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Faster insulin action is associated with improved glycaemic outcomes during closed-loop insulin delivery and sensor-augmented pump therapy in adults with type 1 diabetes

Published version
Peer-reviewed

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Authors

Ruan, Y 
Thabit, H 
Leelarathna, L 
Hartnell, S 
Wilinska, ME 

Abstract

We aimed to evaluate the relationship between insulin pharmacodynamics and glycaemic outcomes during closed-loop insulin delivery and sensor-augmented pump therapy. We retrospectively analysed data from a multicentre randomized control trial involving 32 adults with type 1 diabetes receiving day-and-night closed-loop insulin delivery and sensor-augmented pump therapy over 12 weeks. We estimated time-to-peak insulin action (tmax,IA) and insulin sensitivity (Extra close brace or missing open brace_Ix}_Ix}) during both interventions, and correlated these with demographic factors and glycaemic outcomes. During both interventions, tmax,IA was positively correlated with pre- and post-intervention HbA1c (r = 0.50-0.52, P  < .01) and mean glucose (r = 0.45-0.62, P  < .05), and inversely correlated with time sensor glucose, which was in target range 3.9 to 10 mmol/L (r = -0.64 to -0.47, P  < .05). Increased body mass index was associated with higher tmax,I and lower S I (both P  < .05). During closed-loop insulin delivery, tmax,IA, was positively correlated with glucose variability ( P  < .05). Faster insulin action is associated with improved glycaemic control during closed-loop insulin delivery and sensor-augmented pump therapy.

Description

Keywords

CSII, glycaemic control, insulin delivery, insulin pump therapy, pharmacodynamics, type 1 diabetes

Journal Title

Diabetes Obesity and Metabolism

Conference Name

Journal ISSN

1462-8902
1463-1326

Volume Title

Publisher

Wiley
Sponsorship
European Commission (247138)
Wellcome Trust (100574/Z/12/Z)
Seventh Framework Programme of the European Union (ICT FP7- 247138). Additional support for the Artificial Pancreas work by JDRF, National Institute for Health Research Cambridge Biomed ical Research Centre and Wellcome Strategic Award (100574/Z/12/Z). Abbott Diabetes Care supplied discounted continuous glucose-monitoring devices, sensors, and communication protocol to facilitate real-time connectivity.