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Overnight, unsupervised closed-loop system may be viable option
SAN FRANCISCO — An overnight, unsupervised, closed-loop insulin delivery system in the form of an artificial pancreas is a potentially effective home-based therapeutic tool for adult patients with type 1 diabetes, according to data presented at the American Diabetes Association’s 74th Scientific Sessions.
“Recent randomized [clinical research center-based], transitional and diabetes camp studies have shown us that closed-loop increased time-in-target or reduced time spent in hypoglycemia,” Hood Thabit, MBBCh, MRCPI, MD, of the University of Cambridge, said during a presentation here.
For the first time, the researchers examined the unsupervised home usage of closed-loop insulin administration over 4 weeks in 24 adults with type 1 diabetes (with a mean age 43 years; HbA1c 8.1%; BMI 26 kg/m2; and duration of diabetes 29 years) in a randomized 3-center crossover study design. A model predictive control algorithm was used to automatically direct insulin delivery, with 4 weeks of sensor-augmented pump therapy used as a control.
Their intention-to-treat analysis showed that the proportion of time when sensor glucose was in target range (70 mg/dL to 144 mg/dL) overnight (midnight to 7 a.m.) was significantly greater during closed-loop usage; the mean overnight glucose and time spent above target were significantly lower during closed-loop usage, according to data.
Furthermore, the time spent below target was low and comparable (median: <10 minutes per night), according to data.
“Overnight closed-loop for 4 weeks at home without supervision is feasible in adults with type 1 diabetes,” Thabit said. – by Samantha Costa
Disclosure: The researchers report no relevant financial disclosures.
For more information:Thabit H. Abstract 233-OR. Presented at: American Diabetes Association’s 74th Scientific Sessions; June 13-17, 2014; San Francisco.