Hypoglycaemia incidence and recovery during home use of hybrid closed‐loop insulin delivery in adults with type 1 diabetes
Year: 2018
Type: article
Abstract: Glucose excursion was assessed prior to and post hypoglycaemia to increase understanding of hypoglycaemia incidence and recovery during hybrid closed-loop insulin delivery. We retrospectively analysed data from 60 adults with type 1 diabetes who received, in a crossover randomized design, day-and-night hybrid closed-loop insulin delivery and insulin pump therapy, the latter with or without real-time continuous glucose monitoring. Over 4-week study periods, we identified hypoglycaemic episodes, defined as sensor glucose <3.0 mmol/L, and analysed sensor glucose relative to the onset of hypoglycaemia. We identified 377 hypoglycaemic episodes during hybrid closed-loop intervention vs 662 during control intervention (P < .001), with a predominant reduction of nocturnal hypoglycaemia. The slope of sensor glucose prior to hypoglycaemia was steeper during closed-loop intervention than during control intervention (P < .01), while insulin delivery was reduced (P < .01). During both day and night, participants recovered from hypoglycaemia faster when treated by closed-loop intervention. At 120 minutes post hypoglycaemia, sensor glucose levels were higher during closed-loop intervention compared to the control period (P < .05). In conclusion, closed-loop intervention reduces the risk of hypoglycaemia, particularly overnight, with swift recovery from hypoglycaemia leading to higher 2-hour post-hypoglycaemia glucose levels.
Source: Diabetes Obesity and Metabolism
DOI: 10.1111/dom.13304
Institutions: University of Cambridge, Wellcome/MRC Institute of Metabolic Science, University of Bern, University Hospital of Bern, Manchester Academic Health Science Centre, University of Manchester, Cambridge University Hospitals NHS Foundation Trust, Medical University of Graz, Profil Institute for Metabolic Research
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,937
Awards: Institute of Metabolic Science., 24/7 closed-loop in older subjects with type 1 diabetes, One year day-and-night home closed loop in young people with type 1 diabetes, Closing the loop - towards the artificial pancreas in adults with type 1 diabetes, Effect of closed loop insulin delivery from onset of diabetes in youth on progression of 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: W2794226311