دورية أكاديمية
Unsupervised home use of an overnight closed-loop system over 3-4 weeks: a pooled analysis of randomized controlled studies in adults and adolescents with type 1 diabetes.
| العنوان: | Unsupervised home use of an overnight closed-loop system over 3-4 weeks: a pooled analysis of randomized controlled studies in adults and adolescents with type 1 diabetes. |
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| المؤلفون: | Thabit, H, Elleri, D, Leelarathna, L, Allen, JM, Lubina-Solomon, A, Stadler, M, Walkinshaw, E, Iqbal, A, Choudhary, P, Wilinska, ME, Barnard, KD, Heller, SR, Amiel, SA, Evans, ML, Dunger, DB, Hovorka, R |
| بيانات النشر: | Blackwell Publishing Ltd //dx.doi.org/10.1111/dom.12427 Diabetes Obes Metab |
| سنة النشر: | 2015 |
| المجموعة: | Apollo - University of Cambridge Repository |
| مصطلحات موضوعية: | clinical trial, closed-loop insulin delivery, glycaemic control, type 1 diabetes, Adolescent, Adult, Algorithms, Blood Glucose, Blood Glucose Self-Monitoring, Cross-Over Studies, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Middle Aged, Time Factors, Treatment Outcome |
| الوصف: | AIMS: To compare overnight closed-loop and sensor-augmented pump therapy in patients with type 1 diabetes by combining data collected during free-living unsupervised randomized crossover home studies. METHODS: A total of 40 participants with type 1 diabetes, of whom 24 were adults [mean ± standard deviation (s.d.) age 43 ± 12 years and glycated haemoglobin (HbA1c) 8.0 ± 0.9%] and 16 were adolescents (mean ± s.d. age 15.6 ± 3.6 years and HbA1c 8.1 ± 0.8%), underwent two periods of sensor-augmented pump therapy in the home setting, in combination with or without an overnight closed-loop insulin delivery system that uses a model predictive control algorithm to direct insulin delivery. The order of the two interventions was random; each period lasted 4 weeks in adults and 3 weeks in adolescents. The primary outcome was time during which sensor glucose readings were in the target range of 3.9-8.0 mmol/l. RESULTS: The proportion of time when sensor glucose was in the target range (3.9-8.0 mmol/l) overnight (between 24:00 and 08:00 hours) was 18.5% greater during closed-loop insulin delivery than during sensor-augmented therapy (p < 0.001). Closed-loop therapy significantly reduced mean overnight glucose levels by 0.9 mmol/l (p < 0.001), with no difference in glycaemic variability, as measured by the standard deviation of sensor glucose. Time spent above the target range was reduced (p = 0.001), as was time spent in hypoglycaemia (<3.9 mmol/l; p = 0.014) during closed-loop therapy. Lower mean overnight glucose levels during closed-loop therapy were brought about by increased overnight insulin delivery (p < 0.001) without changes to the total daily delivery (p = 0.84). CONCLUSION: Overnight closed-loop insulin therapy at home in adults and adolescents with type 1 diabetes is feasible, showing improvements in glucose control and reducing the risk of nocturnal hypoglycaemia. ; Juvenile Diabetes Research Foundation (#22-2009-802) and Diabetes UK (BDA07/0003549) with additional support for the Artificial ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://www.repository.cam.ac.uk/handle/1810/246830Test |
| الإتاحة: | https://www.repository.cam.ac.uk/handle/1810/246830Test |
| حقوق: | Creative Commons Attribution License 2.0 UK ; http://creativecommons.org/licenses/by/2.0/ukTest/ |
| رقم الانضمام: | edsbas.E5B091AB |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |