利用 Control-IQ 技术自动初始化和调整用户配置文件设置的安全性和可行性评估。

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM
Viral N Shah, Halis K Akturk, Alex Trahan, Nicole Piquette, Alex Wheatcroft, Elain Schertz, Karen Carmello, Lars Mueller, Kirstin White, Larry Fu, Ravid Sassan-Katchalski, Laurel H Messer, Steph Habif, Alex Constantin, Jordan E Pinsker
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引用次数: 0

摘要

背景:优化胰岛素自动给药 (AID) 设置是实现理想血糖结果的必要条件。我们评估了在 1 型糖尿病(T1D)成人患者中初始化和调整带有 Control-IQ 技术的 t:slim X2 胰岛素泵胰岛素给药设置的计算机系统的安全性和有效性:经过两周的连续血糖监测(CGM)磨合期后,使用每日多次注射(MDI)的成年 1 型糖尿病患者(33 人,平均年龄 36.1 岁,57.6% 为女性,糖尿病病程 19.7 年)开始使用为期 13 周的 Control-IQ 技术。计算机化算法为初始泵设置(基础率、胰岛素-碳水化合物比率和校正因子)和每周随访设置生成建议,以优化血糖结果。出于安全考虑,医生可以覆盖自动设置更改:使用 Control-IQ 30 天后,血糖在 70 至 180 mg/dL 范围内的时间从初始阶段的 45.7% 提高到 69.1%,中位数提高了 18.8%(95% 置信区间 [CI]:13.6-23.9,P < .001)。这种改善在研究初期就很明显,并持续了 13 周。时间 P < .001)。在 318 次自动设置调整中,只有 6 次(1.9%)被研究调查人员推翻:结论:在成人 T1D 患者中,计算机化启动和调整 Control-IQ 技术的设置(从基线计量吸入器疗法开始)是安全的。使用这种简化的系统来启动和优化 Control-IQ 技术可能有助于提高 AID 的使用率,并减轻临床护理中工作人员和患者的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Safety and Feasibility Evaluation of Automated User Profile Settings Initialization and Adaptation With Control-IQ Technology.

Background: Optimization of automated insulin delivery (AID) settings is required to achieve desirable glycemic outcomes. We evaluated safety and efficacy of a computerized system to initialize and adjust insulin delivery settings for the t:slim X2 insulin pump with Control-IQ technology in adults with type 1 diabetes (T1D).

Methods: After a 2-week continuous glucose monitoring (CGM) run-in period, adults with T1D using multiple daily injections (MDI) (N = 33, mean age 36.1 years, 57.6% female, diabetes duration 19.7 years) were transitioned to 13 weeks of Control-IQ technology usage. A computerized algorithm generated recommendations for initial pump settings (basal rate, insulin-to-carbohydrate ratio, and correction factor) and weekly follow-up settings to optimize glycemic outcomes. Physicians could override the automated settings changes for safety concerns.

Results: Time in range 70 to 180 mg/dL improved from 45.7% during run-in to 69.1% during the last 30 days of Control-IQ use, a median improvement of 18.8% (95% confidence interval [CI]: 13.6-23.9, P < .001). This improvement was evident early in the study and was sustained over 13 weeks. Time <70 mg/dL showed a gradual decreasing trend over time. Percentage of participants achieving HbA1c <7% went from zero at baseline to 55% at study end (P < .001). Only six of the 318 automated settings adaptations (1.9%) were overridden by study investigators.

Conclusions: Computerized initiation and adaptation of Control-IQ technology settings from baseline MDI therapy was safe in adults with T1D. The use of this simplified system for onboarding and optimizing Control-IQ technology may be useful to increase uptake of AID and reduce staff and patient burden in clinical care.

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来源期刊
Journal of Diabetes Science and Technology
Journal of Diabetes Science and Technology Medicine-Internal Medicine
CiteScore
7.50
自引率
12.00%
发文量
148
期刊介绍: The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.
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