Fully automated closed-loop glucose control compared with standard insulin therapy in adults with type 2 diabetes requiring dialysis: an open-label, randomized crossover trial
| Autor: | Malgorzata E. Wilinska, Andrew Fry, Charlotte K. Boughton, Cecilia Czerlau, David Herzig, Afroditi Tripyla, Lia Bally, Sara Hartnell, Roman Hovorka, Aideen Daly |
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| Přispěvatelé: | Boughton, Charlotte K [0000-0003-3272-9544], Czerlau, Cecilia [0000-0002-9453-2766], Bally, Lia [0000-0003-1993-7672], Hovorka, Roman [0000-0003-2901-461X], Apollo - University of Cambridge Repository, Boughton, Charlotte K. [0000-0003-3272-9544] |
| Rok vydání: | 2021 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty medicine.medical_treatment 610 Medicine & health Type 2 diabetes Hypoglycemia General Biochemistry Genetics and Molecular Biology 692/163/2743/137/773 law.invention Insulin aspart Automation End-stage renal disease Randomized controlled trial law Renal Dialysis Diabetes mellitus Internal medicine Clinical endpoint Medicine Humans Insulin 692/699/1585/104/1586 Aged Cross-Over Studies business.industry article General Medicine Middle Aged medicine.disease Crossover study Publisher Correction Treatment Outcome Diabetes Mellitus Type 2 Female business 610 Medizin und Gesundheit medicine.drug |
| Zdroj: | Nature Medicine Boughton, Charlotte K.; Tripyla, Afroditi; Hartnell, Sara; Daly, Aideen; Herzig, David; Wilinska, Malgorzata E.; Czerlau, Cecilia; Fry, Andrew; Bally, Lia; Hovorka, Roman (2021). Fully automated closed-loop glucose control compared with standard insulin therapy in adults with type 2 diabetes requiring dialysis: an open-label, randomized crossover trial. Nature medicine, 27(8), pp. 1471-1476. Nature Publishing Group 10.1038/s41591-021-01453-z |
| ISSN: | 1546-170X |
| DOI: | 10.1038/s41591-021-01453-z |
| Popis: | Funder: CB was supported by a grant from The Novo Nordisk UK Research Foundation Funder: LB was supported by a grant of the Swiss Society for Endocrinology and a grant of the Diabetes and Swiss Kidney Foundation. Funder: Supported by National Institute for Health Research Cambridge Biomedical Research Centre. We evaluated the safety and efficacy of fully closed-loop insulin therapy compared with standard insulin therapy in adults with type 2 diabetes requiring dialysis. In an open-label, multinational, two-center, randomized crossover trial, 26 adults with type 2 diabetes requiring dialysis (17 men, 9 women, average age 68 ± 11 years (mean ± s.d.), diabetes duration of 20 ± 10 years) underwent two 20-day periods of unrestricted living, comparing the Cambridge fully closed-loop system using faster insulin aspart (‘closed-loop’) with standard insulin therapy and a masked continuous glucose monitor (‘control’) in random order. The primary endpoint was time in target glucose range (5.6–10.0 mmol l−1). Thirteen participants received closed-loop first and thirteen received control therapy first. The proportion of time in target glucose range (5.6–10.0 mmol l−1; primary endpoint) was 52.8 ± 12.5% with closed-loop versus 37.7 ± 20.5% with control; mean difference, 15.1 percentage points (95% CI 8.0–22.2; P < 0.001). Mean glucose was lower with closed-loop than control (10.1 ± 1.3 versus 11.6 ± 2.8 mmol l−1; P = 0.003). Time in hypoglycemia ( |
| Databáze: | OpenAIRE |
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