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dc.contributor.authorThabit, Hooden
dc.contributor.authorElleri, Danielaen
dc.contributor.authorLeelarathna, Lalanthaen
dc.contributor.authorAllen, Janeten
dc.contributor.authorLubina-Solomon, Alexandraen
dc.contributor.authorStadler, Mariettaen
dc.contributor.authorWalkinshaw, Emmaen
dc.contributor.authorIqbal, Ahmeden
dc.contributor.authorChoudhary, Pratiken
dc.contributor.authorWilinska, Malgorzataen
dc.contributor.authorBarnard, Katharine Den
dc.contributor.authorHeller, Simon Ren
dc.contributor.authorAmiel, Stephanie Aen
dc.contributor.authorEvans, Marken
dc.contributor.authorDunger, Daviden
dc.contributor.authorHovorka, Romanen
dc.identifier.citationDiabetes, Obesity and Metabolism Volume 17, Issue 5, pages 452–458, May 2015. DOI: 10.1111/dom.12427en
dc.description.abstractAims: Closed loop studies in research facility and transitional settings demonstrated improved glucose control and reduced risk of hypoglycaemia in type 1 diabetes. We combined data collected during free-living unsupervised randomised crossover home studies comparing overnight closed loop and sensor augmented pump therapy. Materials and methods: 40participants with type 1 diabetes [24 adults (age 43±12 years, HbA1c 8.0±0.9%; mean±SD)and 16 adolescents (15.6±3.6 years, HbA1c 8.1±0.8%)] underwent two periods of sensor augmented pump therapy at home settings in combination with or without overnight closed-loop utilising model predictive control algorithm to direct insulin delivery. Order of interventions was random; each period lasted four weeks in adults and three weeks in adolescents. Primary outcome was time when sensor glucose was in the target range between 3.9 and 8.0mmol/l. Results: Proportion of time when sensor glucose was in target range (3.9-8.0mmol/l) between midnight and 08:00 was increased by 18.5% during closed-loop compared to sensor augmented therapy (P<0.001). Closed loop significantly reduced mean overnight glucose by 0.8mmol/l (P<0.001), with no difference in glycaemic variability as measured by the standard deviation of sensor glucose. Time spent above target range was reduced (P=0.001) and so was time spent in hypoglycaemia below 3.9mmol/l (P=0.014) during closed loop. Lower mean overnight glucose during closed loop was brought about by increased overnight insulin delivery (P<0.001) without changing the total daily delivery (P=0.84). Conclusion: Overnight closed loop at home in adults and adolescents with type 1 diabetes is feasible, demonstrating improvements in glucose control and reducing the risk of nocturnal hypoglycaemia.
dc.description.sponsorshipJuvenile Diabetes Research Foundation (#22-2009-802) and Diabetes UK (BDA07/0003549) with additional support for the Artificial Pancreas work by National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK085621), and National Institute for Health Research Cambridge Biomedical Research Centre. Abbott Diabetes Care supplied continuous glucose delivery devices and sensors and modified devices to facilitate real-time connectivity.
dc.rightsCreative Commons Attribution License 2.0 UK
dc.subjectclinical trialen
dc.subjectglycaemic controlen
dc.subjectclosed-loop insulin deliveryen
dc.subjecttype 1 diabetesen
dc.titleUnsupervised home use of overnight closed-loop system over 3 to 4 weeks – Pooled analysis of randomized controlled studies in adults and adolescents with type 1 diabetesen
dc.description.versionThis if the final version of the article. It was originally published by Wiley in Diabetes, Obesity and Metabolism at
prism.publicationNameDiabetes, Obesity and Metabolismen
dc.contributor.orcidWilinska, Malgorzata [0000-0003-2739-1753]
dc.contributor.orcidEvans, Mark [0000-0001-8122-8987]
dc.contributor.orcidDunger, David [0000-0002-2566-9304]
dc.contributor.orcidHovorka, Roman [0000-0003-2901-461X]
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (Roman Hovorka)
pubs.funder-project-idNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (R01DK085621)
pubs.funder-project-idMRC (G0600717B)
pubs.funder-project-idWellcome Trust (100574/Z/12/Z)

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Creative Commons Attribution License 2.0 UK
Except where otherwise noted, this item's licence is described as Creative Commons Attribution License 2.0 UK