Year: 2017
Type: article
Abstract: AIM: 58-86 mmol/mol (7.5%-10%)] and well-controlled [58 mmol/mol (< 7.5%)] Type 1 diabetes. METHODS: Retrospective analysis of daytime and night-time insulin delivery during home use of closed-loop over 4 weeks. Daytime and night-time controller effort, defined as amount of insulin delivered by closed-loop relative to usual basal insulin delivery, and daytime bolus effort, defined as total bolus insulin delivery relative to total daytime insulin delivery were compared between both cohorts. Correlation analysis was performed between individual bolus behaviour (bolus effort and frequency) and daytime controller efforts, and proportion of time spent within and below sensor glucose target range. RESULTS: Individuals with suboptimally controlled Type 1 diabetes had significantly lower bolus effort (P = 0.038) and daily bolus frequency (P < 0.001) compared with those with well-controlled diabetes. Controller effort during both daytime (P = 0.007) and night-time (P = 0.005) were significantly higher for those with suboptimally controlled Type 1 diabetes. Time when glucose was within the target range (3.9-10.0 mmol/L) during daytime correlated positively with bolus effort (r = 0.37, P = 0.016) and bolus frequency (r = 0.33, P = 0.037). Time when glucose was below the target range during daytime was comparable in both groups (P = 0.36), and did not correlate significantly with bolus effort (r = 0.28, P = 0.066) or bolus frequency (r = -0.21, P = 0.19). CONCLUSION: More frequent bolusing and higher proportion of insulin delivered as bolus during hybrid closed-loop use correlated positively with time glucose was in target range. This emphasises the need for user input and educational support to benefit from this novel therapeutic modality.
Source: Diabetic Medicine
DOI: 10.1111/dme.13436
Institutions: University of Bern, University of Cambridge, University Hospital of Bern, Cambridge University Hospitals NHS Foundation Trust, Wellcome/MRC Institute of Metabolic Science, University of Graz, Medical University of Graz, Profil Institute for Metabolic Research, University of Manchester, Manchester University NHS Foundation Trust
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,704
Funders: National Science Foundation, Juvenile Diabetes Research Foundation International, Eli Lilly and Company, AstraZeneca, Sanofi, Leona M. and Harry B. Helmsley Charitable Trust, Wellcome Trust, National Institute for Health and Care Research, European Commission, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Novo Nordisk, Servier, Roche Diabetes Care, Horizon 2020 Framework Programme, Abbott Diabetes Care, Efficacy and Mechanism Evaluation Programme, Seventh Framework Programme, NIHR Cambridge Biomedical Research Centre, National Institute on Aging, National Institute of Diabetes and Digestive and Kidney Diseases, NIHR Evaluation Trials and Studies Coordinating Centre
Awards: G10500178, G1178615512, G2018687014, Firing modes and synaptic transmission in the forebrain., G434337789, G4577803176, G461391184, Institute of Metabolic Science., 24/7 closed-loop in older subjects with type 1 diabetes, G4903748289, One year day-and-night home closed loop in young people with type 1 diabetes, G4937468798, G5246447471, Closing the loop - towards the artificial pancreas in adults with type 1 diabetes, G6049260834, Bringing the artificial pancreas home, G6351477851, G6525891988, Home testing of 24/7 closed-loop control in children and adolescents with type 1, Effect of closed loop insulin delivery from onset of diabetes in youth on progression of type 1 diabetes, G8589133502, G8771701153, The artificial pancreas in children aged 1 to 7 years with type 1 diabetes, University of Southern California Alzheimer’s Disease (AD) and Alzheimer’s Disease-Related Dementias (ADRD) Resource Center for Minority Aging Research (USC AD/ADRD RCMAR)
OpenAlex ID: W2740419151