Abstract:
OBJECTIVES:We evaluated patterns of meal intake, insulin bolus delivery, and fingerstick glucose measurements during hybrid closed-loop and sensor-augmented pump (SAP) therapy, including associations with glucose control. METHODS:Data were retrospectively analyzed from pump-treated adults with type 1 diabetes who underwent, in random order, 12 weeks free-living closed-loop (n = 32) and 12 weeks SAP (n = 33) periods. We quantified daily patterns of main meals, snacks, prandial insulin boluses, correction boluses, and fingerstick glucose measurements by analyzing data recorded on the study glucometer and on study insulin pump. RESULTS:We analyzed 1942 closed-loop days and 2530 SAP days. The total number of insulin boluses was reduced during closed-loop versus SAP periods by mean 1.0 per day (95% confidence interval 0.6-1.4, P < 0.001) mainly because of a reduced number of correction boluses by mean 0.7 per day (0.4-1.0, P < 0.001). Other behavioral patterns were unchanged. The carbohydrate content of snacks but not the number of snacks was positively correlated with (1) glycemic variability as measured by standard deviation of sensor glucose (closed-loop P < 0.05; SAP P < 0.01), (2) mean sensor glucose (P < 0.05), and (3) postintervention HbA1c (P < 0.05). Behavioral patterns explained 47% of between-subject variance in glucose variability during SAP period and 30%-33% of variance of means sensor glucose and postintervention HbA1c. CONCLUSION:Fewer correction boluses are delivered during closed-loop period. The size of snacks appears to worsen glucose control possibly because of carbohydrate-rich content of snacks. Modifiable behavioral patterns may be important determinants of glucose control.
journal_name
Diabetes Technol Therjournal_title
Diabetes technology & therapeuticsauthors
Emami A,Willinska ME,Thabit H,Leelarathna L,Hartnell S,Dellweg S,Benesch C,Mader JK,Holzer M,Kojzar H,Pieber TR,Arnolds S,Evans ML,Hovorka Rdoi
10.1089/dia.2016.0307subject
Has Abstractpub_date
2017-07-01 00:00:00pages
433-437issue
7eissn
1520-9156issn
1557-8593journal_volume
19pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp. METHODS:This double-blind, randomized, crossover active-controlled trial compared 2...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究
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pub_type: 杂志文章
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
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更新日期:2016-01-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1089/dia.2014.0047
更新日期:2014-11-01 00:00:00
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2011.0225
更新日期:2012-05-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2016-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-05-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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更新日期:2011-09-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2004-12-01 00:00:00