Outpatient Closed-Loop Control with Unannounced Moderate Exercise in Adolescents Using Zone Model Predictive Control

Autor: Gregory P. Forlenza, Eyal Dassau, Lauren M. Huyett, Francis J. Doyle, Trang T. Ly, David M. Maahs, Suzette Reuschel-DiVirgilio, Bruce A. Buckingham, R. Paul Wadwa, Laurel H. Messer, Ravi Gondhalekar, Jordan E. Pinsker
Rok vydání: 2017
Předmět:
Male
Pancreas
Artificial
medicine.medical_specialty
Adolescent
Adolescent Nutritional Physiological Phenomena
Endocrinology
Diabetes and Metabolism
Child Behavior
030209 endocrinology & metabolism
Artificial pancreas
Cohort Studies
Food Preferences
03 medical and health sciences
0302 clinical medicine
Endocrinology
Bolus (medicine)
Diabetes mellitus
Activities of Daily Living
medicine
Humans
030212 general & internal medicine
Child
Exercise
Glycemic
Type 1 diabetes
business.industry
Monitoring system
Original Articles
medicine.disease
Combined Modality Therapy
Hypoglycemia
United States
Medical Laboratory Technology
Model predictive control
Diabetes Mellitus
Type 1
Adolescent Behavior
Hyperglycemia
Physical therapy
Moderate exercise
Feasibility Studies
Female
Child Nutritional Physiological Phenomena
business
Algorithms
Sports
Zdroj: Diabetes Technology & Therapeutics. 19:331-339
ISSN: 1557-8593
1520-9156
Popis: The artificial pancreas (AP) has the potential to improve glycemic control in adolescents. This article presents the first evaluation in adolescents of the Zone Model Predictive Control and Health Monitoring System (ZMPC+HMS) AP algorithms, and their first evaluation in a supervised outpatient setting with frequent exercise.Adolescents with type 1 diabetes underwent 3 days of closed-loop control (CLC) in a hotel setting with the ZMPC+HMS algorithms on the Diabetes Assistant platform. Subjects engaged in twice-daily exercise, including soccer, tennis, and bicycling. Meal size (unrestricted) was estimated and entered into the system by subjects to trigger a bolus, but exercise was not announced.Ten adolescents (11.9-17.7 years) completed 72 h of CLC, with data on 95 ± 14 h of sensor-augmented pump (SAP) therapy before CLC as a comparison to usual therapy. The percentage of time with continuous glucose monitor (CGM) 70-180 mg/dL was 71% ± 10% during CLC, compared to 57% ± 16% during SAP (P = 0.012). Nocturnal control during CLC was safe, with 0% (0%, 0.6%) of time with CGM70 mg/dL compared to 1.1% (0.0%, 14%) during SAP. Despite large meals (estimated up to 120 g carbohydrate), only 8.0% ± 6.9% of time during CLC was spent with CGM250 mg/dL (16% ± 14% during SAP). The system remained connected in CLC for 97% ± 2% of the total study time. No adverse events or severe hypoglycemia occurred.The use of the ZMPC+HMS algorithms is feasible in the adolescent outpatient environment and achieved significantly more time in the desired glycemic range than SAP in the face of unannounced exercise and large announced meal challenges.
Databáze: OpenAIRE
Externí odkaz: