insulin delivery provides superior glycaemic regulation to subcutaneous insulin delivery in model predictive control-based fully-automated artificial pancreas in patients with type 1 diabetes: a pilot study
| العنوان: | Intraperitoneal insulin delivery provides superior glycaemic regulation to subcutaneous insulin delivery in model predictive control-based fully-automated artificial pancreas in patients with type 1 diabetes: a pilot study |
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| المؤلفون: | Justin Lee, Anne Farret, Ankush Chakrabarty, Marie‐José Pelletier, Eyal Dassau, Howard Zisser, Francis J. Doyle, Jerome Place, Eric Renard, Lauren M. Huyett |
| المساهمون: | Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) |
| المصدر: | Diabetes, Obesity and Metabolism Diabetes, Obesity and Metabolism, Wiley, 2017, 19 (12), pp.1698--1705. ⟨10.1111/dom.12999⟩ |
| بيانات النشر: | HAL CCSD, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Blood Glucose, Male, model predictive control, type 1 diabetes, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Pilot Projects, 030204 cardiovascular system & hematology, Infusions, Subcutaneous, 0302 clinical medicine, Endocrinology, Insulin, Regular, Human, Medicine, Infusions, Parenteral, Insulin Lispro, artificial pancreas, Middle Aged, insulin pump, DiaPort, Female, France, Algorithms, medicine.drug, Insulin pump, Adult, Pancreas, Artificial, medicine.medical_specialty, hypoglycaemia intraperitoneal, 030209 endocrinology & metabolism, Hypoglycemia, Artificial pancreas, Proof of Concept Study, Article, 03 medical and health sciences, Insulin Infusion Systems, Internal medicine, Internal Medicine, Insulin lispro, Humans, Hypoglycemic Agents, Glycated Hemoglobin, Type 1 diabetes, closed-loop, business.industry, CGM, Insulin, CSII, Carbohydrate, medicine.disease, Diabetes Mellitus, Type 1, Hyperglycemia, Regular insulin, business, hyperglycaemia |
| الوصف: | International audience; To compare intraperitoneal (IP) to subcutaneous (SC) insulin delivery in an artificial pancreas (AP). RESEARCH DESIGN AND METHODS: Ten adults with type 1 diabetes participated in a non-randomized, non-blinded sequential AP study using the same SC glucose sensing and Zone Model Predictive Control (ZMPC) algorithm adjusted for insulin clearance. On first admission, subjects underwent closed-loop control with SC delivery of a fast-acting insulin analogue for 24 hours. Following implantation of a DiaPort IP insulin delivery system, the identical 24-hour trial was performed with IP regular insulin delivery. The clinical protocol included 3 unannounced meals with 70, 40 and 70 g carbohydrate, respectively. Primary endpoint was time spent with blood glucose (BG) in the range of 80 to 140 mg/dL (4.4-7.7 mmol/L). RESULTS: Percent of time spent within the 80 to 140 mg/dL range was significantly higher for IP delivery than for SC delivery: 39.8 \textpm 7.6 vs 25.6 \textpm 13.1 ( P = .03). Mean BG (mg/dL) and percent of time spent within the broader 70 to 180 mg/dL range were also significantly better for IP insulin: 151.0 \textpm 11.0 vs 190.0 \textpm 31.0 ( P = .004) and 65.7 \textpm 9.2 vs 43.9 \textpm 14.7 ( P = .001), respectively. Superiority of glucose control with IP insulin came from the reduced time spent in hyperglycaemia (\textgreater180 mg/dL: 32.4 \textpm 8.9 vs 53.5 \textpm 17.4, P = .014; \textgreater250 mg/dL: 5.9 \textpm 5.6 vs 23.0 \textpm 11.3, P = .0004). Higher daily doses of insulin (IU) were delivered with the IP route (43.7 \textpm 0.1 vs 32.3 \textpm 0.1, P \textless .001) with no increased percent time spent \textless70 mg/dL (IP: 2.5 \textpm 2.9 vs SC: 4.1 \textpm 5.3, P = .42). CONCLUSIONS: Glycaemic regulation with fully-automated AP delivering IP insulin was superior to that with SC insulin delivery. This pilot study provides proof-of-concept for an AP system combining a ZMPC algorithm with IP insulin delivery. |
| اللغة: | English |
| تدمد: | 1462-8902 1463-1326 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::286684e8ff388f713247b41611bb2a47Test https://hal.archives-ouvertes.fr/hal-01761874Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....286684e8ff388f713247b41611bb2a47 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14628902 14631326 |
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