Overnight Closed-Loop Control Improves Glycemic Control in a Multicenter Study of Adults With Type 1 Diabetes
| Autor: | Stacey M. Anderson, Shelly K. McCrady-Spitzer, Angelo Avogaro, Boris Kovatchev, Patrick Keith-Hynes, Yogish C. Kudva, Yenny Leal, Sue A. Brown, Nihat Baysal, Carol J. Levy, Simone Del Favero, Ananda Basu, Roberto Visentin, Silvia Galasso, Federico Boscari, David W. Lam, Claudio Cobelli, Laura L. Kollar, Camilla Levister, Daniela Bruttomesso, Ling Hinshaw, Marc D. Breton, Vikash Dadlani |
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| Rok vydání: | 2017 |
| Předmět: |
Blood Glucose
Male Adult Blood Glucose Self-Monitoring Cross-Over Studies Diabetes Mellitus Type 1 Female Glycated Hemoglobin A Humans Hypoglycemic Agents Insulin Middle Aged Young Adult Circadian Rhythm Insulin Infusion Systems Endocrinology Diabetes and Metabolism Biochemistry Endocrinology Clinical Biochemistry Biochemistry (medical) endocrine system diseases law.invention 0302 clinical medicine Randomized controlled trial immune system diseases law Medicine 030212 general & internal medicine humanities Diabetes and Metabolism Type 1 Insulin pump medicine.medical_specialty 030209 endocrinology & metabolism Context (language use) 03 medical and health sciences Internal medicine Diabetes mellitus Diabetes Mellitus Clinical Research Articles Glycemic Glycated Hemoglobin Type 1 diabetes urogenital system business.industry nutritional and metabolic diseases medicine.disease Crossover study business |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 102:3674-3682 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2017-00556 |
| Popis: | Context Closed-loop control (CLC) for the management of type 1 diabetes (T1D) is a novel method for optimizing glucose control, and strategies for individualized implementation are being developed. Objective To analyze glycemic control in an overnight CLC system designed to "reset" the patient to near-normal glycemic targets every morning. Design Randomized, crossover, multicenter clinical trial. Participants Forty-four subjects with T1D requiring insulin pump therapy. Intervention Sensor-augmented pump therapy (SAP) at home vs 5 nights of CLC (active from 23:00 to 07:00) in a supervised outpatient setting (research house or hotel), with a substudy of 5 nights of CLC subsequently at home. Main Outcome Measure The percentage of time spent in the target range (70 to 180 mg/dL measured using a continuous glucose monitor). Results Forty subjects (age, 45.5 ± 9.5 years; hemoglobin A1c, 7.4% ± 0.8%) completed the study. The time in the target range (70 to 180 mg/dL) significantly improved in CLC vs SAP over 24 hours (78.3% vs 71.4%; P = 0.003) and overnight (85.7% vs 67.6%; P < 0.001). The time spent in a hypoglycemic range ( |
| Databáze: | OpenAIRE |
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