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Day and night home closed-loop insulin delivery in adults with type 1 diabetes: three-center randomized crossover study.

Abstract：

OBJECTIVE:To evaluate the feasibility of day and night closed-loop insulin delivery in adults with type 1 diabetes under free-living conditions. RESEARCH DESIGN AND METHODS:Seventeen adults with type 1 diabetes on insulin pump therapy (means ± SD age 34 ± 9 years, HbA1c 7.6 ± 0.8%, and duration of diabetes 19 ± 9 years) participated in an open-label multinational three-center crossover study. In a random order, participants underwent two 8-day periods (first day at the clinical research facility followed by 7 days at home) of sensor-augmented insulin pump therapy (SAP) or automated closed-loop insulin delivery. The primary end point was the time when sensor glucose was in target range between 3.9 and 10.0 mmol/L during the 7-day home phase. RESULTS:During the home phase, the percentage of time when glucose was in target range was significantly higher during closed-loop compared with SAP (median 75% [interquartile range 61-79] vs. 62% [53-70], P = 0.005). Mean glucose (8.1 vs. 8.8 mmol/L, P = 0.027) and time spent above target (P = 0.013) were lower during closed loop, while time spent below target was comparable (P = 0.339). Increased time in target was observed during both daytime (P = 0.017) and nighttime (P = 0.013). CONCLUSIONS:Compared with SAP, 1 week of closed-loop insulin delivery at home reduces mean glucose and increases time in target without increasing the risk of hypoglycemia in adults with relatively well-controlled type 1 diabetes.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Leelarathna L,Dellweg S,Mader JK,Allen JM,Benesch C,Doll W,Ellmerer M,Hartnell S,Heinemann L,Kojzar H,Michalewski L,Nodale M,Thabit H,Wilinska ME,Pieber TR,Arnolds S,Evans ML,Hovorka R,AP@home Consortium.

doi

10.2337/dc13-2911

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

1931-7

issue

7

eissn

0149-5992

issn

1935-5548

pii

37/7/1931

journal_volume

37

pub_type

杂志文章,多中心研究,随机对照试验

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