التفاصيل البيبلوغرافية
| العنوان: |
Outpatient Randomized Crossover Automated Insulin Delivery Versus Conventional Therapy with Induced Stress Challenges. |
| المؤلفون: |
Kaur, Ravinder Jeet1 (AUTHOR), Deshpande, Sunil2,3 (AUTHOR), Pinsker, Jordan E.3 (AUTHOR), Gilliam, Wesley P.4 (AUTHOR), McCrady-Spitzer, Shelly1 (AUTHOR), Zaniletti, Isabella5 (AUTHOR), Desjardins, Donna1 (AUTHOR), Church, Mei Mei3 (AUTHOR), Doyle III, Francis J.2,3 (AUTHOR), Kremers, Walter K.5 (AUTHOR), Dassau, Eyal2,3 (AUTHOR), Kudva, Yogish C.1 (AUTHOR) kudva.yogish@mayo.edu |
| المصدر: |
Diabetes Technology & Therapeutics. May2022, Vol. 24 Issue 5, p338-349. 12p. |
| مصطلحات موضوعية: |
*INSULIN pumps, *INSULIN, *TYPE 1 diabetes, *PSYCHOLOGICAL stress, *GLYCEMIC control, *INSULIN therapy, *BLOOD sugar monitoring, *HYPOGLYCEMIC agents, *BLOOD sugar, *RESEARCH funding, *GLUCOSE, *CROSSOVER trials |
| مستخلص: |
Background: Automated insulin delivery (AID) systems have not been evaluated in the context of psychological and pharmacological stress in type 1 diabetes. Our objective was to determine glycemic control and insulin use with Zone Model Predictive Control (zone-MPC) AID system enhanced for states of persistent hyperglycemia versus sensor-augmented pump (SAP) during outpatient use, including in-clinic induced stress. Materials and Methods: Randomized, crossover, 2-week trial of zone-MPC AID versus SAP in 14 adults with type 1 diabetes. In each arm, each participant was studied in-clinic with psychological stress induction (Trier Social Stress Test [TSST] and Socially Evaluated Cold Pressor Test [SECPT]), followed by pharmacological stress induction with oral hydrocortisone (total four sessions per participant). The main outcomes were 2-week continuous glucose monitor percent time in range (TIR) 70-180 mg/dL, and glucose and insulin outcomes during and overnight following stress induction. Results: During psychological stress, AID decreased glycemic variability percentage by 13.4% (P = 0.009). During pharmacological stress, including the following overnight, there were no differences in glucose outcomes and total insulin between AID and physician-assisted SAP. However, with AID total user-requested insulin was lower by 6.9 U (P = 0.01) for pharmacological stress. Stress induction was validated by changes in heart rate and salivary cortisol levels. During the 2-week AID use, TIR was 74.4% (vs. SAP 63.1%, P = 0.001) and overnight TIR was 78.3% (vs. SAP 63.1%, P = 0.004). There were no adverse events. Conclusions: Zone-MPC AID can reduce glycemic variability and the need for user-requested insulin during pharmacological stress and can improve overall glycemic outcomes. Clinical Trial Identifier NCT04142229. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |
