Hypoglycaemia incidence and recovery during home use of hybrid closed-loop insulin delivery in adults with type 1 diabetes.
Mader, Julia K
Diabetes, obesity & metabolism
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Ruan, Y., Bally, L., Thabit, H., Leelarathna, L., Hartnell, S., Tauschmann, M., Wilinska, M., et al. (2018). Hypoglycaemia incidence and recovery during home use of hybrid closed-loop insulin delivery in adults with type 1 diabetes.. Diabetes, obesity & metabolism, 20 (8), 2004-2008. https://doi.org/10.1111/dom.13304
Introduction Glucose excursion were assessed prior and post hypoglycaemia to increase understanding of hypoglycaemia incidence and recovery during hybrid closed-loop insulin delivery. Methods We retrospectively analysed data from 60 adults with type 1 diabetes who received in crossover randomised 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 < 3.0mmol/l analysed sensor glucose relative to the onset of hypoglycaemia. Results We identified 377 hypoglycaemic episodes during hybrid closed-loop versus 662 during control intervention (P<0.001) with a predominant reduction of nocturnal hypoglycaemia. The slope of sensor glucose prior to hypoglycaemia was steeper during closed-loop than during control intervention (P<0.01), while insulin delivery was reduced (P<0.01). During both daytime and night-time, participants recovered from hypoglycaemia faster when treated by closed-loop. At 120 min post-hypoglycaemia, sensor glucose levels were higher during closed-loop compared to control period (P<0.05). Conclusions Closed-loop reduces the risk of hypoglycaemia particularly overnight with swift recovery from hypoglycaemia leading to higher 2-hour post-hypoglycaemia glucose levels.
Humans, Diabetes Mellitus, Type 1, Hyperglycemia, Hypoglycemia, Blood Glucose, Blood Glucose Self-Monitoring, Monitoring, Ambulatory, Insulin Infusion Systems, Activities of Daily Living, Incidence, Risk, Retrospective Studies, Cross-Over Studies, Pancreas, Artificial, Time Factors, Adult, Middle Aged, Female, Male, Self-Management
Wellcome Trust (100574/Z/12/Z)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
EC FP7 CP (247138)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (UC4DK108520)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (1DP3DK112176-01)
External DOI: https://doi.org/10.1111/dom.13304
This record's URL: https://www.repository.cam.ac.uk/handle/1810/276974