Evaluating the Impact of Applying Personal Glucose Targets in a Closed-Loop System for People With Type 1 Diabetes
Year: 2022
Type: article
Abstract: Background CamAPS FX is a hybrid closed-loop smartphone app used to manage type one diabetes. The closed-loop algorithm has a default target glucose of 5.8 mmol/L (104.5 mg/dL), but users can select personal glucose targets (adjustable between 4.4 mmol/L and 11.0 mmol/L [79 mg/dL and 198 mg/dL, respectively]). Method In this post-hoc analysis, we evaluated the impact of personal glucose targets on glycemic control using data from participants in five randomized controlled trials. Results Personal glucose targets were widely used, with 20.3% of all days in the data set having a target outside the default target bin (5.5-6.0 mmol/L [99-108 mg/dL]). Personal glucose targets >6.5 mmol/L (117 mg/dL) were associated with significantly less time in target range (3.9-10.0 mmol/L [70-180 mg/dL]; 6.5-7.0 mmol/L [117-126 mg/dL]: mean difference = −3.2 percentage points [95% CI: −5.3 to −1.2; P < .001]; 7.0-7.5 mmol/L [126-135 mg/dL]: −10.8 percentage points [95% CI: −14.1 to −7.6; P < .001]). Personal targets >6.5 mmol/L (117 mg/dL) were associated with significantly lower time (<3.9 mmol/L [<70 mg/dL]; 6.5-7.0 mmol/L [117-126 mg/dL]: −1.85 percentage points [95% CI: −2.37 to −1.34; P < .001]; 7.0-7.5 mmol/L [126-135 mg/dL]: −2.68 percentage points [95% CI: −3.49 to −1.86; P < .001]). Conclusions Discrete study populations showed differences in glucose control when applying similar personal targets.
Authors: Mustafa Fattah, Charlotte K. Boughton, Julia Ware, Janet M. Allen, Sara Hartnell, Malgorzata E. Willinska, Ajay Thankamony, Carine de Beaufort, Fiona M. Campbell, Elke Fröhlich-Reiterer, Sabine E. Hofer, Thomas M. Kapellen, Birgit Rami-Merhar, Atrayee Ghatak, Tabitha L. Randell, Rachel E. J. Besser, Daniela Elleri, Nicola Trevelyan, Louise Denvir MD, Nikki Davis, Lia Bally, Hood Thabit, Lalantha Leelarathna, Mark L. Evans, Julia K. Mader, Roman Hovorka
Institutions: University of Cambridge, Wellcome/MRC Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, NIHR Cambridge Biomedical Research Centre, Wellcome Trust, Centre Hospitalier de Luxembourg, University of Luxembourg, Leeds Teaching Hospitals NHS Trust, Medical University of Graz, Innsbruck Medical University, University Hospital Leipzig, Leipzig University, Medical University of Vienna, Alder Hey Children's NHS Foundation Trust, Alder Hey Children's Hospital, John Radcliffe Hospital, University of Oxford, NIHR Oxford Biomedical Research Centre, Southampton Children's Hospital, University of Bern, University Hospital of Bern, 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: $3,500
Funders: Leona M. and Harry B. Helmsley Charitable Trust, Juvenile Diabetes Research Foundation United States of America, Wellcome Trust, National Institute for Health and Care Research, University of Cambridge, Horizon 2020 Framework Programme, NIHR Cambridge Biomedical Research Centre, National Institute of Diabetes and Digestive and Kidney Diseases, NIHR Evaluation Trials and Studies Coordinating Centre
Awards: G10500178, G2018687014, G4577803176, 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, Effect of closed loop insulin delivery from onset of diabetes in youth on progression of type 1 diabetes, G8589133502, G8758826526
OpenAlex ID: W4312065417