Efficacy of an Overnight Predictive Low-Glucose Suspend System in Relation to Hypoglycemia Risk Factors in Youth and Adults With Type 1 Diabetes
| Autor: | Craig Kollman, Peter Calhoun, John Lum, Roy W. Beck, Irene Hramiak, Bruce A. Buckingham, Paula Clinton, Darrell M. Wilson, David M. Maahs, Peter Chase, Tandy Aye, Laurel H. Messer |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Blood Glucose Male Insulin pump medicine.medical_specialty Adolescent endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment Biomedical Engineering 030209 endocrinology & metabolism Bioengineering Hypoglycemia Bedtime Young Adult 03 medical and health sciences Insulin Infusion Systems 0302 clinical medicine Blood Glucose Self-Monitoring Internal medicine Internal Medicine Humans Hypoglycemic Agents Insulin Medicine 030212 general & internal medicine Child Type 1 diabetes business.industry nutritional and metabolic diseases Middle Aged medicine.disease Diabetes Mellitus Type 1 Endocrinology ROC Curve Area Under Curve Child Preschool Exercise intensity Female Ketosis Corrigendum business |
| Zdroj: | Journal of Diabetes Science and Technology. 10:1216-1221 |
| ISSN: | 1932-2968 |
| Popis: | Background: We developed a system to suspend insulin pump delivery overnight when the glucose trend predicts hypoglycemia. This predictive low-glucose suspend (PLGS) system substantially reduces nocturnal hypoglycemia without an increase in morning ketosis. Evaluation of hypoglycemia risk factors that could potentially influence the efficacy of the system remains critical for understanding possible problems with the system and identifying patients that may have the greatest benefit when using the system. Methods: The at-home randomized trial consisted of 127 study participants with hemoglobin A1c (A1C) of ≤8.5% (mmol/mol) for patients aged 4-14 years and ≤8.0% for patient aged 15-45 years. Factors assessed included age, gender, A1C, diabetes duration, daily percentage basal insulin, total daily dose of insulin (units/kg-day), bedtime BG, bedtime snack, insulin on board, continuous glucose monitor (CGM) rate of change (ROC), day of the week, time system activated, daytime exercise intensity, and daytime CGM-measured hypoglycemia. Results: The PLGS system was effective in preventing hypoglycemia for each factor subgroup. There was no evidence that the PLGS system was more or less effective in preventing hypoglycemia in any one subgroup compared with the other subgroups based on that factor. In addition, the effect of the system on overnight hyperglycemia did not differ in subgroups. Conclusions: The PLGS system tested in this study effectively reduced hypoglycemia without a meaningful increase in hyperglycemia across a variety of factors. |
| Databáze: | OpenAIRE |
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