Evaluation of an Automated Priming Bolus for Improving Prandial Glucose Control in Full Closed Loop Delivery.

IF 5.7 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Marcela Moscoso-Vasquez, Patricio Colmegna, Charlotte Barnett, Morgan Fuller, Chaitanya L K Koravi, Sue A Brown, Mark D DeBoer, Marc D Breton
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引用次数: 0

Abstract

Background: Automated insulin delivery (AID) is widely available to people with type 1 diabetes (T1D), providing superior glycemic control versus traditional methods. The next generation of AID devices focus on minimizing user/device interactions, especially around meals ("full closed loop," [FCL]). Our goal was to assess the postprandial glycemic impact of the bolus priming system (BPS), an algorithm delivering fixed insulin doses based on the likelihood of a meal having occurred, in conjunction with UVA's latest AID. Method: Eleven adults with T1D participated in a supervised randomized-crossover trial assessing glycemic control during two 24-h sessions with identical meals and activity-with and without BPS. On the day in-between study sessions, participants underwent food and activity challenges to test BPS safety and robustness. Continuous glucose monitor (CGM) outcomes and total insulin doses were assessed overall and following meals with potential for BPS to dose additional insulin (CGM >90 mg/dL for 1 h prior). Results: Daytime CGM outcomes were similar with and without BPS: time-in-range (TIR) 70-180 mg/dL 70.6% [62.2-76.5] versus 65.7% [58.6%-80.6%]; time-below-range <70 mg/dL 0% [0-2.1] versus 0% [0-1.3]; respectively. Insulin delivery during 3 h postprandial was indistinguishable 33.5 U [26.4-47.0] versus 35.7 U [28.7-44.9]. Among 43 out of 66 meals with potential to trigger BPS (24/19 BPS/no-BPS), postprandial incremental area-under-the-curve (iAUC) was lower for BPS versus no-BPS (2530 ± 1934 versus 3228 ± 2029, P = 0.047), but CGM outcomes were inconclusive: 4-h-TIR 51.2% [19.8-83.3] versus 40.2% [20.8-56.3] (P = 0.24). There were no severe adverse events. Conclusion: While there was no difference in TIR, when BPS was active an improved postprandial AUC in FCL was obtained via earlier insulin injection.

评估全闭环给药中用于改善餐前血糖控制的自动启动给药。
背景:胰岛素自动给药(AID)已广泛应用于 1 型糖尿病(T1D)患者,与传统方法相比,它能提供更优越的血糖控制。下一代自动胰岛素给药设备的重点是最大限度地减少用户与设备之间的互动,尤其是在进餐前后("全闭环"[FCL])。我们的目标是评估胰岛素初始化系统(BPS)对餐后血糖的影响,这是一种根据进餐可能性提供固定胰岛素剂量的算法,与 UVA 的最新 AID 结合使用。方法:11 名患有 T1D 的成人参加了一项监督下的随机交叉试验,评估在进餐和活动完全相同的两个 24 小时时段内,使用 BPS 和不使用 BPS 的血糖控制情况。在两次研究之间的一天,参与者接受了食物和活动挑战,以测试 BPS 的安全性和稳健性。对连续血糖监测仪(CGM)的结果和胰岛素总剂量进行整体评估,并在餐后评估 BPS 是否会增加胰岛素剂量(餐前 1 小时 CGM >90 mg/dL)。结果:使用和不使用 BPS 的日间 CGM 结果相似:时间在范围内 (TIR) 70-180 mg/dL 70.6% [62.2-76.5] 对 65.7% [58.6%-80.6%] ;时间低于范围 P = 0.047),但 CGM 结果不确定:4 h-TIR 51.2% [19.8-83.3] 对 40.2% [20.8-56.3] (P = 0.24)。没有发生严重不良事件。结论:虽然 TIR 没有差异,但当 BPS 起作用时,通过提前注射胰岛素可改善 FCL 的餐后 AUC。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diabetes technology & therapeutics
Diabetes technology & therapeutics 医学-内分泌学与代谢
CiteScore
10.60
自引率
14.80%
发文量
145
审稿时长
3-8 weeks
期刊介绍: Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.
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