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dc.contributor.authorDaly, Aideen
dc.contributor.authorHartnell, Sara
dc.contributor.authorBoughton, Charlotte
dc.contributor.authorEvans, Mark
dc.date.accessioned2021-11-02T17:04:23Z
dc.date.available2021-11-02T17:04:23Z
dc.date.issued2021-11
dc.identifier.issn1932-2968
dc.identifier.other10.1177_19322968211035447
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330197
dc.description.abstractBACKGROUND: Gastroparesis is associated with unpredictable gastric emptying and can lead to erratic glucose profiles and negative impacts on quality-of-life. Many people with gastroparesis are unable to meet glycemic targets and there is a need for new approaches for this population. Hybrid closed-loop systems improve glucose control and quality-of-life but evidence for their use in people with diabetic gastroparesis is limited. METHODS: We present a narrative review of the challenges associated with type 1 diabetes management for people with gastroparesis and present a case series of 7 people with type 1 diabetes and gastroparesis. We compare glycemic control before and during the first 12 months of hybrid closed-loop therapy. Data were analyzed using electronic patient records and glucose management platforms. We also discuss future advancements for closed-loop systems that may benefit this population. RESULTS: Five of 7 patients had data available for time in range before and during hybrid closed-loop therapy, and all had an improvement in percentage time in target glucose range, with the overall mean time in range increasing from 26.0% ± 15.7% to 58.4% ± 8.6% during HCL use, (P = .004). There were significant reductions in HbA1c (83 ± 9 mmol/mol to 71 ± 14 mmol/mol) and mean glucose from 13.0 ± 1.7 mmol/L (234 ± 31 mg/dL) to 10.0 ± 0.7 mmol/L (180 ± 13 mg/dL) with use of a hybrid closed-loop system. Importantly, this was achieved without an increase in time in hypoglycemia (P = .50). CONCLUSION: Hybrid closed-loop systems may represent a valuable approach to improve glycemic control for people with type 1 diabetes and gastroparesis. Prospective studies are required to confirm these findings.
dc.languageen
dc.publisherSAGE Publications
dc.rightsEmbargo: ends 2021-08-11
dc.subjectSpecial Section: The Artificial Pancreas: Improving Clinical Performance
dc.subjectcontinuous glucose monitoring
dc.subjectdiabetes technology
dc.subjectgastroparesis
dc.subjecthybrid closed-loop
dc.subjecttype 1 diabetes
dc.titleHybrid Closed-loop to Manage Gastroparesis in People With Type 1 Diabetes: a Case Series.
dc.typeArticle
dc.date.updated2021-11-02T17:04:23Z
prism.endingPage1223
prism.issueIdentifier6
prism.publicationNameJ Diabetes Sci Technol
prism.startingPage1216
prism.volume15
dc.identifier.doi10.17863/CAM.77638
rioxxterms.versionofrecord10.1177/19322968211035447
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
rioxxterms.licenseref.startdate2021-08-11
dc.contributor.orcidDaly, Aideen [0000-0001-5003-9630]
dc.contributor.orcidBoughton, Charlotte [0000-0003-3272-9544]
dc.contributor.orcidEvans, Mark [0000-0001-8122-8987]
dc.identifier.eissn1932-2968
cam.issuedOnline2021-08-11
rioxxterms.freetoread.startdate2021-08-11


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