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Overnight insulin requirements more variable than daytime, total daily in type 1 diabetes
Compared with daytime and total daily insulin requirements, overnight insulin requirements are significantly more variable in adults with type 1 diabetes.
Roman Hovorka, PhD, director of research in the department of pediatrics at the University of Cambridge in the United Kingdom, and colleagues evaluated overnight, daytime and total daily insulin amounts delivered during a multicenter closed-loop trial in 32 adults with type 1 diabetes. Researchers sought to determine the variability of insulin requirements during closed-loop insulin delivery.
Roman Hovorka
They examined results from 1,918 nights, 1,883 daytime periods and 1,564 total days characterized by closed-loop use during 85% of time. Insulin requirements ranged from about 50% to 300% for overnight, 50% to 200% for daytime and 70% to 200% for total daily. Differences were found in the coefficients of variation between the three periods (P < .001). Total daily insulin requirements were 14 percentage points lower than the coefficient variation of overnight insulin requirements (P < .001), and overnight insulin requirements were 9 percentage points higher than daytime requirements (P < .001).
“Insulin requirements assessed by closed-loop insulin delivery during the overnight period were significantly more variable than daytime and total daily amounts,” the researchers wrote. “This may explain why some people with type 1 diabetes report frustrating variability in morning glycemia.” – by Amber Cox
Disclosure: Hovorka reports receiving speaker honoraria from BBraun, Eli Lilly, MiniMed Medtronic and Novo Nordisk; serving on advisory panel for Eli Lilly, Novo Nordisk and Merck; receiving license fees from BBraun and Medtronic; and having served as a consultant to BBraun and Profil. Please see the full study for a list of all other authors’ relevant financial disclosures.