Clinical Management and Pump Parameter Adjustment of the Control-IQ Closed-Loop Control System: Results from a 6-Month, Multicenter, Randomized Clinical Trial
| Autor: | Grenye, O'Malley, Laurel H, Messer, Carol J, Levy, Jordan E, Pinsker, Gregory P, Forlenza, Elvira, Isganaitis, Yogish C, Kudva, Laya, Ekhlaspour, Dan, Raghinaru, John, Lum, Sue A, Brown, J L Roy, Beck |
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| Rok vydání: | 2021 |
| Předmět: |
Type 1 diabetes
Pediatrics medicine.medical_specialty urogenital system business.industry Blood Glucose Self-Monitoring Endocrinology Diabetes and Metabolism Control (management) MEDLINE Insulin delivery Original Articles medicine.disease law.invention Medical Laboratory Technology Diabetes Mellitus Type 1 Insulin Infusion Systems Endocrinology Randomized controlled trial law Diabetes mellitus medicine Humans Hypoglycemic Agents Insulin business |
| Zdroj: | Diabetes Technol Ther |
| ISSN: | 1557-8593 1520-9156 |
| DOI: | 10.1089/dia.2020.0472 |
| Popis: | Background: Data are limited on the need for and benefits of pump setting optimization with automated insulin delivery. We examined clinical management of a closed-loop control (CLC) system and its relationship to glycemic outcomes. Materials and Methods: We analyzed personal parameter adjustments in 168 participants in a 6-month multicenter trial of CLC with Control-IQ versus sensor-augmented pump (SAP) therapy. Preset parameters (BR = basal rates, CF = correction factors, CR = carbohydrate ratios) were optimized at randomization, 2 and 13 weeks, for safety issues, participant concerns, or initiation by participants' usual diabetes care team. Time in range (TIR 70–180 mg/dL) was compared in the week before and after parameter changes. Results: In 607 encounters for parameter changes, there were fewer adjustments for CLC than SAP (3.4 vs. 4.1/participant). Adjustments involved BR (CLC 69%, SAP 80%), CR (CLC 68%, SAP 50%), CF (CLC 44%, SAP 41%), and overnight parameters (CLC 62%, SAP 75%). TIR before and after adjustments was 71.2% and 71.3% for CLC and 61.0% and 62.9% for SAP. The highest baseline HbA(1c) CLC subgroup had the largest TIR improvement (51.2% vs. 57.7%). When a CR was made more aggressive in the CLC group, postprandial time >180 mg/dL was 43.1% before the change and 36.0% after the change. The median postprandial time |
| Databáze: | OpenAIRE |
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