Steven Trawley, Hye Jin Kwon, Sara Vogrin, Peter G Colman, Spiros Fourlanos, Melissa H Lee, Richard J MacIsaac, David N O'Neal, Niamh A O'Regan, Vijaya Sundararajan, Glenn M Ward, Sybil A McAuley
{"title":"一项随机试验中老年1型糖尿病患者驾驶过程中自动胰岛素输送效果","authors":"Steven Trawley, Hye Jin Kwon, Sara Vogrin, Peter G Colman, Spiros Fourlanos, Melissa H Lee, Richard J MacIsaac, David N O'Neal, Niamh A O'Regan, Vijaya Sundararajan, Glenn M Ward, Sybil A McAuley","doi":"10.1089/dia.2024.0303","DOIUrl":null,"url":null,"abstract":"<p><p>Dysglycemia among drivers with type 1 diabetes (T1D) is associated with impaired driving performance, and glucose levels \"above 5 to drive\" are often recommended for insulin-treated drivers. Evidence for diabetes treatments that support euglycemia while driving is minimal, particularly for older drivers. In this randomized, crossover trial involving adults aged ≥60 years with T1D, we used continuous glucose monitoring (CGM) during driving to compare the first-generation closed-loop automated insulin delivery (AID) versus a sensor-augmented pump therapy. There were 1894 trips undertaken by 8 drivers (median age 68 years [IQR: 64-70]). During AID versus sensor-augmented pump, time in range >5.0-10.0 mmol/L was greater (100% [0-100] vs. 81% [0-100]; <i>P</i> = 0.033) and fewer trips had any CGM >16.7 mmol/L (3.5% vs. 6.4%; <i>P</i> = 0.006). Three percent of all trips included CGM <3.9 mmol/L, with no between-stage difference (3.0% vs. 3.5%; <i>P</i> = 0.52). System alerts occurred in 10% of all trips, with no between-stage difference (9% vs. 11%; <i>P</i> = 0.078). First-generation AID reduces hyperglycemic driving among older drivers with T1D, without increasing hypoglycemia. Developing dedicated \"driving-mode\" settings could prioritize safety while minimizing distraction. Trial Registration: ACTRN12619000515190.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"134-138"},"PeriodicalIF":5.7000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Automated Insulin Delivery Effects During Driving Among Older Adults with Type 1 Diabetes in a Randomized Trial.\",\"authors\":\"Steven Trawley, Hye Jin Kwon, Sara Vogrin, Peter G Colman, Spiros Fourlanos, Melissa H Lee, Richard J MacIsaac, David N O'Neal, Niamh A O'Regan, Vijaya Sundararajan, Glenn M Ward, Sybil A McAuley\",\"doi\":\"10.1089/dia.2024.0303\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Dysglycemia among drivers with type 1 diabetes (T1D) is associated with impaired driving performance, and glucose levels \\\"above 5 to drive\\\" are often recommended for insulin-treated drivers. Evidence for diabetes treatments that support euglycemia while driving is minimal, particularly for older drivers. In this randomized, crossover trial involving adults aged ≥60 years with T1D, we used continuous glucose monitoring (CGM) during driving to compare the first-generation closed-loop automated insulin delivery (AID) versus a sensor-augmented pump therapy. There were 1894 trips undertaken by 8 drivers (median age 68 years [IQR: 64-70]). During AID versus sensor-augmented pump, time in range >5.0-10.0 mmol/L was greater (100% [0-100] vs. 81% [0-100]; <i>P</i> = 0.033) and fewer trips had any CGM >16.7 mmol/L (3.5% vs. 6.4%; <i>P</i> = 0.006). Three percent of all trips included CGM <3.9 mmol/L, with no between-stage difference (3.0% vs. 3.5%; <i>P</i> = 0.52). System alerts occurred in 10% of all trips, with no between-stage difference (9% vs. 11%; <i>P</i> = 0.078). First-generation AID reduces hyperglycemic driving among older drivers with T1D, without increasing hypoglycemia. Developing dedicated \\\"driving-mode\\\" settings could prioritize safety while minimizing distraction. Trial Registration: ACTRN12619000515190.</p>\",\"PeriodicalId\":11159,\"journal\":{\"name\":\"Diabetes technology & therapeutics\",\"volume\":\" \",\"pages\":\"134-138\"},\"PeriodicalIF\":5.7000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes technology & therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/dia.2024.0303\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes technology & therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/dia.2024.0303","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Automated Insulin Delivery Effects During Driving Among Older Adults with Type 1 Diabetes in a Randomized Trial.
Dysglycemia among drivers with type 1 diabetes (T1D) is associated with impaired driving performance, and glucose levels "above 5 to drive" are often recommended for insulin-treated drivers. Evidence for diabetes treatments that support euglycemia while driving is minimal, particularly for older drivers. In this randomized, crossover trial involving adults aged ≥60 years with T1D, we used continuous glucose monitoring (CGM) during driving to compare the first-generation closed-loop automated insulin delivery (AID) versus a sensor-augmented pump therapy. There were 1894 trips undertaken by 8 drivers (median age 68 years [IQR: 64-70]). During AID versus sensor-augmented pump, time in range >5.0-10.0 mmol/L was greater (100% [0-100] vs. 81% [0-100]; P = 0.033) and fewer trips had any CGM >16.7 mmol/L (3.5% vs. 6.4%; P = 0.006). Three percent of all trips included CGM <3.9 mmol/L, with no between-stage difference (3.0% vs. 3.5%; P = 0.52). System alerts occurred in 10% of all trips, with no between-stage difference (9% vs. 11%; P = 0.078). First-generation AID reduces hyperglycemic driving among older drivers with T1D, without increasing hypoglycemia. Developing dedicated "driving-mode" settings could prioritize safety while minimizing distraction. Trial Registration: ACTRN12619000515190.
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.