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Evaluating the Impact of Applying Personal Glucose Targets in a Closed-Loop System for People With Type 1 Diabetes.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Fattah, Mustafa 
Boughton, Charlotte K  ORCID logo  https://orcid.org/0000-0003-3272-9544
Allen, Janet M 
Hartnell, Sara 

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.

Description

Keywords

algorithm, glucose control, hybrid closed-loop, personal glucose target, type 1 diabetes

Journal Title

Journal of Diabetes Science and Technology

Conference Name

Journal ISSN

1932-2968
1932-2968

Volume Title

Publisher

SAGE Publications
Sponsorship
Wellcome Trust (100574/Z/12/Z)
National Institute of Diabetes and Digestive and Kidney Diseases (UC4DK108520)
National Institute of Diabetes and Digestive and Kidney Diseases (DP3DK112176)
European Commission Horizon 2020 (H2020) Societal Challenges (731560)
NIHR Evaluation Trials and Studies Coordinating Centre (14/23/09)